Topography and morphology of heart action-related EEG potentials

Dirlich, Gerhard; Dietl, Thomas; Vogl, L.; Strian, F.

doi:10.1016/s0168-5597(98)00003-3

Cited by 50 publications

(50 citation statements)

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“…EEG measures of heart-related potentials are made more difficult by the superimposition of ECG waveform, generated within the myocardium, across scalp electrodes. Examining the influence of cardiac field artifacts (CFA) (21,23) reported that, after the ECG T wave (350-650 ms after R wave within these subjects), ECG amplitude dropped to Ͻ1% of total chest recorded ECG amplitude (and Ͻ0.04 V of at-scalp electrodes), providing a low-CFA window within which cortical activity may be measured without distortion from electrical discharges originating from the myocardium. After previous research (23), we selected a 140-ms epoch that occurred after the ECG T-wave (455-595 ms after R wave; Fig.…”

Section: Methodsmentioning

confidence: 99%

“…EEG methods have been applied to the study of afferent cardiac signals, where a heartbeat-evoked potential (HEP) has been described (17)(18)(19)(20). The circumscribed location of this HEP to frontal and central scalp (17,18,21,22) and particularly the observation that its amplitude predicts individual differences in interoceptive awareness (accuracy of heartbeat perception) (19) is consistent with a cardiac afferent source, arising from myocardial, carotid sinus and/or aortic arch baroreceptors, or perhaps mechanoreceptors within tissue distended by ejected blood (23)(24)(25). The association between HEP and pro-arrhythmic cardiac function however has not to date been investigated.…”

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confidence: 97%

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A cortical potential reflecting cardiac function

Gray

Taggart

Sutton

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

186

132

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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. afferent homeostatic feedback ͉ electroencephalography ͉ heart beat-evoked potential ͉ insula cortex ͉ ischemia

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 97%

A cortical potential reflecting cardiac function

Gray

Taggart

Sutton

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

186

132

View full text Add to dashboard Cite

show abstract

“…CEPs associated with cardiac sensation were first examined as heartbeat evoked potentials (HEPs) which are CEPs triggered by an R wave of the ECG and show a positive potential shift of about 250-600 ms after the R wave (Jones et al 1986;Schandry et al 1986;Montaya et al 1993;Dirlish et al 1997Dirlish et al , 1998Pollatos and Schandry 2004;Pollatos et al 2005;Gray et al 2007). HEPs are associated with cardiac sensation as evidenced by the fact that HEP amplitudes are greater in subjects with good heartbeat perception compared with those without it (Pollatos and Schandry 2004;Pollatos et al 2005).…”

Section: Implications Of Ceps With Cardiac Stimulationmentioning

confidence: 99%

“…Second, since electrical stimulation synchronously contracts the heart, it could also activate afferent receptors outside the heart, such as the great vessel baroreceptors and somatosensory receptors of the chest. Third, the results of heart cyclerelated EEG averaging are substantially contaminated by the cardiac electrical field (Dirlish et al 1997(Dirlish et al , 1998Pollatos and Schandry 2004;Pollatos et al 2005) (Fig. 1).…”

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confidence: 99%

Brain Responses to Cardiac Electrical Stimulation: A New EEG Method for Evaluating Cardiac Sensation

Suzuki

Hirose

Watanabe

et al. 2012

Tohoku J. Exp. Med.

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Although cardiac sensation, such as palpitation or chest pain, is common and is sometimes a malignant sign of heart diseases, the mechanism by which the human brain responds to afferent signals from the heart remains unclear. In this study, we investigated whether electrical stimulation of the heart provokes brain responses in humans. We examined 15 patients (age: 65.4 ± 3.1 years old, 11 males and 4 females) implanted with either a cardiac pacemaker or cardiac resynchronization therapy (CRT) device. Electroencephalogram (EEG) was simultaneously recorded from the vertex during right ventricular pacing at 70-100 beats/min at baseline (1.5 V) and intense (6-8 V) stimulation sessions. We evaluated brain responses to cardiac electrical stimulation by measuring cerebral potentials that were obtained by subtracting the average of 100 EEG waves triggered by cardiac pacing during baseline stimulation from those during the intense stimulation. Intense stimulation of the cardiac pacemaker or CRT device reproducibly induced cardiac sensation in 6 out of the 15 patients; namely, the remaining 9 patients showed no reproducible response. Brain responses were evident by averaging cerebral potentials from all of the 15 patients and those from 6 patients with reproducible cardiac sensation. To the best our knowledge, this is the first report that demonstrates the brain responses to cardiac electrical stimulation in humans. This new method should be useful for examining pathophysiology of cardiac diseases with pathological cardiac sensation, including cardiac anxiety and silent myocardial ischemia.

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“…sympathetic + para-sympathetic). The brain electrical activity accompanying cardio-afferent input has been studied to elucidate the processing of signals of cardiac origin [5][6] for cardiac arrhythmias. Abnormality in nerve conduction in efferent and afferent pathways innervating the heart thus could be thought as the early sign of cardiac disease in OSAS patients because abnormal afferent feedback signals may drive proarrhythmic autonomic effects on the heart, most likely interacting at the level of the brainstem.…”

Section: Introductionmentioning

confidence: 99%