European Heart Journal

, volume 45 , issue 19 , pages 1753-1764

Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure

Charbel Gharios ¹

Mandy M.T. van Leent ^{2, 3, 4}

Helena L. Chang ⁵

Shady Abohashem ^{1, 6}

David Oconnor ²

Michael T. Osborne ^{1, 6}

Cheuk Y. Tang ²

Audrey E Kaufman ²

Philip M. Robson ²

Sarayu Ramachandran ²

Claudia Calcagno ²

Venkatesh Mani ²

Maria Giovanna Trivieri ^{4, 7}

Antonia V. Seligowski ¹

Sharon Dekel ^{8, 9}

Willem J.M. Mulder ^{2, 3, 10, 11, 12}

James W. Murrough ^{13, 14}

Lisa M. Shin ^{8, 9, 15}

Ahmed Tawakol ^{1, 5}

Zahi A Fayad ^{2, 3}

Hide authors affiliations Show authors affiliations: 15 affiliations

Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School , 55 Fruit St, Yawkey 5E, Boston, MA 02114-2750 , USA

Harvard University

Massachusetts General Hospital

BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1234, New York, NY 10029-6574 , USA |

Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai , One Gustave L. Levy Place, Box 1234, New York, NY 10029-6574 , USA |

⁴

Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai , New York, NY , USA |

⁵

Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York, NY , USA |

⁶

Division of Cardiology, Massachusetts General Hospital and Harvard Medical School , 55 Fruit St, Yawkey 5E, Boston, MA 10029-6574 , USA

Harvard University

Massachusetts General Hospital

⁷

Division of Cardiology, Icahn School of Medicine at Mount Sinai , New York, NY , USA |

⁸

Department of Psychiatry, Harvard Medical School , Boston, MA , USA |

⁹

Department of Psychiatry, Massachusetts General Hospital , Boston, MA , USA |

¹⁰

Department of Internal Medicine, Radboud University Medical Center , Nijmegen , The Netherlands |

¹¹

Radboud Center for Infectious Diseases, Radboud University Medical Center , Nijmegen , the Netherlands |

¹²

Laboratory of Chemical Biology, Department of Biochemical Engineering, Eindhoven University of Technology , Eindhoven , The Netherlands |

¹³

Depression and Anxiety Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, NY , USA |

¹⁴

Department of Neuroscience, Icahn School of Medicine at Mount Sinai , New York, NY , USA |

¹⁵

Department of Psychology, Tufts University , Medford, MA , USA |

Publication type: Journal Article

Publication date: 2024-05-14

Oxford University Press

European Heart Journal

scimago Q1

wos Q1

SJR: 4.987

CiteScore: 40.3

Impact factor: 35.6

ISSN: 0195668X, 15229645

DOI: 10.1093/eurheartj/ehae149

Copy DOI

PubMed ID: 38753456

Abstract

Background and Aims

Chronic stress associates with cardiovascular disease, but mechanisms remain incompletely defined. Advanced imaging was used to identify stress-related neural imaging phenotypes associated with atherosclerosis.

Methods

Twenty-seven individuals with post-traumatic stress disorder (PTSD), 45 trauma-exposed controls without PTSD, and 22 healthy controls underwent 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI). Atherosclerotic inflammation and burden were assessed using 18F-FDG PET (as maximal target-to-background ratio, TBR max) and MRI, respectively. Inflammation was assessed using high-sensitivity C-reactive protein (hsCRP) and leucopoietic imaging (18F-FDG PET uptake in spleen and bone marrow). Stress-associated neural network activity (SNA) was assessed on 18F-FDG PET as amygdala relative to ventromedial prefrontal cortex (vmPFC) activity. MRI diffusion tensor imaging assessed the axonal integrity (AI) of the uncinate fasciculus (major white matter tract connecting vmPFC and amygdala).

