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Migeot J, Hesse E, Fittipaldi S, Mejía J, Fraile M, García AM, García MDC, Ortega R, Lawlor B, Lopez V, Ibáñez A. Allostatic-interoceptive anticipation of social rejection. Neuroimage 2023; 276:120200. [PMID: 37245560 PMCID: PMC11163516 DOI: 10.1016/j.neuroimage.2023.120200] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/11/2023] [Accepted: 05/26/2023] [Indexed: 05/30/2023] Open
Abstract
Anticipating social stress evokes strong reactions in the organism, including interoceptive modulations. However, evidence for this claim comes from behavioral studies, often with inconsistent results, and relates almost solely to the reactive and recovery phase of social stress exposure. Here, we adopted an allostatic-interoceptive predictive coding framework to study interoceptive and exteroceptive anticipatory brain responses using a social rejection task. We analyzed the heart-evoked potential (HEP) and task-related oscillatory activity of 58 adolescents via scalp EEG, and 385 human intracranial recordings of three patients with intractable epilepsy. We found that anticipatory interoceptive signals increased in the face of unexpected social outcomes, reflected in larger negative HEP modulations. Such signals emerged from key brain allostatic-interoceptive network hubs, as shown by intracranial recordings. Exteroceptive signals were characterized by early activity between 1-15 Hz across conditions, and modulated by the probabilistic anticipation of reward-related outcomes, observed over distributed brain regions. Our findings suggest that the anticipation of a social outcome is characterized by allostatic-interoceptive modulations that prepare the organism for possible rejection. These results inform our understanding of interoceptive processing and constrain neurobiological models of social stress.
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Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Eugenia Hesse
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Departamento de Matemática y Ciencias, Universidad de San Andrés, Buenos Aires, Argentina
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California, San Francisco, United States and Trinity College Dublin, Ireland
| | - Jhonny Mejía
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Matías Fraile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Adolfo M García
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California, San Francisco, United States and Trinity College Dublin, Ireland; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | | | - Rodrigo Ortega
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Brian Lawlor
- Global Brain Health Institute, University of California, San Francisco, United States and Trinity College Dublin, Ireland
| | - Vladimir Lopez
- Escuela de Psicología, Facultad de Ciencias Sociales y Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California, San Francisco, United States and Trinity College Dublin, Ireland; Predictive Brain Health Modelling Group, Trinity College Dublin (TCD), Dublin, Ireland.
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52
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Zhang J, Chen D, Srirangarajan T, Theriault J, Kragel PA, Hartley L, Lee KM, McVeigh K, Wager TD, Wald LL, Satpute AB, Quigley KS, Whitfield-Gabrieli S, Barrett LF, Bianciardi M. Cortical and subcortical mapping of the allostatic-interoceptive system in the human brain: replication and extension with 7 Tesla fMRI. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.20.548178. [PMID: 37546889 PMCID: PMC10401932 DOI: 10.1101/2023.07.20.548178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
The brain continuously anticipates the energetic needs of the body and prepares to meet those needs before they arise, a process called allostasis. In support of allostasis, the brain continually models the internal state of the body, a process called interoception. Using published tract-tracing studies in non-human animals as a guide, we previously identified a large-scale system supporting allostasis and interoception in the human brain with functional magnetic resonance imaging (fMRI) at 3 Tesla. In the present study, we replicated and extended this system in humans using 7 Tesla fMRI (N = 91), improving the precision of subgenual and pregenual anterior cingulate topography as well as brainstem nuclei mapping. We verified over 90% of the anatomical connections in the hypothesized allostatic-interoceptive system observed in non-human animal research. We also identified functional connectivity hubs verified in tract-tracing studies but not previously detected using 3 Tesla fMRI. Finally, we demonstrated that individuals with stronger fMRI connectivity between system hubs self-reported greater interoceptive awareness, building on construct validity evidence from our earlier paper. Taken together, these results strengthen evidence for the existence of a whole-brain system supporting interoception in the service of allostasis and we consider the implications for mental and physical health.
