Time-Resolved Directional Brain–Heart Interplay Measurement Through Synthetic Data Generation Models

Restoring bottom-up communication in brain-heart interplay after trauma-focused psychotherapy in breast cancer patients with post-traumatic stress disorder

BACKGROUND

The psychological impact of breast cancer (BC) is substantial, with a significant number of patients (up to 32 %) experiencing post-traumatic stress disorder (PTSD). Exploring the emotional aspects of PTSD through the functional brain-heart interplay (BHI) offers valuable insights into the condition. BHI examines the functional interactions between cortical and sympathovagal dynamics. This study aims to investigate changes in functional directional BHI after trauma-focused (TF) psychotherapy, specifically Eye Movement Desensitization and Reprocessing (EMDR), in comparison to treatment as usual (TAU) among BC patients with PTSD. To our knowledge, this study represents the first examination of such changes.

METHODS

We enrolled thirty BC patients who met the criteria for a PTSD diagnosis, with fourteen receiving EMDR and fifteen receiving TAU over a two- to three-month period. We analyzed changes in the emotional response during a script-driven imagery setting. Quantification of the functional interplay between EEG and sympathovagal dynamics was achieved using the synthetic data generation model (SDG) on electroencephalographic (EEG) and heartbeat series. Our focus was on the difference in the BHI index extracted at baseline and post-treatment.

RESULTS

We found statistically significant higher coupling in the heart-to-brain direction in patients treated with EMDR compared to controls. This suggests that the flow of information from the autonomic nervous system to the central nervous system is restored following EMDR-induced recovery from PTSD. Furthermore, we observed a significant correlation between improvements in PTSD symptoms and an increase in functional BHI after EMDR treatment.

CONCLUSIONS

TF psychotherapy, particularly EMDR, appears to facilitate the restoration of the bottom-up flow of interoceptive information, which is dysfunctional in patients with PTSD. The application of BHI analysis to the study of PTSD not only aids in identifying biomarkers of the disorder but also enhances our understanding of the changes brought about by TF treatments.

Intracortical brain-heart interplay: An EEG model source study of sympathovagal changes

The interplay between cerebral and cardiovascular activity, known as the functional brain-heart interplay (BHI), and its temporal dynamics, have been linked to a plethora of physiological and pathological processes. Various computational models of the brain-heart axis have been proposed to estimate BHI non-invasively by taking advantage of the time resolution offered by electroencephalograph (EEG) signals. However, investigations into the specific intracortical sources responsible for this interplay have been limited, which significantly hampers existing BHI studies. This study proposes an analytical modeling framework for estimating the BHI at the source-brain level. This analysis relies on the low-resolution electromagnetic tomography sources localization from scalp electrophysiological recordings. BHI is then quantified as the functional correlation between the intracortical sources and cardiovascular dynamics. Using this approach, we aimed to evaluate the reliability of BHI estimates derived from source-localized EEG signals as compared with prior findings from neuroimaging methods. The proposed approach is validated using an experimental dataset gathered from 32 healthy individuals who underwent standard sympathovagal elicitation using a cold pressor test. Additional resting state data from 34 healthy individuals has been analysed to assess robustness and reproducibility of the methodology. Experimental results not only confirmed previous findings on activation of brain structures affecting cardiac dynamics (e.g., insula, amygdala, hippocampus, and anterior and mid-cingulate cortices) but also provided insights into the anatomical bases of brain-heart axis. In particular, we show that the bidirectional activity of electrophysiological pathways of functional brain-heart communication increases during cold pressure with respect to resting state, mainly targeting neural oscillations in theδ $$ \delta $$ ,β $$ \beta $$ , andγ $$ \gamma $$ bands. The proposed approach offers new perspectives for the investigation of functional BHI that could also shed light on various pathophysiological conditions.

Aberrant brain-heart coupling is associated with the severity of post cardiac arrest brain injury

OBJECTIVE

To investigate autonomic nervous system activity measured by brain-heart interactions in comatose patients after cardiac arrest in relation to the severity and prognosis of hypoxic-ischemic brain injury.

METHODS

Strength and complexity of bidirectional interactions between EEG frequency bands (delta, theta, and alpha) and ECG heart rate variability frequency bands (low frequency, LF and high frequency, HF) were computed using a synthetic data generation model. Primary outcome was the severity of brain injury, assessed by (i) standardized qualitative EEG classification, (ii) somatosensory evoked potentials (N20), and (iii) neuron-specific enolase levels. Secondary outcome was the 3-month neurological status, assessed by the Cerebral Performance Category score [good (1-2) vs. poor outcome (3-4-5)].

