Test anxiety (TA), a recognized form of social anxiety, is the most prominent cause of anxiety among students and, if left unmanaged, can escalate to psychiatric disorders. TA profoundly impacts both central and autonomic nervous systems, presenting as a dual manifestation of cognitive and autonomic components. While limited studies have explored the physiological underpinnings of TA, none have directly investigated the intricate interplay between the CNS and ANS in this context. In this study, we introduce a non-invasive, integrated neuro-cardiovascular approach to comprehensively characterize the physiological responses of 27 healthy subjects subjected to test anxiety induced via a simulated exam scenario. Our experimental findings highlight that an isolated analysis of electroencephalographic and heart rate variability data fails to capture the intricate information provided by a brain-heart axis assessment, which incorporates an analysis of the dynamic interaction between the brain and heart. With respect to resting state, the simulated examination induced a decrease in the neural control onto heartbeat dynamics at all frequencies, while the studying condition induced a decrease in the ascending heart-to-brain interplay at EEG oscillations up to 12Hz. This underscores the significance of adopting a multisystem perspective in understanding the complex and especially functional directional mechanisms underlying test anxiety.

考试焦虑（TA）是一种公认​​的社交焦虑形式，是学生焦虑的最主要原因，如果不加以控制，可能会升级为精神疾病。TA 深刻影响中枢神经系统和自主神经系统，表现为认知和自主神经成分的双重表现。虽然探索 TA 生理基础的研究有限，但没有人直接研究中枢神经系统 (CNS) 和自主神经系统 (ANS) 之间复杂的相互作用。在这项研究中，我们引入了一种非侵入性、综合神经心血管方法，以全面描述 27 名健康受试者在模拟考试场景中受到考试焦虑的生理反应。我们的实验结果强调，对脑电图和心率变异性数据的孤立分析无法捕获脑心轴评估提供的复杂信息，该评估结合了对大脑和心脏之间动态相互作用的分析。就静息状态而言，模拟检查导致所有频率下对心跳动态的神经控制减弱，而研究条件则导致脑电图振荡高达 12Hz 时心脑相互作用的上升减弱。这强调了采用多系统视角来理解考试焦虑背后复杂的、特别是功能性的定向机制的重要性。