Structural and functional brain changes in acute Takotsubo Syndrome

Hilal Khan* (Corresponding Author), David Gamble, Amelia Rudd, Alice Mezincescu, Hassan Abbas, Awsan Noman, Andrew Stewart, Graham Horgan, Rajeev Krishnadas, Christopher Williams, Gordon Waiter, Dana Dawson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Takotsubo syndrome mimics an acute myocardial infarction, typically in the aftermath of mental or physical stress.
Objectives: The mechanism by which emotional processing in the context of stress leads to significant cardiac injury is poorly understood, therefore a full exploration of brain structure and function in takotsubo syndrome patients merits investigation.
Methods: Twenty-five acute (< 5 days) takotsubo patients and 25 controls were recruited into this observational cross-sectional study. Surface-based morphometry was carried out on brain magnetic resonance imaging (MRI) scans to extract cortical morphology based on volume, thickness and surface area using Freesurfer. Cortical morphology general linear models were corrected for age, gender, photoperiod and total brain volume. Resting state functional MRI and diffusion tensor tractography images were pre-processed/analysed with
FMRIB’s Diffusion Toolbox/ CONN toolbox.
Results: There was significantly smaller total white matter and subcortical grey matter volumes in takotsubo (pConclusions: We showed smaller grey and white matter volumes driven by smaller cortical surface area, but increased cortical thickness and structural tractography connections with bidirectional changes in functional connectivity linked to emotion, language, reasoning,
Original languageEnglish
JournalJACC. Heart failure
Early online date11 Jan 2023
Publication statusE-pub ahead of print - 11 Jan 2023

Bibliographical note

Professor Mark Petrie, Consultant Cardiologist, Glasgow, Dr David Corcoran, Consultant Cardiologist, Glasgow, Prof Stephen Leslie, Consultant Cardiologist, Inverness for identifying patients recruited in this study. We would like to acknowledge NHS Grampian Endowment EA9667/ES868, BHF Project Grant no. PG/18/35/33786, “Physical Exercise and mental wellbeing rehabilitation for Acute StrEss-induced takotsubo cardiomyopathy: The PLEASE trial and The Welcome Trust for supporting the work used in this study.


  • cardiomyopathy
  • takotsubo
  • brain
  • Imaging


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