RESULTS

Between January 2007 and July 2021, 181 patients were admitted to ICU for a resuscitated cardiac arrest. Poor neurological outcome was observed in 134 patients (74%). Qualitative EEG patterns suggesting high severity were associated with decreased LF/HF. Severity of EEG changes were proportional to higher absolute values of brain-to-heart coupling strength (p < 0.02 for all brain-to-heart frequencies) and lower values of alpha-to-HF complexity (p = 0.049). Brain-to-heart coupling strength was significantly higher in patients with bilateral absent N20 and correlated with neuron-specific enolase levels at Day 3. This aberrant brain-to-heart coupling (increased strength and decreased complexity) was also associated with 3-month poor neurological outcome.

INTERPRETATION

Our results suggest that autonomic dysfunctions may well represent hypoxic-ischemic brain injury post cardiac arrest pathophysiology. These results open avenues for integrative monitoring of autonomic functioning in critical care patients.

Integrative neuro-cardiovascular dynamics in response to test anxiety: A brain-heart axis study

Test anxiety (TA), a recognized form of social anxiety, is the most prominent cause of anxiety among students and, if left unmanaged, can escalate to psychiatric disorders. TA profoundly impacts both central and autonomic nervous systems, presenting as a dual manifestation of cognitive and autonomic components. While limited studies have explored the physiological underpinnings of TA, none have directly investigated the intricate interplay between the CNS and ANS in this context. In this study, we introduce a non-invasive, integrated neuro-cardiovascular approach to comprehensively characterize the physiological responses of 27 healthy subjects subjected to test anxiety induced via a simulated exam scenario. Our experimental findings highlight that an isolated analysis of electroencephalographic and heart rate variability data fails to capture the intricate information provided by a brain-heart axis assessment, which incorporates an analysis of the dynamic interaction between the brain and heart. With respect to resting state, the simulated examination induced a decrease in the neural control onto heartbeat dynamics at all frequencies, while the studying condition induced a decrease in the ascending heart-to-brain interplay at EEG oscillations up to 12Hz. This underscores the significance of adopting a multisystem perspective in understanding the complex and especially functional directional mechanisms underlying test anxiety.

Microstates of the cortical brain-heart axis

Electroencephalographic (EEG) microstates are brain states with quasi-stable scalp topography. Whether such states extend to the body level, that is, the peripheral autonomic nerves, remains unknown. We hypothesized that microstates extend at the brain-heart axis level as a functional state of the central autonomic network. Thus, we combined the EEG and heartbeat dynamics series to estimate the directional information transfer originating in the cortex targeting the sympathovagal and parasympathetic activity oscillations and vice versa for the afferent functional direction. Data were from two groups of participants: 36 healthy volunteers who were subjected to cognitive workload induced by mental arithmetic, and 26 participants who underwent physical stress induced by a cold pressure test. All participants were healthy at the time of the study. Based on statistical testing and goodness-of-fit evaluations, we demonstrated the existence of microstates of the functional brain-heart axis, with emphasis on the cerebral cortex, since the microstates are derived from EEG. Such nervous-system microstates are spatio-temporal quasi-stable states that exclusively refer to the efferent brain-to-heart direction. We demonstrated brain-heart microstates that could be associated with specific experimental conditions as well as brain-heart microstates that are non-specific to tasks.

Towards the definition of Microstates of the Cortical Brain-Heart Axis

Brain microstates are defined as states with quasi-stable scalp activity topography and have been widely studied in literature. Whether those states are brain-specific or extend to the body level is unknown yet. We investigate the extension of cortical microstates to the peripheral autonomic nerve, specifically at the brain-heart axis level as a functional state of the central autonomic network. To achieve this, we combined Electroencephalographic (EEG) and heart rate variability (HRV) series from 36 healthy volunteers undergoing a cognitive workload elicitation after a resting state. Our results showed the existence of microstates at the functional brain-heart axis with spatio-temporal and quasi-stable states that exclusively pertained to the efferent direction from the brain to the heart. Some of the identified microstates are specific for neural or cardiovascular frequency bands, while others topographies are recurrent over the EEG and HRV spectra. Furthermore, some of the identified brain-heart microstates were associated with specific experimental conditions, while others were nonspecific to tasks. Our findings support the hypothesis that EEG microstates extend to the brain-heart axis level and may be exploited in future neuroscience and clinical research.

Complex Brain-Heart Mapping in Mental and Physical Stress

OBJECTIVE

The central and autonomic nervous systems are deemed complex dynamic systems, wherein each system as a whole shows features that the individual system sub-components do not. They also continuously interact to maintain body homeostasis and appropriate react to endogenous and exogenous stimuli. Such interactions are comprehensively referred to functional brain-heart interplay (BHI). Nevertheless, it remains uncertain whether this interaction also exhibits complex characteristics, that is, whether the dynamics of the entire nervous system inherently demonstrate complex behavior, or if such complexity is solely a trait of the central and autonomic systems. Here, we performed complexity mapping of the BHI dynamics under mental and physical stress conditions.

