Work

Dynamic cortical responses to premature contractions of the heart in humans

Year: 2026

Type: preprint

Abstract: Premature contractions (PCs), often perceived as transient stuttering of the heartbeat, are the most common arrhythmias and, when frequent, are associated with adverse cardiovascular outcomes. The neural response to PCs remains unclear, particularly whether it is confined to brainstem reflexes or also engages cortical systems involved in interoception. We studied 103 individuals with frequent PCs (51 atrial, 52 ventricular), and matched controls using simultaneous electrocardiography and electroencephalography; an additional 11 individuals with frequent PCs underwent concurrent functional magnetic resonance imaging with electrocardiography. PCs, especially ventricular PCs, were associated with reduced activity in the insular cortex and anterior cingulate cortex (ACC). The subsequent heartbeat elicited early increases in orbitofrontal and ACC activity. These findings reveal temporally structured cortical responses to PCs: reduced activity during PCs is compatible with diminished afferent cardiovascular signalling, whereas post-PC activity suggests rapid updating of internal representations following transient disruption of cardiac input.

Source: Research Square

DOI: 10.21203/rs.3.rs-10703389/v1