Results

Median age was 37 years old and 54% of participants were female. There were no significant differences in atherosclerotic inflammation between participants with PTSD and controls; adjusted mean difference in TBR max (95% confidence interval) of the aorta 0.020 (−0.098, 0.138), and of the carotids 0.014 (−0.091, 0.119). Participants with PTSD had higher hsCRP, spleen activity, and aorta atherosclerotic burden (normalized wall index). Participants with PTSD also had higher SNA and lower AI. Across the cohort, carotid atherosclerotic burden (standard deviation of wall thickness) associated positively with SNA and negatively with AI independent of Framingham risk score.

Conclusions

In this study of limited size, participants with PTSD did not have higher atherosclerotic inflammation than controls. Notably, impaired cortico-limbic interactions (higher amygdala relative to vmPFC activity or disruption of their intercommunication) associated with carotid atherosclerotic burden. Larger studies are needed to refine these findings.

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GOST |

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GOST Copy

Gharios C. et al. Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure // European Heart Journal. 2024. Vol. 45. No. 19. pp. 1753-1764.

GOST all authors (up to 50) Copy

Gharios C., van Leent M. M., Chang H. L., Abohashem S., Oconnor D., Osborne M. T., Tang C. Y., Kaufman A. E., Robson P. M., Ramachandran S., Calcagno C., Mani V., Trivieri M. G., Seligowski A. V., Dekel S., Mulder W. J., Murrough J. W., Shin L. M., Tawakol A., Fayad Z. A. Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure // European Heart Journal. 2024. Vol. 45. No. 19. pp. 1753-1764.

RIS |

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RIS Copy

TY - JOUR

DO - 10.1093/eurheartj/ehae149

UR - https://academic.oup.com/eurheartj/article/45/19/1753/7675312

TI - Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure

T2 - European Heart Journal

AU - Gharios, Charbel

AU - van Leent, Mandy M.T.

AU - Chang, Helena L.

AU - Abohashem, Shady

AU - Oconnor, David

AU - Osborne, Michael T.

AU - Tang, Cheuk Y.

AU - Kaufman, Audrey E

AU - Robson, Philip M.

AU - Ramachandran, Sarayu

AU - Calcagno, Claudia

AU - Mani, Venkatesh

AU - Trivieri, Maria Giovanna

AU - Seligowski, Antonia V.

AU - Dekel, Sharon

AU - Mulder, Willem J.M.

AU - Murrough, James W.

AU - Shin, Lisa M.

AU - Tawakol, Ahmed

AU - Fayad, Zahi A

PY - 2024

DA - 2024/05/14

PB - Oxford University Press

SP - 1753-1764

IS - 19

VL - 45

PMID - 38753456

SN - 0195-668X

SN - 1522-9645

ER -

BibTex |

Cite this

BibTex (up to 50 authors) Copy

@article{2024_Gharios,

author = {Charbel Gharios and Mandy M.T. van Leent and Helena L. Chang and Shady Abohashem and David Oconnor and Michael T. Osborne and Cheuk Y. Tang and Audrey E Kaufman and Philip M. Robson and Sarayu Ramachandran and Claudia Calcagno and Venkatesh Mani and Maria Giovanna Trivieri and Antonia V. Seligowski and Sharon Dekel and Willem J.M. Mulder and James W. Murrough and Lisa M. Shin and Ahmed Tawakol and Zahi A Fayad},

title = {Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure},

journal = {European Heart Journal},

year = {2024},

volume = {45},

publisher = {Oxford University Press},

month = {may},

url = {https://academic.oup.com/eurheartj/article/45/19/1753/7675312},

number = {19},

pages = {1753--1764},

doi = {10.1093/eurheartj/ehae149}

}

MLA

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MLA Copy

Gharios, Charbel, et al. “Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure.” European Heart Journal, vol. 45, no. 19, May. 2024, pp. 1753-1764. https://academic.oup.com/eurheartj/article/45/19/1753/7675312.

Publisher

Oxford University Press

Journal

European Heart Journal

scimago Q1

wos Q1

SJR

4.987

CiteScore

40.3

Impact factor

35.6

ISSN

0195668X (Print)

15229645 (Electronic)