METHODS AND PROCEDURES

Electroencephalographic and heart rate variability series were obtained from 56 healthy individuals performing mental arithmetic or cold-pressure tasks, and physiological series were properly combined to derive directional BHI series, whose complexity was quantified through fuzzy entropy.

RESULTS

The experimental results showed that BHI complexity is mainly modulated in the efferent functional direction from the brain to the heart, and mainly targets vagal oscillations during mental stress and sympathovagal oscillations during physical stress.

CONCLUSION

We conclude that the complexity of BHI mapping may provide insightful information on the dynamics of both central and autonomic activity, as well as on their continuous interaction.

CLINICAL IMPACT

This research enhances our comprehension of the reciprocal interactions between central and autonomic systems, potentially paving the way for more accurate diagnoses and targeted treatments of cardiovascular, neurological, and psychiatric disorders.

Depression as a cardiovascular disorder: central-autonomic network, brain-heart axis, and vagal perspectives of low mood

If depressive symptoms are not caused by the physiological effects of a substance or other medical or neurological conditions, they are generally classified as mental disorders that target the central nervous system. However, recent evidence suggests that peripheral neural dynamics on cardiovascular control play a causal role in regulating and processing emotions. In this perspective, we explore the dynamics of the Central-Autonomic Network (CAN) and related brain-heart interplay (BHI), highlighting their psychophysiological correlates and clinical symptoms of depression. Thus, we suggest that depression may arise from dysregulated cardiac vagal and sympathovagal dynamics that lead to CAN and BHI dysfunctions. Therefore, treatments for depression should target the nervous system as a whole, with particular emphasis on regulating vagal and BHI dynamics.

Modeling brain-heart interactions from Poincaré plot-derived measures of sympathetic-vagal activity

Recent studies suggest that the interaction between the brain and heart plays a key role in cognitive processes, and measuring these interactions is crucial for understanding the interaction between the central and autonomic nervous systems. However, studying this bidirectional interplay presents methodological challenges, and there is still much room for exploration. This paper presents a new computational method called the Poincaré Sympathetic-Vagal Synthetic Data Generation Model (PSV-SDG) for estimating brain-heart interactions. The PSV-SDG combines EEG and cardiac sympathetic-vagal dynamics to provide time-varying and bidirectional estimators of mutual interplay. The method is grounded in the Poincaré plot, a heart rate variability method to estimate sympathetic-vagal activity that can account for potential non-linearities. This algorithm offers a new approach and computational tool for functional assessment of the interplay between EEG and cardiac sympathetic-vagal activity. The method is implemented in MATLAB under an open-source license. • A new brain-heart interaction modeling approach is proposed. • The modeling is based on coupled synthetic data generators of EEG and heart rate series. • Sympathetic and vagal activities are gathered from Poincaré plot geometry.

Central autonomic network alterations in male endurance athletes

Physical exercise causes marked adjustments in brain function and the cardiovascular system. Brain regions of the so-called central autonomic network (CAN) are likely to show exercise-related alterations due to their involvement in cardiac control, yet exercise-induced CAN changes remain unclear. Here we investigate the effects of intensive exercise on brain regions involved in cardiac autonomic regulation using resting-state functional connectivity (rsFC). We explored rsFC of six core regions within CAN, namely ventromedial prefrontal cortex, dorsolateral anterior cingulate cortex, left/right amygdala, and left/right anterior insula, in 20 endurance athletes and 21 non-athletes. We showed that athletes had enhanced rsFC within CAN and sensorimotor areas compared to non-athletes. Likewise, we identified two networks with increased rsFC encompassing autonomic and motor-related areas using network-based statistics analysis. In addition, rsFC displayed an inverse relationship with heart rate, where the stronger rsFC in athletes correlates with their slower heart rate. Despite this significant relationship, mediation analysis revealed that heart rate is a weak mediator of the effect of intensive physical training on rsFC. Our findings prove that physical exercise enhances brain connectivity in central autonomic and sensorimotor networks and highlight the close link between brain and heart.

Pairwise and higher-order measures of brain-heart interactions in children with temporal lobe epilepsy

OBJECTIVE

While it is well-known that epilepsy has a clear impact on the activity of both the central nervous system (CNS) and the autonomic nervous system (ANS), its role on the complex interplay between CNS and ANS has not been fully elucidated yet. In this work, pairwise and higher-order predictability measures based on the concepts of Granger causality (GC) and Partial Information Decomposition (PID) were applied on time series of electroencephalographic (EEG) brain wave amplitude and heart rate variability (HRV) in order to investigate directed brain-heart interactions associated with the occurrence of focal epilepsy.

