Neural Correlates of Stress and Abdominal Obesity in Patients With Coronary Artery Disease

ABSTRACT Objective This study aimed to investigate the relationship between waist circumference as a measure of abdominal obesity and brain responses to stress among patients with coronary artery disease (CAD). Methods Patients with CAD (N = 151) underwent acute mental stress tasks in conjunction with high-resolution positron emission tomography and radiolabeled water imaging of the brain. Brain responses to mental stress were correlated with waist circumference. Results Waist circumference was positively correlated with increased activation in the right and left frontal lobes (β values ranging from 2.81 to 3.75 in the paracentral, medial, and superior gyri), left temporal lobe, left hippocampal, left amygdala, left uncus, and left anterior and posterior cingulate gyri (β values ranging from 2.93 to 3.55). Waist circumference was also negatively associated with the left and right parietal lobes, right superior temporal gyrus, and right insula and precuneus (β values ranging from 2.82 to 5.20). Conclusion Increased brain activation in the brain regions involved in the stress response and autonomic regulation of the cardiovascular system during psychological stress may underlie stress-induced overeating and abdominal obesity in patients with CAD.

[1]  Peter J. Gianaros,et al.  Neural Mechanisms Linking Emotion with Cardiovascular Disease , 2018, Current Cardiology Reports.

[2]  Amit J. Shah,et al.  Brain Correlates of Mental Stress-Induced Myocardial Ischemia , 2018, Psychosomatic medicine.

[3]  D. Drossman,et al.  A Perspective on Brain–Gut Communication: The American Gastroenterology Association and American Psychosomatic Society Joint Symposium on Brain–Gut Interactions and the Intestinal Microenvironment , 2017, Psychosomatic medicine.

[4]  Yan V. Sun,et al.  Hemodynamic, catecholamine, vasomotor and vascular responses: Determinants of myocardial ischemia during mental stress. , 2017, International journal of cardiology.

[5]  Yan V. Sun,et al.  The Mental Stress Ischemia Prognosis Study: Objectives, Study Design, and Prevalence of Inducible Ischemia , 2017, Psychosomatic medicine.

[6]  P. Gianaros,et al.  Cardiovascular and autonomic reactivity to psychological stress: Neurophysiological substrates and links to cardiovascular disease , 2017, Autonomic Neuroscience.

[7]  R. Sinha,et al.  Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight , 2017, Obesity.

[8]  G. Coppin The anterior medial temporal lobes: Their role in food intake and body weight regulation , 2016, Physiology & Behavior.

[9]  Amit J. Shah,et al.  Sex Differences in Mental Stress‐Induced Myocardial Ischemia in Patients With Coronary Heart Disease , 2016, Journal of the American Heart Association.

[10]  S. Grundy,et al.  Comparison of visceral fat mass measurement by dual-X-ray absorptiometry and magnetic resonance imaging in a multiethnic cohort: the Dallas Heart Study , 2016, Nutrition & Diabetes.

[11]  Ashley M. Fox,et al.  Stress eating and sleep disturbance as mediators in the relationship between depression and obesity in low-income, minority women. , 2016, Obesity research & clinical practice.

[12]  L. Køber,et al.  Normal-Weight Central Obesity and Mortality Risk in Older Adults With Coronary Artery Disease. , 2016, Mayo Clinic proceedings.

[13]  C. Tsioufis,et al.  Waist circumference compared with other obesity parameters as determinants of coronary artery disease in essential hypertension: a 6-year follow-up study , 2016, Hypertension Research.

[14]  Mark D. Huffman,et al.  Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association , 2016, Circulation.

[15]  E. Loucks,et al.  The Role of Adverse Childhood Experiences in Cardiovascular Disease Risk: a Review with Emphasis on Plausible Mechanisms , 2015, Current Cardiology Reports.

[16]  Tor D Wager,et al.  Brain-Body Pathways Linking Psychological Stress and Physical Health , 2015, Current directions in psychological science.

[17]  R. Sinha,et al.  Food cravings mediate the relationship between chronic stress and body mass index , 2015, Journal of health psychology.

[18]  A. Thorp,et al.  Relevance of Sympathetic Nervous System Activation in Obesity and Metabolic Syndrome , 2015, Journal of diabetes research.

