Neuroimaging Studies of the Neural Correlates of Heart Rate Variability: A Systematic Review

Abstract

Direct and indirect links between brain regions and cardiac function have been reported. We performed a systematic literature review to summarize current knowledge regarding the associations of heart rate variability (HRV) and brain region morphology, activity and connectivity involved in autonomic control at rest in healthy subjects. Both positive and negative correlations of cortical thickness and gray matter volumes of brain structures with HRV were observed. The strongest were found for a cluster located within the cingulate cortex. A decline in HRV, as well as cortical thickness with increasing age, especially in the orbitofrontal cortex were noted. When associations of region-specific brain activity with HRV were examined, HRV correlated most strongly with activity in the insula, cingulate cortex, frontal and prefrontal cortices, hippocampus, thalamus, striatum and amygdala. Furthermore, significant correlations, largely positive, between HRV and brain region connectivity (in the amygdala, cingulate cortex and prefrontal cortex) were observed. Notably, right-sided neural structures may be preferentially involved in heart rate and HRV control. However, the evidence for left hemispheric control of cardiac vagal function has also been reported. Our findings provide support for the premise that the brain and the heart are interconnected by both structural and functional networks and indicate complex multi-level interactions. Further studies of brain–heart associations promise to yield insights into their relationship to health and disease.

The effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: a safety study

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“…On the other hand, it is also possible that the adjustment of autonomic nervous function in this study did not directly affect OFC but instead affected value judgments through the activity of other brain regions. For example, the insular cortex is also thought to monitor the state of the body and in uence decision-making (Loued-Khenissi et al, 2020; Matusik et al, 2023). Further neuroimaging studies are required to address this issue.…”

Heart rate fragmentation and brain MRI markers of small vessel disease in MESA

“…C, Histogram of PIP in participants with no microbleeds and in participants with one or more microbleeds Published studies of conventional HR variability metrics in relation to brain MRI findings have focused on structural and resting state connectivity measures but not MRI markers of small vessel disease. 25 For example, studies in healthy volunteers, most < 60 years old, indicate that higher rMSSD is associated with greater orbitofrontal cortical thickness. [26][27][28] The present analysis did not find associations of rMSSD or SDNN with brain MRI findings, but we studied MRI markers of small vessel disease rather than cortical thickness, and the MESA participants were older with a substantial prevalence of obesity, hypertension, and diabetes.…”

“…Published studies of conventional HR variability metrics in relation to brain MRI findings have focused on structural and resting state connectivity measures but not MRI markers of small vessel disease 25 . For example, studies in healthy volunteers, most < 60 years old, indicate that higher rMSSD is associated with greater orbitofrontal cortical thickness 26–28 .…”