APPROACH

HRV and the envelopes of δ and α EEG activity recorded from ipsilateral (ipsi-EEG) and contralateral (contra-EEG) scalp regions were analyzed in 18 children suffering from temporal lobe epilepsy monitored during pre-ictal, ictal and post-ictal periods. After linear parametric model identification, we compared pairwise GC measures computed between HRV and a single EEG component with PID measures quantifying the unique, redundant and synergistic information transferred from ipsi-EEG and contra-EEG to HRV.

MAIN RESULTS

The analysis of GC revealed a dominance of the information transfer from EEG to HRV and negligible transfer from HRV to EEG, suggesting that CNS activities drive the ANS modulation of the heart rhythm, but did not evidence clear differences between δ and α rhythms, ipsi-EEG and contra-EEG, or pre- and post-ictal periods. On the contrary, PID revealed that epileptic seizures induce a reorganization of the interactions from brain to heart, as the unique predictability of HRV originated from the ipsi-EEG for the δ waves and from the contra-EEG for the α waves in the pre-ictal phase, while these patterns were reversed after the seizure.

SIGNIFICANCE

These results highlight the importance of considering higher-order interactions elicited by PID for the study of the neuro-autonomic effects of focal epilepsy, and may have neurophysiological and clinical implications.

A new framework for modeling the bidirectional interplay between brain oscillations and cardiac sympathovagal activity

The study of functional brain-heart interplay (BHI) aims to describe the dynamical interactions between central and peripheral autonomic nervous systems. Here, we introduce the Sympathovagal Synthetic Data Generation Model, which constitutes a new computational framework for the assessment of functional BHI. The model estimates the bidirectional interplay with novel quantifiers of cardiac sympathovagal activity gathered from Laguerre expansions of RR series (from the ECG), as an alternative to the classical spectral analysis. The main features of the model are time-varying coupling coefficients linking Electroencephalography (EEG) oscillations and cardiac sympathetic or parasympathetic activity, for either ascending or descending direction of the information flow. In this proof-of-concept study, functional BHI is quantified in the direction from-heart-to-brain, on data from 16 human volunteers undergoing a cold-pressor test. Results show that thermal stress induces heart-to-brain functional interplay originating from sympathetic and parasympathetic activities and sustaining EEG oscillations mainly in the δ and γ bands. The proposed computational framework could provide a viable tool for the functional assessment of the causal interplay between cortical and cardiac sympathovagal dynamics.

Complexity Modulation in functional Brain-Heart Interplay series driven by Emotional Stimuli: an early study using Fuzzy Entropy

Increasing attention has recently been devoted to the multidisciplinary investigation of functional brain-heart interplay (BHI), which has provided meaningful insights in neuroscience and clinical domains including cardiology, neurology, clinical psychology, and psychiatry. While neural (brain) and heartbeat series show high nonlinear and complex dynamics, a complexity analysis on BHI series has not been performed yet. To this end, in this preliminary study, we investigate BHI complexity modulation in 17 healthy subjects undergoing a 3-minute resting state and emotional elicitation through standardized image slideshow. Electroencephalographic and heart rate variability series were the inputs of an adhoc BHI model, which provides directional (from-heart-to-brain and from-brain-to-heart) estimates at different frequency bands. A Fuzzy entropy analysis was performed channel-wise on the model output for the two experimental conditions. Results suggest that BHI complexity increases in the emotional elicitation phase with respect to a resting state, especially in the functional direction from the heart to the brain. We conclude that BHI complexity may be a viable computational tool to characterize neurophysiological and pathological states under different experimental conditions.

Causal Symbolic Information Transfer for the Assessment of functional Brain-Heart Interplay through EEG Microstates Occurrences: a proof-of-concept study

Electroencephalography (EEG) microstates analysis provides a sequence of topographies representing the scalp-related electric field over time, and each microstate is synthetically represented by a symbol. Despite recent advances on functional brain-heart interplay (BHI) assessment, to our knowledge no methodology takes EEG microstates into account to relate the causal heartbeat dynamics. Moreover, standard BHI methods are tailored to a single EEG-channel analysis, neglecting the comprehensive information associated with a multichannel cluster or a whole-brain activity. To overcome these limitations, we devised a novel methodological frame-work for the assessment of functional BHI that exploits the symbolic representation of both EEG microstates and heart rate variability (HRV) series. Directional BHI quantification is then performed through Kullback-Leibler Divergence (KLD) and Transfer Entropy. The proposed methodology is here preliminarily tested on a dataset gathered from healthy subjects undergoing a resting state and a mental arithmetic task. Except for the KLD in the from-brain-to-heart direction, all other estimates showed significant differences between the two experimental conditions. We conclude that the proposed frame-work may promisingly provide novel insights on brain-heart phenomena through a whole-brain symbolic representation.

