Cardiac–brain integration and stress: a mechanistic role for the heartbeat-evoked potential?

The heartbeat-evoked potential (HEP) is an electrophysiological marker of cortical heartbeat processing that offers an informative index of neural interoception (i.e. the central sensing and integration of internal bodily signals). Stress is known to influence both peripheral and central physiology, and the HEP provides a metric of heart-brain integration with explanatory power beyond that of either the cardiac response or the brain alone. Emerging evidence suggests that the HEP can provide informative insight into individual differences across a range of clinical and emotional measures, with the opportunity to advance our understanding of the mechanisms underlying acute and chronic stress responses. This short communication highlights the potential of the HEP as a future neurophysiological marker in stress research and provides a roadmap for future research to advance its investigation within the field of stress.