Heartbeat evoked potential (HEP) amplitude showed no difference between clinical conditions and healthy comparisons, precluding its current utility as a clinical biomarker.
Meta-Analysis
Does heartbeat evoked potential (HEP) amplitude differ between clinical conditions and healthy comparisons?
Current evidence is insufficient to establish heartbeat evoked potential amplitude as a clinical biomarker due to widespread methodological inconsistencies and heterogeneity.
The heartbeat evoked potential (HEP) is an electrophysiological indicator of cortical processing of cardiac signals and a putative neural index of cardiac interoception. Various clinical conditions are associated with disrupted heart-brain communication, raising the possibility that the HEP could serve as a valid biomarker of disrupted cardiac interoception. Yet there is limited understanding about how the HEP signal, and its various parameters, is associated with different health conditions. We synthesised the current evidence for HEP amplitude as a biomarker across all available clinical subpopulations using a random-effects multilevel meta-analysis. Secondly, we systematically characterised and quantitatively evaluated key HEP parameters, such as latency windows, reference electrodes, and scalp topographies across HEP studies (OSF Doi: 10.17605/OSF.IO/TMQ3W). Subgroup analyses for each condition showed no difference in HEP amplitude between clinical conditions relative to healthy comparisons; however, large negative effect estimates were found in neurological and cardiovascular diseases, though these were based on a small number of studies and should be interpreted with caution. In subsequent multivariate analysis, clinical category partially explained the global variability in HEP parameters. Based on these results, no firm conclusions can be drawn regarding the utility of HEP amplitude as a clinical biomarker. Substantial heterogeneity and widespread methodological inconsistencies across studies preclude definitive interpretations, and rigorous, standardised research is needed before the clinical value of HEP can be established.
Wilkinson et al. (Fri,) conducted a meta-analysis in Clinical subpopulations (health and disease). Heartbeat evoked potential (HEP) amplitude vs. Healthy comparisons was evaluated on Difference in HEP amplitude between clinical conditions and healthy comparisons. Heartbeat evoked potential (HEP) amplitude showed no difference between clinical conditions and healthy comparisons, precluding its current utility as a clinical biomarker.