Cardiac sympathetic-vagal activity initiates a functional brain-body response to emotional arousal

We investigate the temporal dynamics of brain and cardiac activities in healthy subjects who underwent an emotional elicitation through videos. We demonstrate that, within the first few seconds, emotional stimuli modulate heartbeat activity, which in turn stimulates an emotion intensity (arousal)–specific cortical response. The emotional processing is then sustained by a bidirectional brain–heart interplay, where the perceived arousal level modulates the amplitude of ascending heart-to-brain neural information flow. These findings may constitute fundamental knowledge linking neurophysiology and psychiatric disorders, including the link between depressive symptoms and cardiovascular disorders.

A century-long debate on bodily states and emotions persists. While the involvement of bodily activity in emotion physiology is widely recognized, the specificity and causal role of such activity related to brain dynamics has not yet been demonstrated. We hypothesize that the peripheral neural control on cardiovascular activity prompts and sustains brain dynamics during an emotional experience, so these afferent inputs are processed by the brain by triggering a concurrent efferent information transfer to the body. To this end, we investigated the functional brain–heart interplay under emotion elicitation in publicly available data from 62 healthy subjects using a computational model based on synthetic data generation of electroencephalography and electrocardiography signals. Our findings show that sympathovagal activity plays a leading and causal role in initiating the emotional response, in which ascending modulations from vagal activity precede neural dynamics and correlate to the reported level of arousal. The subsequent dynamic interplay observed between the central and autonomic nervous systems sustains the processing of emotional arousal. These findings should be particularly revealing for the psychophysiology and neuroscience of emotions.

Functional assessment of bidirectional cortical and peripheral neural control on heartbeat dynamics: a brain-heart study on thermal stress

The study of functional brain-heart interplay (BHI) from non-invasive recordings has gained much interest in recent years. Previous endeavors aimed at understanding how the two dynamical systems exchange information, providing novel holistic biomarkers and important insights on essential cognitive aspects and neural system functioning. However, the interplay between cardiac sympathovagal and cortical oscillations still has much room for further investigation. In this study, we introduce a new computational framework for a functional BHI assessment, namely the Sympatho-Vagal Synthetic Data Generation Model, combining cortical (electroencephalography, EEG) and peripheral (cardiac sympathovagal) neural dynamics. The causal, bidirectional neural control on heartbeat dynamics was quantified on data gathered from 26 human volunteers undergoing a cold-pressor test. Results show that thermal stress induces heart-to-brain functional interplay sustained by EEG oscillations in the delta and gamma bands, primarily originating from sympathetic activity, whereas brain-to-heart interplay originates over central brain regions through sympathovagal control. The proposed methodology provides a viable computational tool for the functional assessment of the causal interplay between cortical and cardiac neural control.

Functional brain-heart interplay extends to the multifractal domain

The study of functional brain-heart interplay has provided meaningful insights in cardiology and neuroscience. Regarding biosignal processing, this interplay involves predominantly neural and heartbeat linear dynamics expressed via time and frequency domain-related features. However, the dynamics of central and autonomous nervous systems show nonlinear and multifractal behaviours, and the extent to which this behaviour influences brain-heart interactions is currently unknown. Here, we report a novel signal processing framework aimed at quantifying nonlinear functional brain-heart interplay in the non-Gaussian and multifractal domains that combines electroencephalography (EEG) and heart rate variability series. This framework relies on a maximal information coefficient analysis between nonlinear multiscale features derived from EEG spectra and from an inhomogeneous point-process model for heartbeat dynamics. Experimental results were gathered from 24 healthy volunteers during a resting state and a cold pressor test, revealing that synchronous changes between brain and heartbeat multifractal spectra occur at higher EEG frequency bands and through nonlinear/complex cardiovascular control. We conclude that significant bodily, sympathovagal changes such as those elicited by cold-pressure stimuli affect the functional brain-heart interplay beyond second-order statistics, thus extending it to multifractal dynamics. These results provide a platform to define novel nervous-system-targeted biomarkers. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.

