Heartbeat-evoked responses in M/EEG: A systematic review of methods with suggestions for analysis and reporting

Abstract

Heartbeat-evoked responses (HER), as measured by electroencephalography (EEG) or magnetoencephalography (MEG), represent neural activity time-locked to heartbeats and are widely used as a marker of cardiac interoception in the study of brain-body interactions. However, HER studies report largely variable findings, at least partially due to methodological variability. To achieve consensus on HER processing and improve the reproducibility of findings, the field urgently requires a structured summary of the methods employed so far. To this end, we conducted a systematic review of 132 HER studies using non-invasive M/EEG recordings in humans. Our results reveal substantial heterogeneity across most steps of HER analysis, ranging from data acquisition and preprocessing to HER estimation and statistical approaches. The large diversity in the processing choices is accompanied by considerable proportions of unreported methodological information across reviewed studies, reaching up to 80% for key processing steps. In addition, less than 33% of studies had enough statistical power to reliably detect meta-level HER effects, while their reported spatiotemporal locations varied substantially. We provide a comprehensive reporting and quality control checklist to aid in the development of more standardized procedures, highlighting critical steps for robust HER investigations. Additionally, we share the full extracted dataset, including an interactive version, to support other researchers in answering additional specific questions they may have. We hope that these resources will improve the robustness, reproducibility, and transparency of research in the growing HER field.