[19]  C. Mantzoros,et al.  Stress- and PTSD-associated obesity and metabolic dysfunction: a growing problem requiring further research and novel treatments. , 2014, Metabolism: clinical and experimental.

[20]  U. Ladabaum,et al.  Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010. , 2014, The American journal of medicine.

[21]  K. Flegal,et al.  Prevalence of childhood and adult obesity in the United States, 2011-2012. , 2014, JAMA.

[22]  Cameron S. Carter,et al.  Chronic stress exposure may affect the brain's response to high calorie food cues and predispose to obesogenic eating habits , 2013, Physiology & Behavior.

[23]  Hugo D. Critchley,et al.  Central autonomic network mediates cardiovascular responses to acute inflammation: Relevance to increased cardiovascular risk in depression? , 2013, Brain, Behavior, and Immunity.

[24]  K. Goel,et al.  Combining body mass index with measures of central obesity in the assessment of mortality in subjects with coronary disease: role of "normal weight central obesity". , 2013, Journal of the American College of Cardiology.

[25]  F. Zitman,et al.  The impact of stress systems and lifestyle on dyslipidemia and obesity in anxiety and depression , 2013, Psychoneuroendocrinology.

[26]  W. Kop,et al.  Central nervous system involvement in the autonomic responses to psychological distress , 2013, Netherlands Heart Journal.

[27]  Marc N. Potenza,et al.  Neural Correlates of Stress- and Food Cue–Induced Food Craving in Obesity , 2013, Diabetes Care.

[28]  H. Critchley,et al.  Brain systems for baroreflex suppression during stress in humans , 2012, Human brain mapping.

[29]  J Szumowski,et al.  Comparison of 3 T MRI and CT for the measurement of visceral and subcutaneous adipose tissue in humans. , 2012, The British journal of radiology.

[30]  R. Sinha,et al.  Acute stress potentiates brain response to milkshake as a function of body weight and chronic stress , 2012, International Journal of Obesity.

[31]  Julian F Thayer,et al.  Sex differences in the neural correlates of autonomic arousal: a pilot PET study. , 2011, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[32]  C. Torp‐Pedersen,et al.  Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. , 2011, Journal of the American College of Cardiology.

[33]  J. Després,et al.  Inflammatory biomarkers, physical activity, waist circumference, and risk of future coronary heart disease in healthy men and women. , 2011, European heart journal.

[34]  C. Shively,et al.  Social stress, visceral obesity, and coronary artery atherosclerosis: product of a primate adaptation , 2009, American journal of primatology.

[35]  H. Critchley,et al.  Inflammation Causes Mood Changes Through Alterations in Subgenual Cingulate Activity and Mesolimbic Connectivity , 2009, Biological Psychiatry.

[36]  Yulei He,et al.  American Journal of Epidemiology Original Contribution Psychosocial Stress and Change in Weight among Us Adults , 2022 .

[37]  K. Matthews,et al.  Gain in Adiposity Across 15 Years is Associated With Reduced Gray Matter Volume in Healthy Women , 2009, Psychosomatic medicine.

[38]  M. Friedman,et al.  Understanding the Relation Between Obesity and Depression: Causal Mechanisms and Implications for Treatment , 2008 .

[39]  J. Brug,et al.  A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults , 2008, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[40]  C. Nowson,et al.  Relationship between stress, eating behavior, and obesity. , 2007, Nutrition.

[41]  E. Vermetten,et al.  Cortisol, Dehydroepiandrosterone, and Estradiol Measured Over 24 Hours in Women With Childhood Sexual Abuse-Related Posttraumatic Stress Disorder , 2007, The Journal of nervous and mental disease.

[42]  E. Epel,et al.  Stress, eating and the reward system , 2007, Physiology & Behavior.

[43]  K. Su,et al.  A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. , 2007, The Journal of clinical psychiatry.

[44]  D. Allison,et al.  Waist Circumference and Cardiometabolic Risk , 2007, Diabetes Care.

[45]  Paul K. Marsden,et al.  Attenuation of Insulin-Evoked Responses in Brain Networks Controlling Appetite and Reward in Insulin Resistance , 2006, Diabetes.

