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Takotsubo syndrome – A close connection to the brain: a prospective study investigating neuropsychiatric traits


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 (2016). Takotsubo syndrome – A close connection to the brain: a prospective study investigating neuropsychiatric traits. International Journal of Cardiology - Metabolic & Endocrine, 12:36-41.

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.

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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Takotsubo cardiomyopathy, Brain-heart connection, Autonomic nervous system, Neuropsychological tests
Language:English
Date:2016
Deposited On:04 Dec 2017 17:22
Last Modified:02 Feb 2018 12:33
Publisher:Elsevier
ISSN:2214-7624
OA Status:Gold
Publisher DOI:https://doi.org/10.1016/j.ijcme.2016.06.001

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