Increased Cerebral Blood Flow in the Anterior Cingulate Cortex and Plasma Noradrenaline Level During Cardiac Pacemaker Stimulation

BACKGROUND: Chest symptoms, such as angina and palpitation, are common complaints in patients with cardiovascular diseases, but few studies have addressed how cardiac afferent information is processed through the brain. METHODS AND RESULTS: O positron emission tomography (PET) followed by blood sampling during right ventricular pacing of sham (1.5 V) and stimulation (7.5-8 V) conditions with a 10min interval. A voxel-wise analysis of the brain PET images identified the anterior cingulate cortex (ACC), posterior cingulate cortex, prefrontal cortex, thalamus, amygdala and midbrain as regions of increased regional cerebral blood flow (rCBF) under stimulation compared to sham conditions at a family-wise error-corrected cluster-extent threshold of P