[46]  N. Volkow,et al.  Gastric stimulation in obese subjects activates the hippocampus and other regions involved in brain reward circuitry , 2006, Proceedings of the National Academy of Sciences.

[47]  J. Mann,et al.  A controlled trial of homocysteine lowering and cognitive performance. , 2006, The New England journal of medicine.

[48]  D. Lawlor,et al.  The thermolabile variant of MTHFR is associated with depression in the British Women's Heart and Health Study and a meta-analysis , 2006, Molecular Psychiatry.

[49]  J. Bremner,et al.  The enduring effects of abuse and related adverse experiences in childhood , 2006, European Archives of Psychiatry and Clinical Neuroscience.

[50]  M. Dallman,et al.  Chronic stress and comfort foods: self-medication and abdominal obesity , 2005, Brain, Behavior, and Immunity.

[51]  J. May,et al.  Is There a Functional Neural Correlate of Individual Differences in Cardiovascular Reactivity? , 2005, Psychosomatic medicine.

[52]  D. Chapman,et al.  Insights Into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study , 2004, Circulation.

[53]  J. Jennings,et al.  Regional cerebral blood flow correlates with heart period and high-frequency heart period variability during working-memory tasks: Implications for the cortical and subcortical regulation of cardiac autonomic activity. , 2004, Psychophysiology.

[54]  T. Shallice,et al.  Human cingulate cortex and autonomic control: converging neuroimaging and clinical evidence. , 2003, Brain : a journal of neurology.

[55]  S. L. la Fleur,et al.  Chronic stress and obesity: A new view of “comfort food” , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[56]  S. Southwick,et al.  Neural correlates of declarative memory for emotionally valenced words in women with posttraumatic stress disorder related to early childhood sexual abuse , 2003, Biological Psychiatry.

[57]  S. Southwick,et al.  MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. , 2003, The American journal of psychiatry.

[58]  S. B. Evans,et al.  Expression of receptors for insulin and leptin in the ventral tegmental area/substantia nigra (VTA/SN) of the rat , 2003, Brain Research.

[59]  M. W. Molen,et al.  Vagal function in health and disease: studies in Pittsburgh , 2002, Physiology & Behavior.

[60]  David Sheffield,et al.  Mental Stress–Induced Ischemia and All-Cause Mortality in Patients With Coronary Artery Disease: Results From the Psychophysiological Investigations of Myocardial Ischemia Study , 2002, Circulation.

[61]  W. Heiss,et al.  The ECAT HRRT: performance and first clinical application of the new high resolution research tomograph , 2000, 2000 IEEE Nuclear Science Symposium. Conference Record (Cat. No.00CH37149).

[62]  C. Bouchard,et al.  A glucocorticoid receptor gene marker is associated with abdominal obesity, leptin, and dysregulation of the hypothalamic-pituitary-adrenal axis. , 2000, Obesity research.

[63]  L. Ferrucci,et al.  Vitamin B(12) deficiency and depression in physically disabled older women: epidemiologic evidence from the Women's Health and Aging Study. , 2000, The American journal of psychiatry.

[64]  S. Southwick,et al.  Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder. , 1999, The American journal of psychiatry.

[65]  R. Lane,et al.  Neuroanatomical correlates of happiness, sadness, and disgust. , 1997, The American journal of psychiatry.

[66]  B. Toone,et al.  METHYLATION AND MOOD , 1984, The Lancet.

[67]  D. Allison,et al.  Waist circumference and cardiometabolic risk : a consensus statement from Shaping America ’ s Health : Association for Weight Management and Obesity Prevention , 2007 .

[68]  Heinz Schneider,et al.  Prevention and treatment of obesity with lifestyle interventions: review and meta-analysis , 2007, International Journal of Public Health.

[69]  W. Rathmann,et al.  Sex differences in the relation of body composition to markers of inflammation. , 2006, Atherosclerosis.

[70]  L. Ferrucci,et al.  Vitamin B 12 Deficiency and Depression in Physically Disabled Older Women : Epidemiologic Evidence From the Women ’ s Health and Aging Study , 2000 .