Causality of cortical and cardiovascular activity during cyclic alternating pattern in non-rapid eye movement sleep

The dynamic interplay between central and autonomic nervous system activities plays a pivotal role in orchestrating sleep. Macrostructural changes such as sleep-stage transitions or phasic, brief cortical events elicit fluctuations in neural outflow to the cardiovascular system, but the causal relationships between cortical and cardiovascular activities underpinning the microstructure of sleep are largely unknown. Here, we investigate cortical-cardiovascular interactions during the cyclic alternating pattern (CAP) of non-rapid eye movement sleep in a diverse set of overnight polysomnograms. We determine the Granger causality in both 507 CAP and 507 matched non-CAP sequences to assess the causal relationships between electroencephalography (EEG) frequency bands and respiratory and cardiovascular variables (heart period, respiratory period, pulse arrival time and pulse wave amplitude) during CAP. We observe a significantly stronger influence of delta activity on vascular variables during CAP sequences where slow, low-amplitude EEG activation phases (A1) dominate than during non-CAP sequences. We also show that rapid, high-amplitude EEG activation phases (A3) provoke a more pronounced change in autonomic activity than A1 and A2 phases. Our analysis provides the first evidence on the causal interplay between cortical and cardiovascular activities during CAP. Granger causality analysis may also be useful for probing the level of decoupling in sleep disorders. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.

Activation of brain-heart axis during REM sleep: a trigger for dreaming

Dreams may be recalled after awakening from sleep following a defined electroencephalographic pattern that involves local decreases in low-frequency activity in the posterior cortical regions. While a dreaming experience implies bodily changes at many organ-, system-, and timescale-levels, the entity and causal role of such peripheral changes in a conscious dream experience are unknown. We performed a comprehensive, causal, multivariate analysis of physiological signals acquired during REM sleep at night, including high-density EEG and peripheral dynamics including electrocardiography and blood pressure. In this preliminary study, we investigated multiple recalls and non-recalls of dream experiences using data from nine healthy volunteers. The aim was not only to investigate the changes in central and autonomic dynamics associated with dream recalls and non-recalls, but also to characterize the central-peripheral dynamical and (causal) directional interactions, and the temporal relations of the related arousals upon awakening. We uncovered a brain-body network that drives a conscious dreaming experience that acts with specific interaction and time delays. Such a network is sustained by the blood pressure dynamics and the increasing functional information transfer from the neural heartbeat regulation to the brain. We conclude that bodily changes play a crucial and causative role in a conscious dream experience during REM sleep.

The role of electroencephalography electrical reference in the assessment of functional brain-heart interplay: From methodology to user guidelines

BACKGROUND

The choice of EEG reference has been widely studied. However, the choice of the most appropriate re-referencing for EEG data is still debated. Moreover, the role of EEG reference in the estimation of functional Brain-Heart Interplay (BHI), together with different multivariate modelling strategies, has not been investigated yet.

METHODS

This study identifies the best methodology combining a proper EEG electrical reference and signal processing methods for an effective functional BHI assessment. The effects of the EEG reference among common average, mastoids average, Laplacian reference, Cz reference, and the reference electrode standardization technique (REST) were explored throughout different BHI methods including synthetic data generation (SDG) model, heartbeat-evoked potentials, heartbeat-evoked oscillations, and maximal information coefficient.

RESULTS

The SDG model exhibited high robustness between EEG references, whereas the maximal information coefficient method exhibited a high sensitivity. The common average and REST references for EEG showed a good consistency in the between-method comparisons. Laplacian, and Cz references significantly bias a BHI measurement.

COMPARISON WITH EXISTING METHODS

The use of EEG reference based on a common average outperforms on the use of other references for consistency in estimating directed functional BHI. We do not recommend the use of EEG references based on analytical derivations as the experimental conditions may not meet the requirements of their optimal estimation, particularly in clinical settings.

CONCLUSION

The use of a common average for EEG electrical reference is concluded to be the most appropriate choice for a quantitative, functional BHI assessment.

Intensification of functional neural control on heartbeat dynamics in subclinical depression

Subclinical depression (dysphoria) is a common condition that may increase the risk of major depression and leads to impaired quality of life and severe comorbid somatic diseases. Despite its prevalence, specific biological markers are unknown; consequently, the identification of dysphoria currently relies exclusively on subjective clinical scores and structured interviews. Based on recent neurocardiology studies that link brain and cardiovascular disorders, it was hypothesized that multi-system biomarkers of brain-body interplay may effectively characterize dysphoria. Thus, an ad hoc computational technique was developed to quantify the functional bidirectional brain-heart interplay. Accordingly, 32-channel electroencephalographic and heart rate variability series were obtained from 24 young dysphoric adults and 36 healthy controls. All participants were females of a similar age, and results were obtained during a 5-min resting state. The experimental results suggest that a specific feature of dysphoria is linked to an augmented functional central-autonomic control to the heart, which originates from central, frontopolar, and occipital oscillations and acts through cardiovascular sympathovagal activity. These results enable further development of a large set of novel biomarkers for mood disorders based on comprehensive brain-body measurements.

