Takotsubo syndrome – A close connection to the brain: A prospective study investigating neuropsychiatric traits. (September 2016)

• Record Type: Journal Article
• Authors: Mayer, Kristina N.; Ghadri, Jelena-Rima; Jaguszewski, Milosz; Scherff, Frank; Saguner, Ardan M.; Kazemian, Elycia; Baumann, Christian R.; Jenewein, Josef; Tsakiris, Manos; Lüscher, Thomas F.; Brugger, Peter; Templin, Christian
• Is Part Of: IJC metabolic & endocrine. Volume 12(2016)
• Page Start: 36
• Page End: 41
• Publication Date: 2016-09
• Subjects: ESS Epworth Sleepiness Scale -- FPI-R Freiburg Personality Inventory, revised version -- FSS Fatigue Severity Scale -- HADS Hospital Anxiety and Depression Scale -- HRV Heart Rate Variability -- IA Interoceptive awareness -- MCI Mild Cognitive Impairment -- MoCA Montreal Cognitive Assessment -- RMSSD Root Mean Square of the Successive Differences -- SCSS Screening Scale for Chronic Stress -- SDANN Standard Deviation of sequential five-minute Normal to Normal means -- SDNN Standard Deviation of Normal to Normal interbeat interval -- TICS Trier Inventory for Chronic Stress -- TMT Trail Making Test -- TTS Takotsubo syndrome -- VAS Visual analog scale; Takotsubo cardiomyopathy -- Brain-heart connection -- Autonomic nervous system -- Neuropsychological tests; Cardiovascular system -- Pathophysiology -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1016/j.ijcme.2016.06.001
• Languages: English
• ISSNs: 2214-7624

Abstract

Abstract: Background: Takotsubo syndrome (TTS) is frequently triggered by a stressful event. Overactivation of the sympathetic nervous system has been hypothesized as the underlying mechanism. In a prospective, cross-sectional, single center study we aimed to investigate neuropsychiatric traits in patients with TTS. Methods: Twenty-six patients with TTS with a median latency of 17.5 months from their index event underwent detailed medical examination, neuropsychologic examination, and Holter-ECG and were screened for psychiatric comorbidities, chronic stress and personality traits with questionnaires. Results: 38.5% (10/26) of patients suffered from a neurological disease, and 50.0% (13/26) from at least one mental disorder. In 23.1% (6/26) the hospital anxiety scale (HADS–A) was suspicious for an anxiety disorder. There was a high prevalence of left-handedness (19.2%; 5/26). Despite good performance in cognitive testing, 11 patients had an abnormal score in the fatigue severity scale. Recovery of cardiac function was documented, although symptoms in 69.2% of patients persisted. An increase in the root mean square of the successive differences (RMSSD) (p = 0.01) was noted on the Holter-ECG. Conclusion: The study highlights a high prevalence of psychiatric and neurologic comorbidities in patients with TTS, which so far have been under-diagnosed. Future studies will have to show whether these patients might benefit from a combined psychocardiologic rehabilitation. Highlights: Persisting symptoms despite recovery of cardiac function is common. TTC patients show good neuropsychologic functioning, but there is high prevalence of fatigue. Psychiatric comorbidities seem to be under-diagnosed in patients newly diagnosed with TTC.