Vol. 7, Issue 1, Part A (2025)

The brain-heart axis functions as a sophisticated communication system which connects central nervous system operations with cardiovascular regulation through autonomic nervous system pathways and neurohumoral and neuroanatomical connections. This review provides an extensive analysis of the anatomical and physiological basis of this axis by focusing on the insula and hypothalamus and brainstem as they control cardiac function through sympathetic and parasympathetic nerve signals. The review examines brain-heart communication mechanisms through detailed analysis of the hypothalamic-pituitary-adrenal (HPA) axis alongside autonomic nervous system regulation and baroreflex and chemoreflex mechanisms and the essential functions of the vagus nerve and central autonomic network. The analysis investigates how neurological disorders starting with stroke and traumatic brain injury and including epilepsy and psychiatric conditions impact cardiac function and how cardiac diseases including heart failure and atrial fibrillation and myocardial infarction and cardiac arrest affect brain health. Neuroradiology functions as an emerging interdisciplinary field which combines diagnostic tools such as heart rate variability and brain imaging with novel therapeutic approaches including autonomic modulation therapies. The review examines specific examples of brain-heart interactions including Takotsubo cardiomyopathy and sudden unexpected death in epilepsy (SUDEP) and Parkinson’s disease and Alzheimer’s disease. The review identifies present research limitations while proposing future research paths that require interdisciplinary teamwork and enhanced neuroimaging and electrophysiology methods and artificial intelligence and machine learning applications in brain-heart research. The review presents translational and clinical implications to support integrated care approaches that enhance patient results in brain-heart axis-related diseases.