Toward brain-heart computer interfaces: a study on the classification of upper limb movements using multisystem directional estimates

OBJECTIVE

Brain-computer interfaces (BCI) exploit computational features from brain signals to perform a given task. Despite recent neurophysiology and clinical findings indicating the crucial role of functional interplay between brain and cardiovascular dynamics in locomotion, heartbeat information remains to be included in common BCI systems. In this study, we exploit the multidimensional features of directional and functional interplay between electroencephalographic and heartbeat spectra to classify upper limb movements into three classes.

APPROACH

We gathered data from 26 healthy volunteers that performed 90 movements; the data were processed using a recently proposed framework for brain-heart interplay (BHI) assessment based on synthetic physiological data generation. Extracted BHI features were employed to classify, through sequential forward selection scheme and k-nearest neighbors algorithm, among resting state and three classes of movements according to the kind of interaction with objects.

MAIN RESULTS

The results demonstrated that the proposed brain-heart computer interface (BHCI) system could distinguish between rest and movement classes automatically with an average 90% of accuracy.

SIGNIFICANCE

Further, this study provides neurophysiology insights indicating the crucial role of functional interplay originating at the cortical level onto the heart in the upper limb neural control. The inclusion of functional BHI insights might substantially improve the neuroscientific knowledge about motor control, and this may lead to advanced BHCI systems performances.

An Inhomogeneous Point-process Model for the Assessment of the Brain-to-Heart Functional Interplay: a Pilot Study

We propose a novel computational framework for the estimation of functional directional brain-to-heart interplay in an instantaneous fashion. The framework is based on inhomogeneous point-process models for human heartbeat dynamics and employs inverse-Gaussian probability density functions characterizing the timing of R-peak events. The instantaneous estimation of the functional directional coupling is based on the definition of point-process transfer entropy, which is here retrieved from heart rate variability (HRV) and Electroencephalography (EEG) power spectral series gathered from 12 healthy subjects undergoing significant sympathovagal changes induced by a cold-pressor test. Results suggest that EEG oscillations dynamically influence heartbeat dynamics with specific time delays in the 30-60s and 90-120s ranges, and through a functional activity over specific cortical regions.

Methodological Considerations on EEG Electrical Reference: A Functional Brain-Heart Interplay Study

The growing interest in the study of functional brain-heart interplay (BHI) has motivated the development of novel methodological frameworks for its quantification. While a combination of electroencephalography (EEG) and heartbeat-derived series has been widely used, the role of EEG preprocessing on a BHI quantification is yet unknown. To this extent, here we investigate on four different EEG electrical referencing techniques associated with BHI quantifications over 4-minute resting-state in 15 healthy subjects. BHI methods include the synthetic data generation model, heartbeat-evoked potentials, heartbeat-evoked oscillations, and maximal information coefficient (MIC). EEG signals were offline referenced under the Cz channel, common average, mastoids average, and Laplacian method, and statistical comparisons were performed to assess similarities between references and between BHI techniques. Results show a topographical agreement between BHI estimation methods depending on the specific EEG reference. Major differences between BHI methods occur with the Laplacian reference, while major differences between EEG references are with the MIC analysis. We conclude that the choice of EEG electrical reference may significantly affect a functional BHI quantification.

Quantifying Functional Links between Brain and Heartbeat Dynamics in the Multifractal Domain: a Preliminary Analysis

Quantification of brain-heart interplay (BHI) has mainly been performed in the time and frequency domains. However, such functional interactions are likely to involve nonlinear dynamics associated with the two systems. To this extent, in this preliminary study we investigate the functional coupling between multifractal properties of Electroencephalography (EEG) and Heart Rate Variability (HRV) series using a channel- and time scale-wise maximal information coefficient analysis. Experimental results were gathered from 24 healthy volunteers undergoing a resting state and a cold-pressure test, and suggest that significant changes between the two experimental conditions might be associated with nonlinear quantifiers of the multifractal spectrum. Particularly, major brain-heart functional coupling was associated with the secondorder cumulant of the multifractal spectrum. We conclude that a functional nonlinear relationship between brain- and heartbeat-related multifractal sprectra exist, with higher values associated with the resting state.

