Evidence for brain activation in patients with takotsubo cardiomyopathy.

BACKGROUND It remains to be elucidated whether brain activity is altered in takotsubo cardiomyopathy. METHODS AND RESULTS We measured cerebral blood flow (CBF) in 3 consecutive patients with takotsubo cardiomyopathy using (99m)Tc ethyl cysteinate dimmer single photon-emission computed tomography (SPECT) in the acute and chronic phases. In all patients, CBF was significantly increased in the hippocampus, brainstem and basal ganglia and significantly decreased in the prefrontal cortex in the acute phase, which changes subsided in the chronic phase with full recovery of cardiac wall motion. CONCLUSIONS These results provide the first direct evidence for brain activation in takotsubo cardiomyopathy.