Fig. 1

Physiological human stress response. HPA hypothalamic–pituitary–adrenal axis; SAM sympatho adrenal medullary system; HR heart rate; BP: blood pressure; RMSSD root mean square of successive differences between normal heartbeats; α Alpha; β Beta; θ theta. Figure created using Biorender.com. The stress response is a dynamic process starting with the sympathetic activation of the SAM system generating large amounts of catecholamines (epinephrine and norepinephrine) within seconds, elevating HR and blood pressure, and decreasing HR variability (e.g. root mean square of successive differences between normal heartbeats [RMSSD]). It is followed by the HPA axis awakening producing peak levels of cortisol occurring 15 to 20 min after the stressor. Furthermore, electroencephalography investigations have consistently revealed that psychological stress heightens frontal beta oscillations, especially beta-2, whilst reducing theta and alpha oscillations