Bacomics: a comprehensive cross area originating in the studies of various brain-apparatus conversations

The brain is the most important organ of the human body, and the conversations between the brain and an apparatus can not only reveal a normally functioning or a dysfunctional brain but also can modulate the brain. Here, the apparatus may be a nonbiological instrument, such as a computer, and the consequent brain-computer interface is now a very popular research area with various applications. The apparatus may also be a biological organ or system, such as the gut and muscle, and their efficient conversations with the brain are vital for a healthy life. Are there any common bases that bind these different scenarios? Here, we propose a new comprehensive cross area: Bacomics, which comes from brain-apparatus conversations (BAC) + omics. We take Bacomics to cover at least three situations: (1) The brain is normal, but the conversation channel is disabled, as in amyotrophic lateral sclerosis. The task is to reconstruct or open up new channels to reactivate the brain function. (2) The brain is in disorder, such as in Parkinson's disease, and the work is to utilize existing or open up new channels to intervene, repair and modulate the brain by medications or stimulation. (3) Both the brain and channels are in order, and the goal is to enhance coordinated development between the brain and apparatus. In this paper, we elaborate the connotation of BAC into three aspects according to the information flow: the issue of output to the outside (BAC-1), the issue of input to the brain (BAC-2) and the issue of unity of brain and apparatus (BAC-3). More importantly, there are no less than five principles that may be taken as the cornerstones of Bacomics, such as feedforward and feedback control, brain plasticity, harmony, the unity of opposites and systems principles. Clearly, Bacomics integrates these seemingly disparate domains, but more importantly, opens a much wider door for the research and development of the brain, and the principles further provide the general framework in which to realize or optimize these various conversations.

Heartbeat Dynamics Analysis under Cold-Pressure Test using Wavelet p-Leader Non-Gaussian Multiscale Expansions

Multiscale and multifractal (MF) analyses have been proven an effective tool for the characterisation of heartbeat dynamics in physiological and pathological conditions. However, pre-processing methods for the unevenly sampled heartbeat interval series are known to affect the estimation of MF properties. In this study, we employ a recently proposed method based on wavelet p-leaders MF spectra to estimate MF properties from cardiovascular variability series, which are also pre-processed through an inhomogeneous point-process modelling. Particularly, we exploit a non-Gaussian multiscale expansion to study changes in heartbeat dynamics as a response to a sympathetic elicitation given by the cold-pressor test. By comparing MF estimates from raw heartbeat series and the point-process model, results suggest that the proposed modelling provides features statistically discerning between stress and resting condition at different time scales. These findings contribute to a comprehensive characterization of autonomic nervous system activity on cardiovascular control during cold-pressor elicitation.

Functional Linear and Nonlinear Brain–Heart Interplay during Emotional Video Elicitation: A Maximum Information Coefficient Study

Brain and heart continuously interact through anatomical and biochemical connections. Although several brain regions are known to be involved in the autonomic control, the functional brain–heart interplay (BHI) during emotional processing is not fully characterized yet. To this aim, we investigate BHI during emotional elicitation in healthy subjects. The functional linear and nonlinear couplings are quantified using the maximum information coefficient calculated between time-varying electroencephalography (EEG) power spectra within the canonical bands (δ,θ,α,β and γ), and time-varying low-frequency and high-frequency powers from heartbeat dynamics. Experimental data were gathered from 30 healthy volunteers whose emotions were elicited through pleasant and unpleasant high-arousing videos. Results demonstrate that functional BHI increases during videos with respect to a resting state through EEG oscillations not including the γ band (>30 Hz). Functional linear coupling seems associated with a high-arousing positive elicitation, with preferred EEG oscillations in the θ band ([4,8) Hz) especially over the left-temporal and parietal cortices. Differential functional nonlinear coupling between emotional valence seems to mainly occur through EEG oscillations in the δ,θ,α bands and sympathovagal dynamics, as well as through δ,α,β oscillations and parasympathetic activity mainly over the right hemisphere. Functional BHI through δ and α oscillations over the prefrontal region seems primarily nonlinear. This study provides novel insights on synchronous heartbeat and cortical dynamics during emotional video elicitation, also suggesting that a nonlinear analysis is needed to fully characterize functional BHI.

Wavelet p-Leader Non-Gaussian Multiscale Expansions for EEG series: an Exploratory Study on Cold-Pressor Test

Brain dynamics recorded through electroencephalography (EEG) have been proven to be the output of a nonstationary and nonlinear system. Thus, multifractality of EEG series has been exploited as a useful tool for a neurophysiological characterization in health and disease. However, the role of EEG multifractality under peripheral stress is unknown. In this study, we propose to make use of a novel tool, the recently defined non-Gaussian multiscale analysis, to investigate brain dynamics in the range of 4-8Hz following a cold-pressor test versus a resting state. The method builds on the wavelet p-leader multifractal spectrum to quantify different types of departure from Gaussian and linear properties, and is compared here to standard linear descriptive indices. Results suggest that the proposed non-Gaussian multiscale indices were able to detect expected changes over the somatosensory and premotor cortices, over regions different from those detected by linear analyses. They further indicate that preferred responses for the contralateral somatosensory cortex occur at scales 2.5s and 5s. These findings contribute to the characterization of the so-called central autonomic network, linking dynamical changes at a peripheral and a central nervous system levels.