Background
Cognitive reappraisal is a form of emotion regulation that alters emotional responding
by changing the meaning of emotional stimuli. Reappraisal engages regions of the prefrontal
cortex that support multiple functions, including visceral control functions implicated
in regulating the immune system. Immune activity plays a role in the preclinical pathophysiology
of atherosclerotic cardiovascular disease (CVD), an inflammatory condition that is
highly comorbid with affective disorders characterized by problems with emotion regulation.
Here, we tested whether prefrontal engagement by reappraisal would be associated with
atherosclerotic CVD risk and whether this association would be mediated by inflammatory
activity.
Methods
Community volunteers (n = 157; 30–54 years of age; 80 women) without DSM-IV Axis-1 psychiatric diagnoses or
cardiovascular or immune disorders performed a functional neuroimaging task involving
the reappraisal of negative emotional stimuli. Carotid artery intima-media thickness
and inter-adventitial diameter were measured by ultrasonography and used as markers
of preclinical atherosclerosis. Also measured were circulating levels of interleukin-6
(IL-6), an inflammatory cytokine linked to CVD risk and prefrontal neural activity.
Results
Greater reappraisal-related engagement of the dorsal anterior cingulate cortex was
associated with greater preclinical atherosclerosis and IL-6. Moreover, IL-6 mediated
the association of dorsal anterior cingulate cortex engagement with preclinical atherosclerosis.
These results were independent of age, sex, race, smoking status, and other known
CVD risk factors.
Conclusions
The cognitive regulation of emotion might relate to CVD risk through a pathway involving
the functional interplay between the anterior cingulate region of the prefrontal cortex
and inflammatory activity.
Key Words
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Article info
Publication history
Published online: November 21, 2013
Accepted:
October 11,
2013
Received in revised form:
September 19,
2013
Received:
April 26,
2013
Identification
Copyright
© 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
