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INNOSC Theranostics and
Pharmacological Sciences The Takotsubo syndrome: A gender disparity

disparate manner. Long-term stress might lead to the barrier properties of brain microvascular endothelial cells
development of GR resistance, which raises GR levels and in vitro. Front Cardiovasc Med. 2020;7:73.
impairs the suppression of inflammation. Consequently, a doi: 10.3389/fcvm.2020.00073
persistent rise in the systemic concentrations of GCs can lead 3. Herrmann MJ, Boehme S, Becker MP, et al. Phasic and
to immunosuppression, metabolic diseases, autoimmune sustained brain responses in the amygdala and the bed
diseases, and mood disorders due to their pleiotropic action, nucleus of the stria terminalis during threat anticipation.
which appears to be more prevalent in women. Hum Brain Mapp. 2016;37:1091-1102.
In every area of medicine, there should be a strong doi: 10.1002/hbm.23088
emphasis on preventive medicine. This is especially true
when there are modifiable risk factors involved, such as 4. Brinkmann L, Buff C, Feldker K, et al. Distinct phasic and
sustained brain responses and connectivity of amygdala and
stress, which affects the heart and psychology. The non- bed nucleus of the stria terminalis during threat anticipation
invasive (transcutaneous) vagus nerve stimulation (VNS) in panic disorder. Psychol Med. 2017;47:2675-2688.
therapy, which is beneficial for parasympathetic activity and
plays a significant part in lowering chronic inflammation, doi: 10.1017/S0033291717001192
has high therapeutic value for TTS, according to research by 5. Brinkmann L, Buff C, Neumeister P, et al. Dissociation
Frank et al. It should be highlighted that gender differences between amygdala and bed nucleus of the stria terminalis
54
must be taken into account with regard to VNS. 56 during threat anticipation in female post-traumatic stress
disorder patients. Hum Brain Mapp. 2017;38:2190-2205.
Acknowledgments doi: 10.1002/hbm.23513

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Funding
doi: 10.1038/nrn2647
This work is supported by research grant DFG FO 315/5-1
awarded to C.Y.F. 7. Templin C, Hänggi J, Klein C, et al. Altered limbic and
autonomic processing supports brain-heart axis in
Conflict of interest Takotsubo syndrome. Eur Heart J. 2019;40:1183-1187.
The authors declare they have no competing interests. doi: 10.1093/eurheartj/ehz068
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Ethics approval and consent to participate
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