Brain changes linked to emotion have been found in people with "broken heart syndrome", according to a new study.
Scientists at the University of Aberdeen have shed light on how the brain and heart are linked in this rare condition.
Known medically as Takotsubo syndrome, it is usually brought on by physical or emotional stress, such as the loss of a loved one - hence the name.
It's a sudden form of acute heart failure which is estimated to affect as many as 5,000 people in the UK each year and is mainly seen in post-menopausal women.
It can cause the same symptoms as a heart attack, and although the arteries leading to the heart are not blocked, the risk of complications is similar.
It is not yet fully understood what causes the condition, but it is usually brought on by emotional or physical stress such as the loss of a loved one – hence being referred to as broken heart syndrome.
Researchers discovered changes in the level of brain activity in areas known to control the beating of the heart.
In the most detailed study of its kind, they looked at the brains of 25 patients who had suffered an episode of Takotsubo in the previous five days.
They used brain MRI scans to measure brain volume, surface area, and the signals of communication between different areas of the brain.
These results were then compared with control patients who were matched for age, gender, and other medical conditions.
The researchers found that there were decreased connections in the thalamus, amygdala, insula and basal ganglia of Takotsubo patients compared with healthy people.
These are areas of the brain involved in regulating higher-level functions such as emotions, thinking, language, stress responses and controlling the heart.
The study also found that the thalamus and insula areas of the brain were enlarged, while the total brain volume including amygdala and the brain stem were smaller compared with healthy people.
The scientists now plan to perform follow-up brain MRI scans on the same patients to track the natural course of Takotsubo in the brain.
They are also in the process of scanning the brains of heart attack patients in the hope of determining whether the condition causes changes to the brain or whether the changes cause Takotsubo syndrome.
Dr Hilal Khan, clinical research fellow at the university, said: “For years we’ve known that there is a link between the brain and the heart, but the role this plays in Takotsubo has been a mystery.
“For the first time we’ve revealed changes in the brain regions that are responsible for controlling the heart and emotions.
“Further work will be required to determine if these changes cause Takotsubo syndrome.”
Dr Khan said that with more research it is hoped more effective ways of treating the syndrome can be found.
The university’s research was presented at the British Cardiovascular Society centenary conference in Manchester.
Professor James Leiper, associate medical director at the British Heart Foundation, said: “This research is a significant step forward in our understanding of how the brain and the heart are intricately linked in this enigmatic condition, and how an emotional event can lead to heart failure.”
Carol Duncan, 73, from Aberdeen, is part of the study as she suffered an episode of Takotsubo after her brother fell ill and was admitted to ICU.
She said because Takotsubo can be triggered by an emotional event, there is a misconception that it is just in your head.
“Knowing that researchers saw measurable changes in my scans makes me feel that we are getting closer to Takotsubo being considered a physical condition,” she said.
“I am so pleased to have taken part in this research.
“It really gives me hope that scientists are moving towards fully understanding and better treating this misunderstood condition.”
Broken heart syndrome symptoms
According to John Hopkins Medicine, the symptoms of broken heart syndrome can mimic symptoms of a heart attack, including:
- Chest pain
- Shortness of breath
- Diaphoresis (sweating)
These symptoms may begin as soon as minutes or as long as hours after an emotionally or physically stressful event.
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