Interesante articulo publicado en Circulation Cardiovascular Imaging que estudia la asociación entre la activación de la corteza frontal inducida por el estrés mental y los problemas coronarios.
El lóbulo frontal inferior es una zona importante del cerebro que participa en la respuesta al estrés, y una mayor activación con un estrés mental agudo puede indicar una reacción al estrés más grave. Sin embargo, no está claro si la activación de esta región con el estrés se correlaciona con presencia de dolor torácico tipo angina de pecho en personas que padecen de problemas coronarios.
Se realizó un estudio con personas con enfermedad coronaria estable, que fueron sometidos a una prueba de estrés mental utilizando una serie de factores estresantes, empleando imágenes de tomografía por emisión de positrones de alta resolución del cerebro, para evaluar el flujo sanguíneo al lóbulo frontal inferior y conocer qué áreas del cerebro se activaban y en qué momento.
Para ello se seleccionaron 148 personas (edad media 62 años, 69% varones y 36% raza negra). Cada vez que la corteza frontal inferior duplicó su actividad con respecto a la situación basal, la angina aumentó hasta 14 puntos con respecto al resultado en reposo (cuestionario de angina de Seattle), lo cual resultó estadísticamente significativo (p=0.008).
El estudio también demostró que la activación de otras zonas del cerebro donde se procesa el dolor, como son el tálamo, la ínsula o la amígdala, consiguieron hasta en un 40% el efecto total de la activación de la corteza frontal inferior.
Conclusiones: La activación del lóbulo frontal inferior con estrés mental se asocia independientemente con la angina de pecho en el momento agudo del estrés así como durante el seguimiento. La isquemia inducida por el estrés mental y otras regiones del cerebro que procesan el dolor pueden contribuir a ello.
REFERENCIA
Association Between Mental Stress-Induced Inferior Frontal Cortex Activation and Angina in Coronary Artery Disease. Moazzami K, Wittbrodt MT, Alkhalaf M, et al.
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