5/25/24, 3:34 AM The Brain-Heart Connection: Understanding How the Brain Influences Heart Function - Neurolutions

Key Brain Regions Involved in Heart Regulation

Several areas of the brain impact heart functioning. One key area is the
thalamus, located in the middle of the brain above the brainstem. It acts
as a critical hub region, or “relay station,” to direct diverse information
such as pain or cold to other areas of the brain. It is essential in
integrating diverse information being processed throughout the cerebral
cortex (4).

The hypothalamus is located below the thalamus and just above the
pituitary gland. The hypothalamus controls the ANS and pituitary system
as well as the release of various hormones. For the hypothalamus-
pituitary-hormone “loop” to maintain the proper balance of hormones in
the body, each element needs to function correctly (5).

When a stroke or Traumatic Brain Injury (TBI) damages the thalamus or

hypothalamus, both brain and heart functioning are negatively impacted.
This results in a heightened risk of death (6). For example, high blood
pressure is a common consequence of injury to the hypothalamus, and it
is strongly-linked to an increased risk of heart attack or sudden heart
failure.

How Injury to the Cerebrum can Result in Both Brain and Heart Impacts:
The cerebrum is the largest part of the brain. It enables movement and is
tied to speech and cognitive functioning such as memory and problem-
solving (7). Most strokes are caused by an arterial blood clot in the brain
that injures at least one site in the cerebrum. Its outer layer is called the
cerebral cortex; damage to it can negatively impact mood as well as the
above-described functional arenas.

Notably, chronic anxiety and depression are commonly observed in

cerebral injury due to stroke and TBI (8). These two neuropsychiatric
disorders are also linked to increased risk of heart disorders, primarily due
to changes in the levels of specific hormones in the bloodstream and/or
levels of brain chemicals that result from persistent anxiety and
depression. Moreover, a stroke or TBI affecting one brain location can

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5/25/24, 3:34 AM The Brain-Heart Connection: Understanding How the Brain Influences Heart Function - Neurolutions

have a secondary adverse impact on the hypothalamus, which controls

diverse bodily processes impacting overall heart health (9).

Neurotransmitters and Heart Function

Neurotransmitters are chemicals released in the brain that enable nerves
to carry “messages” to each other throughout the brain and the entire
nervous system. These neurotransmitters include (10):

Acetylcholine
Glutamate
Dopamine
Norepinephrine
Serotonin

Strokes, TBIs, brain tumors, brain infections, and other brain-damaging

events can interfere with the release of the neurotransmitters. Specific
amounts of neurotransmitter release are needed to maintain health and
proper body functioning, and adverse outcomes may arise when an
excess (or deficiency) of neurotransmitters is released.

Acetylcholine is the primary neurotransmitter associated with the PNS.

After our body’s flight or fight response occurs, acetylcholine enables the
heart rate and blood pressure to slow back to normal. Failure to return to
normal can lead to the chronic development of hypertension and an
excessively rapid heart rate, ultimately causing damage to the heart.

Dopamine enables us to feel pleasure, while serotonin is involved in

regulating mood inclusive of both optimism and chronic anxiety. In
particular, a low level of dopamine is associated with depression, chronic
fatigue, and loss of motivation. The result for a stroke or TBI survivor with
a chronically-lowered dopamine level can be reduced interest in
participating in rehabilitation therapy, adversely impacting overall health .

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