The brain–heart axis: effects of cardiovascular disease on the CNS and opportunities for central neuromodulationvan Weperen, Valerie Y. H.; Vaseghi, Marmar
doi: 10.1038/s41583-025-01000-6pmid: 41381719
Bidirectional, multilevel communication between the heart and the brain is pivotal for the beat-to-beat regulation of cardiac function and the close titration of cardiac output to meet metabolic demand. Given this bidirectional communication, it is perhaps not surprising that cardiac pathologies lead to changes in the central and peripheral autonomic nervous system, which in turn lead to further progression of cardiovascular disease. Within the CNS, structural and functional changes have been reported in the setting of hypertension and heart failure in multiple autonomic regions and nuclei, including the spinal cord, brainstem, hypothalamus and higher centres, such as the amygdala and thalamus. These alterations enhance the excitability of sympathetic neuronal populations and diminish the excitability of neurons within the parasympathetic nuclei, resulting in sympathovagal imbalance. The primary drivers of these structural and functional changes appear to be a combination of increased angiotensin signalling (both central and peripheral), neuroinflammation, oxidative stress and glial activation. Targeting the CNS in the setting of cardiovascular disease presents an exciting avenue for the field of neuromodulation.
In vivo multimodal neurochemical interfaces for real-time decoding of brain circuitKim, Yeji; Park, Seongjun
doi: 10.1038/s41583-025-01003-3pmid: 41381720
Neurochemical signalling has emerged as a rapid, versatile and indispensable layer of neural computation, operating alongside electrical activity to shape circuit dynamics, behaviour and disease progression. Decoding these signals in vivo requires sensing platforms that combine spatiotemporal resolution, molecular specificity and anatomical compatibility, capabilities beyond those of traditional sampling methods. Electrochemical technologies, from fast-scan cyclic voltammetry to molecular recognition sensors, deliver subsecond temporal resolution without genetic manipulation, whereas optical approaches using genetically encoded indicators achieve cell-specific measurements with high spatial precision. However, most existing implementations provide only a single sensing function, restricting measurements to a passive chemical dimension and limiting comprehensive or causal circuit analysis. Hybrid systems begin to bridge this gap by coupling stimulation and sensing within unified interfaces, enabling richer interrogation of brain networks. Building on this foundation, transformative multimodal platforms fundamentally expand the boundaries of chemical sensing, overcoming limitations in scope, resolution and accessibility, to enable brain-wide, multianalyte and remote operation. In doing so, they elevate in vivo neurochemical sensing to a frontier discipline, offering unprecedented opportunities to map, decode and therapeutically modulate the chemical logic that underlies cognition, behaviour and pathology.