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Affiliation(s)
- Jiahe Zhang
- Department of Psychology, Northeastern University, Boston, MA 02115
| | - Danlei Chen
- Department of Psychology, Northeastern University, Boston, MA 02115
| | | | - Jordan Theriault
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02139
| | | | - Ludger Hartley
- Department of Psychology, Northeastern University, Boston, MA 02115
| | - Kent M. Lee
- Department of Psychology, Northeastern University, Boston, MA 02115
| | - Kieran McVeigh
- Department of Psychology, Northeastern University, Boston, MA 02115
| | - Tor D. Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755
| | - Lawrence L. Wald
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02139
| | - Ajay B. Satpute
- Department of Psychology, Northeastern University, Boston, MA 02115
| | - Karen S. Quigley
- Department of Psychology, Northeastern University, Boston, MA 02115
| | | | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA 02115
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02139
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02139
| | - Marta Bianciardi
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02139
- Division of Sleep Medicine, Harvard University, Boston, MA
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53
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Zuo ZX, Price CJ, Farb NAS. A machine learning approach towards the differentiation between interoceptive and exteroceptive attention. Eur J Neurosci 2023; 58:2523-2546. [PMID: 37170067 PMCID: PMC10727490 DOI: 10.1111/ejn.16045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/07/2023] [Accepted: 05/09/2023] [Indexed: 05/13/2023]
Abstract
Interoception, the representation of the body's internal state, plays a central role in emotion, motivation and wellbeing. Interoceptive sensibility, the ability to engage in sustained interoceptive awareness, is particularly relevant for mental health but is exclusively measured via self-report, without methods for objective measurement. We used machine learning to classify interoceptive sensibility by contrasting using data from a randomized control trial of interoceptive training, with functional magnetic resonance imaging assessment before and after an 8-week intervention (N = 44 scans). The neuroimaging paradigm manipulated attention targets (breath vs. visual stimuli) and reporting demands (active reporting vs. passive monitoring). Machine learning achieved high accuracy in distinguishing between interoceptive and exteroceptive attention, both for within-session classification (~80% accuracy) and out-of-sample classification (~70% accuracy), revealing the reliability of the predictions. We then explored the classifier potential for 'reading out' mental states in a 3-min sustained interoceptive attention task. Participants were classified as actively engaged about half of the time, during which interoceptive training enhanced their ability to sustain interoceptive attention. These findings demonstrate that interoceptive and exteroceptive attention is distinguishable at the neural level; these classifiers may help to demarcate periods of interoceptive focus, with implications for developing an objective marker for interoceptive sensibility in mental health research.
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Affiliation(s)
- Zoey X. Zuo
- Department of Psychological Clinical Sciences, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Cynthia J. Price
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, USA
| | - Norman A. S. Farb
- Department of Psychological Clinical Sciences, University of Toronto Scarborough, Scarborough, Ontario, Canada
- Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada
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54
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Sandri A, Mingolla GP, Camonita G, Lippolis M, Tinazzi M, Antelmi E. Reduced Interoception Abilities in Patients with Restless Legs Syndrome. Mov Disord Clin Pract 2023; 10:1126-1130. [PMID: 37476313 PMCID: PMC10354597 DOI: 10.1002/mdc3.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 07/22/2023] Open
Abstract
Background Restless legs syndrome (RLS) is a complex sensorimotor disorder occurring with a typical circadian fashion. Association with additional features, like alexithymia and nocturnal compulsive behaviors further complicates the framework. Objectives To assess interoception in RLS. Methods A total of 25 RLS patients and 28 controls underwent the heartbeat tracking task (interoceptive accuracy [IAC]). RLS symptoms' frequency, disturbance and duration, nocturnal behaviors, interoceptive awareness (IAW), alexithymia, depressive and anxiety symptoms were also collected. Results RLS patients showed significant lower IAC (P = 0.0003) and IAW (P = 0.012), and reported more nocturnal eating behaviors (P < 0.001). IAC positively correlated with IAW (R = 0.32), and negatively correlated with age (R = -0.58). Nocturnal eating behavior negatively correlated with IAC (R = -0.44) and IAW (R = -0.50). Conclusions RLS patients presented reduced interoceptive abilities correlating with higher nocturnal eating behaviors. Future studies are needed to explore the role of interoception in RLS pathophysiology, also in relation to other sensorimotor aspects.
