Article Impact Level: HIGH Data Quality: STRONG Summary of Trends in Neurosciences, https://doi.org/10.1016/j.tins.2025.08.004 Dr. Arno Villringer et al.
Points
- Changes in mental and cardiovascular functions occur concurrently, even at short timescales down to subsecond dynamics.
- Brain–body states arise from the tight integration of the CNS, autonomic PNS, and the endocrine and cardiovascular systems.
- Brain–body states are characterized by dimensions like blood pressure, heart rate, and brain activity underlying mental functions.
- A dynamical systems approach categorizes stable brain–body patterns as micro-, meso-, or macro-states based on duration and reversibility.
- Emotions are microstates, stress is a meso-state, while depression, anxiety, and hypertension are examples of macro-states.
Summary
This paper conceptualizes the intricate link between cardiovascular and mental health through the lens of “brain–body states,” arising from the tight integration of the central nervous system (CNS) and autonomic peripheral nervous system (PNS) with the endocrine and cardiovascular systems. These states manifest across various timescales, from subsecond dynamics to long-term conditions, highlighting a continuous functional coupling between the heart and brain. The framework posits that changes in mental and cardiovascular functions occur concurrently, challenging traditional unidirectional or bidirectional causal explanations for comorbidity.
Utilizing a dynamical systems approach, the authors characterize brain–body states as continuously traversing a multidimensional state space defined by physiological activities such as blood pressure, heart rate, and brain activity, which underpin mental functions like cognition and emotion. Stable configurations within this state space are termed “attractors” and are categorized based on their duration and reversibility as micro-, meso-, or macro-states. For instance, emotions are presented as prototypical brain–body microstates, stress as a meso-state, while chronic conditions like depression, anxiety, and hypertension represent macro-states, reflecting different underlying neural interactions, hormonal signaling, and structural plasticity.
This conceptualization offers a unified framework for understanding the mutual dependence of cardiovascular and brain function over the lifespan and in disease development, moving beyond shared risk factors or linear causation. It suggests that specific variations in the integration of cardiovascular and neural function may predispose to and reflect diseases classically categorized as either cardiovascular or mental. The framework has broad conceptual and clinical implications, extensible to include immunological and metabolic dimensions, providing a testable hypothesis for investigating the co-occurrence of these conditions.
Link to the article: https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(25)00171-7
References
Villringer, A., Nikulin, V. V., & Gaebler, M. (2025). Brain–body states as a link between cardiovascular and mental health. Trends in Neurosciences, S0166223625001717. https://doi.org/10.1016/j.tins.2025.08.004
