Resting-state and task-evoked phase-amplitude coupling between cardiac and neural rhythms is sensitive to anxiety severity

Background. High-frequency heart-rate variability (HF-HRV) is a downstream marker of cortico-autonomic regulation linked to executive function. A recent proposal suggests it indexes regulatory processes because it is both a product of and contributor to neural organization within the prefrontal cortex. The oscillatory phase of HF-HRV has been reported to modulate fronto-central EEG amplitude at rest, and this coupling is attenuated in individuals with schizophrenia relative to healthy controls. We evaluated this brain-body correspondence in relation to anxiety symptomatology, which is likewise associated with autonomic dysregulation. Methods. Concurrent EEG and electrocardiography (ECG) were recorded in 22 nonclinical adults at rest and during a mental arithmetic task. Participants rated anxiety severity using the Generalized Anxiety Disorder 7-item scale (GAD-7). We evaluated between-person associations between anxiety severity and HF-HRV-EEG coupling, as well as within-person differences in coupling between rest and mental arithmetic. Results. Anxiety symptomatology was associated with decreased resting-state phase-amplitude coupling between HF-HRV phase and fronto-central theta amplitude, independent of EEG and HRV covariates. Relative to rest, HF-HRV-theta coupling increased during a cognitive task, independent of condition-related changes in EEG, HR, or respiration. Anxiety severity moderated the task-evoked changes in heart-brain coupling such that more anxious individuals exhibited larger condition-related differences. Simple-slope analyses indicated the effect of anxiety on coupling at rest was absent when engaged in a task. Conclusions. HF-HRV-theta phase-amplitude coupling captured anxiety-related and state-dependent variance not evident in conventional cardiac or neural indices. This coupling may index a state-sensitive component of cortico-autonomic regulation, although its putative functional role requires direct testing.