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Reduced Heartbeat-Evoked Responses in a Near-Death Case Report

D. Candia-Rivera, C. Machado

Journal of Clinical Neurology June 1, 2023 DOI: 10.3988/jcn.2022.0415 (opens in new tab)

Study at a glance

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Characteristics Case study Case report Peer reviewed
Sample size 1
Population A patient who experienced ventricular fibrillation
Duration Approximately 20 h of EEG and EKG recording
Measures heartbeat-evoked responses (HERs), heart-rate variability (HRV), EEG power
Key findings As ventricular fibrillation progressed, heartbeat-evoked responses disappeared and overall physiological activity appeared to deteriorate, while parallel changes in EEG power and heart-rate variability were not pronounced. The authors suggest this indicates impaired communication between the central and autonomic nervous systems, and that reduced brain-heart interactions may reflect loss of consciousness and deterioration in overall health.

Abstract

Background and Purpose Whether brain–heart communication continues under ventricular fibrillation (VF) remains to be determined. There is weak evidence of physiological changes in cortical activity under VF. Moreover, brain–heart communication has not previously been studied in this condition. We aimed to measure parallel changes in heart-rate variability (HRV), cortical activity, and brain–heart interactions in a patient who experienced VF.

Methods: The EEG and EKG signals for the case report were acquired for approximately 20 h. We selected different 1-min-long segments based on the changes in the EKG waveform. We present the changes in heartbeat-evoked responses (HERs), HRV, and EEG power for each selected segment.

Results: The overall physiological activity appeared to deteriorate as VF proceeded. Brain–heart interactions measured using HERs disappeared, with a few aberrant amplitudes appearing occasionally. The parallel changes in EEG and HRV were not pronounced, suggesting the absence of bidirectional neural control.

Conclusions: Our measurements of brain–heart interactions suggested that the evolving VF impairs communication between the central and autonomic nervous systems. These results may support that reduced brain–heart interactions reflect loss of consciousness and deterioration in the overall health state.

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