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Affiliation(s)
- Angela Sandri
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Gloria Pompea Mingolla
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Giorgia Camonita
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | | | - Michele Tinazzi
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Elena Antelmi
- Neurology Unit, Parkinson Disease and Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
- DIMI Department of Engineering and Medicine of InnovationUniversity of VeronaVeronaItaly
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55
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Scott KA, Tan Y, Johnson DN, Elsaafien K, Baumer-Harrison C, Eikenberry SA, Sa JM, de Lartigue G, de Kloet AD, Krause EG. Mechanosensation of the heart and gut elicits hypometabolism and vigilance in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.29.547073. [PMID: 37425814 PMCID: PMC10327188 DOI: 10.1101/2023.06.29.547073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Interoception broadly refers to awareness of one's internal milieu. Vagal sensory afferents monitor the internal milieu and maintain homeostasis by engaging brain circuits that alter physiology and behavior. While the importance of the body-to-brain communication that underlies interoception is implicit, the vagal afferents and corresponding brain circuits that shape perception of the viscera are largely unknown. Here, we use mice to parse neural circuits subserving interoception of the heart and gut. We determine vagal sensory afferents expressing the oxytocin receptor, hereafter referred to as NDGOxtr, send projections to the aortic arch or stomach and duodenum with molecular and structural features indicative of mechanosensation. Chemogenetic excitation of NDGOxtr significantly decreases food and water consumption, and remarkably, produces a torpor-like phenotype characterized by reductions in cardiac output, body temperature, and energy expenditure. Chemogenetic excitation of NDGOxtr also creates patterns of brain activity associated with augmented hypothalamic-pituitary-adrenal axis activity and behavioral indices of vigilance. Recurrent excitation of NDGOxtr suppresses food intake and lowers body mass, indicating that mechanosensation of the heart and gut can exert enduring effects on energy balance. These findings suggest that the sensation of vascular stretch and gastrointestinal distention may have profound effects on whole body metabolism and mental health.
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Affiliation(s)
- Karen A. Scott
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Yalun Tan
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Dominique N. Johnson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Khalid Elsaafien
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Caitlin Baumer-Harrison
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Sophia A. Eikenberry
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | - Jessica M. Sa
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
| | | | - Annette D. de Kloet
- Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL 32611, USA
| | - Eric G. Krause
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL 32611, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL 32611, USA
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56
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Wallman-Jones A, Nigg C, Benzing V, Schmidt M. Leave the screen: The influence of everyday behaviors on self-reported interoception. Biol Psychol 2023; 181:108600. [PMID: 37286096 DOI: 10.1016/j.biopsycho.2023.108600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/09/2023]
Abstract
The influence of physical activity on interoception is apparent, however little is known about within-person variability following physical activity and sedentary behavior in daily life. To test this, 70 healthy adults (Mage 21.67 ± 2.50) wore thigh-mounted accelerometers for 7-days, with self-reported interoception recorded on movement-triggered smartphones. Participants additionally reported the predominant activity type performed across the last 15 min. Investigating this timeframe, multi-level analyses revealed that each one-unit increase in physical activity was associated with an increase in self-reported interoception (B = 0.0025, p = .013), whereas contrastingly, each one-minute increase in sedentary behavior was associated with a decrease (B = -0.06. p = .009). Investigating the influence of different activity types in comparison to screen time behavior, both partaking in exercise (B = 4.48, p < .001) and daily-life physical activity (B = 1.21, p < .001) were associated with an increase in self-reported interoception. Regarding other behavior categories, non-screen time behavior both with (B = 1.13, p < .001) and without (B = 0.67, p = .004) social interaction were also associated with an increase in self-reported interoception compared to screen-time behavior. Extending from previous laboratory-based studies, these findings indicate that physical activity influences interoceptive processes in real-life, further supplemented by the novel and contrasting findings regarding sedentary behavior. Furthermore, associations with activity type reveal important mechanistic information, highlighting the importance of reducing screen-time behavior to preserve and support interoceptive perceptions. Findings can be used to inform health recommendations for reducing screen-time behavior and guiding evidence-based physical activity interventions to promote interoceptive processes.
