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Interaktionen zwischen Gehirn und Herz

Interactions between the brain and heart

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Zusammenfassung

Gehirn und Herz stehen eng miteinander in Verbindung. Das Gehirn übt einen physiologischen Einfluss auf das Herz aus. Ein Beispiel für diesen physiologischen Einfluss ist die Kontrolle der Herzfrequenz durch Efferenzen des autonomen Nervensystems. Klinische Beispiele für diese Richtung der Interaktion stellen unter anderem kardiale Komplikationen nach Schlaganfällen sowie die Takotsubo-Kardiomyopathie dar. Herz und Gehirn stehen jedoch bidirektional in Verbindung, sodass auch die Herzaktivität über ihre Funktion als Generator eines Blutstroms zur Versorgung des Gehirns hinaus ihren Einfluss auf das Gehirn ausübt. Beispiele hierfür sind die Wahrnehmung von Stimuli in Abhängigkeit von der Präsentation während des Herzzyklus. Klinische Beispiele für diese Richtung der Interaktion stellen Schlaganfälle als thrombembolische Komplikation des Vorhofflimmerns sowie die Vergesellschaftung von Vorhofflimmern und Demenz dar. In diesem Review soll ein Überblick über die bidirektionalen Interaktionen zwischen Herz und Gehirn, teilweise unter Einbeziehung des Herz-Kreislauf-Systems, gegeben werden, ihre Bedeutung für den Klinikalltag diskutiert und ein Ausblick auf aktuelle Forschungsfelder gegeben werden.

Abstract

The brain and heart are closely interconnected. Physiologically, the brain influences the way the heart beats. An example for this physiological influence is the control of the heart rate via efferences of the autonomic nervous system. Clinical examples for this direction of interactions include cardiac complications after stroke as well as takotsubo cardiomyopathy; however, the heart and brain are reciprocally connected so that heart activity also influences the brain beyond its function as the generator of bloodflow supplying the brain. Examples for this are the perception of stimuli depending on the time of presentation during the heart cycle. Clinical examples of the direction of this interaction constitute stroke as a thromboembolic complication of atrial fibrillation as well as the correlation of atrial fibrillation and dementia. This review article gives an overview of the bidirectional interactions between the heart and brain, partly including the cardiovascular system, discusses their implications for the clinical routine and gives an outlook on current fields of research.

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Authors and Affiliations

  1. Klinik für Neurologie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland

    Sarah Deking &  Jan Liman

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  1. Sarah Deking
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  2. Jan Liman
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Correspondence to Jan Liman.

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Interessenkonflikt

S. Deking und J. Liman geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Deking, S., Liman, J. Interaktionen zwischen Gehirn und Herz. Nervenarzt 92, 977–985 (2021). https://doi.org/10.1007/s00115-021-01170-5

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