{"doi":"10.3233/adr-200287","title":"Neurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease","abstract":"BACKGROUND: Individuals with coronary artery disease (CAD) have worse executive function compared to the general population but the mechanisms are unknown. OBJECTIVE: To investigate the role of acute mental stress (MS) on the executive function of patients with CAD. METHODS: Participants with stable CAD underwent acute MS testing with simultaneous peripheral vascular function measurements and brain imaging using high resolution-positron emission tomography. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during MS/baseline was calculated as a measure of microvascular constriction during MS. Plasma levels of catecholamine and interleukin-6 were assessed at baseline and after MS. Executive function was assessed both at baseline and at 2 years follow-up using the Trail Making Test parts A and B. RESULTS: We studied 389 individuals with brain data available for 148 participants. Of this population follow-up cognitive assessments were performed in 226 individuals (121 with brain imaging). After multivariable adjustment for baseline demographics, risk factors, and medication use, a lower sPAT, indicating greater vasoconstriction, a higher inferior frontal lobe activation with MS, and increases in norepinephrine and IL-6 levels with MS were all independently associated with greater time to complete Trail B test.-38.4pt. CONCLUSION: In response to acute MS, greater peripheral vasoconstriction, higher inferior frontal lobe brain activation, and increases in the levels of norepinephrine and IL-6 are associated with worse executive function.","journal":"Journal of Alzheimer s Disease Reports","year":2021,"id":211602,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9578,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":304830,"name":"Matthew T. Wittbrodt","orcid":"0000-0002-9533-8041","position":1,"is_corresponding":false},{"id":328665,"name":"Bruno B. Lima","orcid":"0000-0001-5540-932X","position":2,"is_corresponding":false},{"id":328668,"name":"Jeong Hwan Kim","orcid":"0000-0001-7186-1033","position":3,"is_corresponding":false},{"id":311866,"name":"Zakaria Almuwaqqat","orcid":"0000-0001-6606-1031","position":4,"is_corresponding":false},{"id":304839,"name":"Amit Shah","orcid":"0000-0001-9099-9687","position":5,"is_corresponding":false},{"id":74595,"name":"Ihab Hajjar","orcid":"0000-0001-6096-5304","position":6,"is_corresponding":false},{"id":325841,"name":"Felicia C. Goldstein","orcid":"0000-0003-2688-3617","position":7,"is_corresponding":false},{"id":68010,"name":"Allan I. Levey","orcid":"0000-0002-3153-502X","position":8,"is_corresponding":false},{"id":287180,"name":"Jonathon A. Nye","orcid":null,"position":9,"is_corresponding":false},{"id":266102,"name":"J. Douglas Bremner","orcid":"0000-0003-1633-6433","position":10,"is_corresponding":false},{"id":292487,"name":"Viola Vaccarino","orcid":"0000-0002-9054-0654","position":11,"is_corresponding":false},{"id":236696,"name":"Arshed A. Quyyumi","orcid":"0000-0002-8166-679X","position":12,"is_corresponding":false},{"id":328669,"name":"Kasra Moazzami","orcid":"0000-0003-0328-2050","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":null,"created_at":"2026-07-18T23:52:20.112538Z","pmid":"33782663","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}