Neurovisceral integration, emotions and health: An update

In the present paper we describe a model of neurovisceral integration in which a set of neural structures involved in cognitive, affective and autonomic regulation are related to heart rate variability (HRV) and health. We show that autonomic imbalance is associated with increased morbidity and mortality. We also provide evidence that this autonomic imbalance can be indexed by HRV. We then provide pharmacological and neuroimaging data in support of the neural structures linking the central nervous system to HRV. Next, in an experiment investigating emotional regulation we showed that resting levels of HRV were related to emotion modulated startle responses such that those with higher HRV produced context appropriate responses compared with those with low HRV. We then show that stimuli presented outside of conscious awareness lead to potentiated startle responses and undifferentiated phasic HR responses. These results suggest that the prefrontal cortex may modulate responses to threat via a top-down regulation of sympathoexcitatory circuits. We propose that these findings have important implications for the understanding of the two-way communication between the heart and the brain, and provide a connection among negative emotions and negative health consequences via the common mechanism of autonomic imbalance and low parasympathetic activity.