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Since stress levels are underpinned by both cardiac and neural factors, multidimensional insights are required to robustly understand their disruption in HTD. Yet, despite their crucial relevance, heart rate variability (HRV) and multimodal neurocognitive markers of stress in HTD remain controversial and unexplored respectively. To bridge this gap, we studied cardiodynamic as well as electrophysiological and neuroanatomical measures of stress in HTD patients and healthy controls. Both groups performed the Trier Social Stress Test (TSST), a validated stress\u2010inducing task comprising a baseline and a mental stress period. During both stages, we assessed a sensitive HRV parameter (the low frequency\/high frequency [LF\/HF ratio]) and an online neurophysiological measure (the heartbeat\u2010evoked potential [HEP]). Also, we obtained neuroanatomical data via voxel\u2010based morphometry (VBM) for correlation with online markers. Relative to controls, HTD patients exhibited increased LF\/HF ratio and greater HEP modulations during baseline, reduced changes between baseline and stress periods, and lack of significant stress\u2010related HRV modulations associated with the grey matter volume of putative frontrostriatal regions. Briefly, HTD patients presented signs of stress\u2010related autonomic imbalance, reflected in a potential basal stress overload and a lack of responsiveness to acute psychosocial stress, accompanied by neurophysiological and neuroanatomical alterations. These multimodal insights underscore the relevance of neurocognitive data for developing innovations in the characterization, prognosis and treatment of HTD and other conditions with autonomic imbalance. More generally, these findings may offer new insights into heart\u2013brain interactions.<\/jats:p>","DOI":"10.1111\/ejn.14979","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T05:52:30Z","timestamp":1600840350000},"page":"2836-2850","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Heart\u2013brain interactions during social and cognitive stress in hypertensive disease: A multidimensional approach"],"prefix":"10.1111","volume":"55","author":[{"given":"Agustina","family":"Legaz","sequence":"first","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Cognitive Neuroscience Center (CNC) Universidad de San Andr\u00e9s  Buenos Aires Argentina"},{"name":"Facultad de Psicolog\u00eda Universidad Nacional de C\u00f3rdoba  C\u00f3rdoba Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Yoris","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Institute of Cognitive and Translational Neuroscience (INCYT) INECO Foundation Favaloro University CONICET  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Sede\u00f1o","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sof\u00eda","family":"Abrevaya","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Institute of Cognitive and Translational Neuroscience (INCYT) INECO Foundation Favaloro University CONICET  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Martorell","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Institute of Cognitive and Translational Neuroscience (INCYT) INECO Foundation Favaloro University CONICET  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florencia","family":"Alifano","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Institute of Cognitive and Translational Neuroscience (INCYT) INECO Foundation Favaloro University CONICET  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-0114","authenticated-orcid":false,"given":"Adolfo M.","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Cognitive Neuroscience Center (CNC) Universidad de San Andr\u00e9s  Buenos Aires Argentina"},{"name":"Faculty of Education National University of Cuyo  Mendoza Argentina"},{"name":"Global Brain Health Institute (GBHI) University of California San Francisco (UCSF)  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6758-5101","authenticated-orcid":false,"given":"Agust\u00edn","family":"Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"National Scientific and Technical Research Council (CONICET)  Buenos Aires Argentina"},{"name":"Cognitive Neuroscience Center (CNC) Universidad de San Andr\u00e9s  Buenos Aires Argentina"},{"name":"Global Brain Health Institute (GBHI) University of California San Francisco (UCSF)  San Francisco CA USA"},{"name":"Universidad Aut\u00f3noma del Caribe  Barranquilla Colombia"},{"name":"Center for Social and Cognitive Neuroscience (CSCN) School of Psychology Universidad Adolfo Ib\u00e1\u00f1ez  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2013.11.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2016.11.001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2014.05.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.07.007"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.2000.0582"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116456"},{"key":"e_1_2_11_8_1","first-page":"490","article-title":"Beck Depression inventory\u2010II","volume":"78","author":"Beck A. 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