AccScience Publishing / BH / Online First / DOI: 10.36922/BH025480073
REVIEW ARTICLE

Brain–heart axis: Advances in clinical insights and future technologies

Jeewanjot Singh1* Ramandeep Singh1 Prabhjot Singh2
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1 Department of Pharmacology, School of Pharmacy, Desh Bhagat University, Mandi Gobindgarh, Punjab, India
2 Department of Pharmaceutics, School of Pharmacy, Desh Bhagat University, Mandi Gobindgarh, Punjab, India
Brain & Heart, 025480073 https://doi.org/10.36922/BH025480073
Received: 27 November 2025 | Revised: 4 April 2026 | Accepted: 8 April 2026 | Published online: 5 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The brain–heart axis is a complex bidirectional communication system involving neural, hormonal, and inflammatory pathways that mutually influence cardiovascular and neurological function. Disruption of this axis may play an important role in the pathogenesis and progression of both cardiovascular and neurological disorders. Stroke and acute brain injury may trigger cardiac dysfunction through proposed mechanisms of sympathetic hyperactivity, neuroinflammation, and oxidative stress. Takotsubo syndrome is widely considered a clinical example of cardiac dysfunction associated with extreme psychological stress, potentially mediated by catecholamine excess and autonomic imbalance. Autonomic dysfunction, characterized by sympathetic overactivity and parasympathetic withdrawal, has been frequently observed in brain–heart disorders, and heart rate variability is widely used as a potential biomarker of this dysregulation. Despite recent mechanistic insights, significant knowledge gaps remain regarding the relative contributions of different pathophysiological pathways, long-term consequences of brain–heart axis dysfunction, and optimal therapeutic strategies. This review aims to summarize recent clinical insights into brain–heart axis dysfunction and highlight emerging technologies for monitoring, diagnosis, and personalized intervention. Wearable monitoring devices and machine learning algorithms enable early detection of pathological changes and personalized interventions. Ultimately, a paradigm shift from organ-specific to integrated brain–heart precision medicine strategies is necessary to improve outcomes in this vulnerable patient population. Achieving this vision demands cross-disciplinary collaboration, standardization of data-collection and analysis protocols, and robust validation studies to translate discoveries into transformative clinical applications.

Keywords
Brain–heart axis
Autonomic nervous system
Neuro-cardiology
Takotsubo syndrome
Stroke
Heart rate variability
Cognitive impairment
Funding
None.
Conflict of interest
The authors declare that they have no conflict of interest.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing