Heightened resting neural activity predicts exaggerated stressor-evoked blood pressure reactivity.
Heightened resting neural activity predicts exaggerated stressor-evoked blood pressure reactivity.
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DOI：
10.1161/hypertensionaha.108.126227
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发表时间：
2009-05
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影响因子：
--
通讯作者：
Wang J
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文献类型：
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作者：
Gianaros PJ;Sheu LK;Remo AM;Christie IC;Crtichley HD;Wang J
对行为压力源表现出相对较大幅度或“夸大”血压（BP）反应的个体可能会增加患心血管疾病的风险。正如最近的神经影像学研究所示，表达夸大的压力诱发的BP反应的个体也表达了中枢调节心血管系统的皮质边缘脑区的神经活动增强。然而，这些研究专门研究了压力源暴露期间的BP反应性和伴随的神经活动。如果过度的BP反应性部分源于中枢调节和倾向性心血管反应倾向，那么静息（应激源前）皮质边缘活动的增强可能预示着应激源诱发的过度BP反应性的后续表达。为了验证这一假设，灌注磁共振成像被用来量化静息局部脑血流量（rCBF;神经活动的间接代谢测量）的男性（n=19）和女性（n=20）年龄在20-37谁随后进行认知应激任务，以唤起BP反应。表现出更大的任务诱导收缩压和舒张压升高的个体也在四个功能相关的皮质边缘区域表现出更高的静息rCBF：背侧和膝周前扣带回、内侧前额叶和岛叶皮质。具体而言，在考虑了总静息CBF、静息BP、任务表现和任务相关的不愉快、唤醒和感知心理控制评级后，这些区域的静息rCBF分别占收缩压（P =0.001）和舒张压（P=0.008）反应性方差的40%和31%。静息皮质边缘活动增强可能代表个体易患过度应激诱发BP反应和可能相关心血管风险的神经生物学相关性。
Individuals who express relatively large-magnitude or ‘exaggerated’ blood pressure (BP) reactions to behavioral stressors are presumably at increased risk for cardiovascular disease. As shown by recent neuroimaging studies, individuals who express exaggerated stressor-evoked BP reactivity also express heightened neural activity in corticolimbic brain areas that centrally regulate the cardiovascular system. These studies, however, have exclusively examined BP reactivity and concomitant neural activity during stressor exposure. If exaggerated BP reactivity originates in part from a centrally-regulated and dispositional cardiovascular response tendency, then heightened resting (pre-stressor) corticolimbic activity may predict the subsequent expression of exaggerated stressor-evoked BP reactivity. To test this hypothesis, perfusion magnetic resonance imaging was used to quantify resting regional cerebral blood flow (rCBF; an indirect metabolic measure of neural activity) in men (n=19) and women (n=20) aged 20-37 who subsequently performed cognitive stressor tasks to evoke BP reactivity. Individuals who expressed larger task-induced rises in systolic and diastolic BP also expressed higher resting rCBF in four functionally-related corticolimbic areas: the dorsal and perigenual anterior cingulate, medial prefrontal, and insular cortices. Specifically, resting rCBF in these areas accounted respectively for 40% and 31% of the variance in systolic (P=0.001) and diastolic (P=0.008) BP reactivity, after accounting for total resting CBF, resting BP, task performance, and task-related ratings of unpleasantness, arousal, and perceived psychological control. Heightened resting corticolimbic activity may represent a neurobiological correlate of an individual’s predisposition for exaggerated stressor-evoked BP reactivity and possibly related cardiovascular risk.