Compensatory Mechanism in Takotsubo Cardiomyopathy: The Paradox of Brain Connectivity
DOI:
https://doi.org/10.12923/2353-8627/2026-0006Keywords:
neuropsychology, Takotsubo cardiomyopathy, neuronal plasticity, emotional stressAbstract
Introduction: Takotsubo syndrome is usually described as a transient stress-induced cardiomyopathy, although a growing body of evidence indicates that its pathophysiology also involves disturbances of the brain-heart axis. The aim of this study was to conduct a structured review of the literature on structural and functional brain connectivity changes in Takotsubo syndrome and to assess whether the observed discrepancies may be interpreted in terms of compensatory mechanisms.
Material and methods: A structured literature review was conducted using the PubMed and Scopus databases, supplemented by searches in Google Scholar and manual screening of the reference lists of key publications. The review included studies concerning Takotsubo syndrome, neuroimaging, stress, neuroplasticity, and the relationship between structural and functional connectivity.
Results: The analysed studies indicate that patients with Takotsubo syndrome exhibit disturbances within the limbic-autonomic network, including, the prefrontal cortex, insula, amygdala and hippocampus, among others. The decoupling between functional and structural connectivity appears to be particularly important, as it does not correspond to a simple damage model. It is more likely that chronic stress first leads to functional destabilisation of systems regulating emotion and autonomic activity, followed only secondarily by slower structural remodelling. Such a pattern of changes may increase autonomic reactivity and the vulnerability of the brainheart axis to destabilisation during acute emotional stress, which has important clinical significance.
Conclusions: Takotsubo syndrome may be interpreted as a disorder of dynamic regulation between the brain, the autonomic nervous system and the heart. Longitudinal studies are needed to clarify the temporal sequence of brain changes and their clinical significance.
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Copyright (c) 2026 Hubert Bukowski (Autor)
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