A cortical potential reflecting cardiac function
Open accessAbstract
Emotional trauma and psychological stress can precipitate cardiac arrhythmia and sudden death through arrhythmogenic effects of efferent sympathetic drive. Patients with preexisting heart disease are particularly at risk. Moreover, generation of proarrhythmic activity patterns within cerebral autonomic centers may be amplified by afferent feedback from a dysfunctional myocardium. An electrocortical potential reflecting afferent cardiac information has been described, reflecting individual differences in interoceptive sensitivity (awareness of one's own heartbeats). To inform our understanding of mechanisms underlying arrhythmogenesis, we extended this approach, identifying electrocortical potentials corresponding to the cortical expression of afferent information about the integrity of myocardial function during stress. We measured changes in cardiac response simultaneously with electroencephalography in patients with established ventricular dysfunction. Experimentally induced mental stress enhanced cardiovascular indices of sympathetic activity (systolic blood pressure, heart rate, ventricular ejection fraction, and skin conductance) across all patients. However, the functional response of the myocardium varied; some patients increased, whereas others decreased, cardiac output during stress. Across patients, heartbeat-evoked potential amplitude at left temporal and lateral frontal electrode locations correlated with stress-induced changes in cardiac output, consistent with an afferent cortical representation of myocardial function during stress. Moreover, the amplitude of the heartbeat-evoked potential in the left temporal region reflected the proarrhythmic status of the heart (inhomogeneity of left ventricular repolarization). These observations delineate a cortical representation of cardiac function predictive of proarrhythmic abnormalities in cardiac repolarization. Our findings highlight the dynamic interaction of heart and brain in stress-induced cardiovascular morbidity.
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Despite the variance, the brain tracks such changes in similar subregions, including the insula, somatosensory cortices, cingulate, amygdala, thalamus, and brainstem.
“Despite the variance, the brain tracks such changes in similar subregions, including the insula, somatosensory cortices, cingulate, amygdala, thalamus, and brainstem (42,43,51–53).”
From Interoception and Mental Health: A Roadmap. (2018) · cites this paper as [51]
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- Authors
- Gray, M. A., Taggart, P., Sutton, P. M., Groves, D., Holdright, D. R., Bradbury, D., Brull, D., & Critchley, H. D.
- Affiliations
- UCL Queen Square Institute of Neurology (GB)
- The Royal Free Hospital (GB)
- Royal Liverpool and Broadgreen University Hospital NHS Trust (GB)
- University College Hospital at Westmoreland Street (GB)
- Whittington Hospital (GB)
- Brighton and Sussex Medical School (GB)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2007-04-17
- Volume
- 104
- Issue
- 16
- Pages
- 6818-6823
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC1871868
- OpenAlex
- W2045412058
- Cited by
- 235
- References
- 6
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 17 · 2023: 10 · 2022: 12 · 2021: 20 · 2020: 19 · 2019: 12 · 2018: 11 · 2017: 15 · 2016: 14 · 2015: 16 · 2014: 11 · 2013: 12 · 2012: 6
- FWCI
- 4.21
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- heartbeat-evoked potentials, cardiac arrhythmias, drug-induced arrhythmia, psychological stress, ventricular dysfunction, sympathetic activity, interoception, cardiac output, heart-brain interaction, sudden cardiac death
- MeSH terms
- Adult, Afferent Pathways, Aged, Arrhythmias, Cardiac, Cerebral Cortex, Electrocardiography, Electroencephalography, Evoked Potentials, Heart Rate, Humans, Male, Middle Aged, Stress, Psychological, Temporal Lobe, Prefrontal Cortex
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