From:  The objective imperative: advancing chronic orofacial pain research with the brain-heart axis

 Integrating the BHA to link psychosocial factors and biological function.

Psychosocial componentCore mechanism (BHA)Proposed biomarkerMeasurement/InterpretationClinical link
Psychological distressHyperactive SN, high sympathetic driveCorrected QT interval (QTc)QTc shortening reflects heightened adrenergic signaling.Confirms biological stress
Self-efficacy/QOLHypoactive DMN, low parasympathetic toneHeart rate variability (HRV)Low HRV indicates poor ANS adaptability/flexibility.Objective measure of functional impairment.

BHA: brain-heart axis; SN: salience network; QOL: quality of life; DMN: default mode network; ANS: autonomic nervous system.