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Affiliation(s)
| | - Carina Nigg
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Valentin Benzing
- Institute of Sport Science, University of Bern, Bern, Switzerland
| | - Mirko Schmidt
- Institute of Sport Science, University of Bern, Bern, Switzerland
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57
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Mayeli A, Al Zoubi O, White EJ, Chappelle S, Kuplicki R, Morton A, Bruce J, Smith R, Feinstein JS, Bodurka J, Paulus MP, Khalsa SS. Parieto-occipital ERP indicators of gut mechanosensation in humans. Nat Commun 2023; 14:3398. [PMID: 37311748 PMCID: PMC10264354 DOI: 10.1038/s41467-023-39058-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/24/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the neural processes governing the human gut-brain connection has been challenging due to the inaccessibility of the body's interior. Here, we investigated neural responses to gastrointestinal sensation using a minimally invasive mechanosensory probe by quantifying brain, stomach, and perceptual responses following the ingestion of a vibrating capsule. Participants successfully perceived capsule stimulation under two vibration conditions (normal and enhanced), as evidenced by above chance accuracy scores. Perceptual accuracy improved significantly during the enhanced relative to normal stimulation, which was associated with faster stimulation detection and reduced reaction time variability. Capsule stimulation induced late neural responses in parieto-occipital electrodes near the midline. Moreover, these 'gastric evoked potentials' showed intensity-dependent increases in amplitude and were significantly correlated with perceptual accuracy. Our results replicated in a separate experiment, and abdominal X-ray imaging localized most capsule stimulations to the gastroduodenal segments. Combined with our prior observation that a Bayesian model is capable of estimating computational parameters of gut-brain mechanosensation, these findings highlight a unique form of enterically-focused sensory monitoring within the human brain, with implications for understanding gut feelings and gut-brain interactions in healthy and clinical populations.
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Affiliation(s)
- Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Harvard Medical School/McLean Hospital, Boston, MA, USA
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Alexa Morton
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Jaimee Bruce
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Stephenson School of Biomedical Engineering, University of Oklahoma, Tulsa, OK, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA.
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA.
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58
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Kim CS. Free energy and inference in living systems. Interface Focus 2023; 13:20220041. [PMID: 37065269 PMCID: PMC10102732 DOI: 10.1098/rsfs.2022.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/18/2023] [Indexed: 04/18/2023] Open
Abstract
Organisms are non-equilibrium, stationary systems self-organized via spontaneous symmetry breaking and undergoing metabolic cycles with broken detailed balance in the environment. The thermodynamic free-energy (FE) principle describes an organism's homeostasis as the regulation of biochemical work constrained by the physical FE cost. By contrast, recent research in neuroscience and theoretical biology explains a higher organism's homeostasis and allostasis as Bayesian inference facilitated by the informational FE. As an integrated approach to living systems, this study presents an FE minimization theory overarching the essential features of both the thermodynamic and neuroscientific FE principles. Our results reveal that the perception and action of animals result from active inference entailed by FE minimization in the brain, and the brain operates as a Schrödinger's machine conducting the neural mechanics of minimizing sensory uncertainty. A parsimonious model suggests that the Bayesian brain develops the optimal trajectories in neural manifolds and induces a dynamic bifurcation between neural attractors in the process of active inference.
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Affiliation(s)
- Chang Sub Kim
- Department of Physics, Chonnam National University, Gwangju 61186, Republic of Korea
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59
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Luettich A, Sievers C, Alfaro Almagro F, Allen M, Jbabdi S, Smith SM, Pattinson KTS. Functional connectivity between interoceptive brain regions is associated with distinct health-related domains: A population-based neuroimaging study. Hum Brain Mapp 2023; 44:3210-3221. [PMID: 36939141 PMCID: PMC10171512 DOI: 10.1002/hbm.26275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/08/2023] [Accepted: 02/27/2023] [Indexed: 03/21/2023] Open
Abstract
Interoception is the sensation, perception, and integration of signals from within the body. It has been associated with a broad range of physiological and psychological processes. Further, interoceptive variables are related to specific regions and networks in the human brain. However, it is not clear whether or how these networks relate empirically to different domains of physiological and psychological health at the population level. We analysed a data set of 19,020 individuals (10,055 females, 8965 males; mean age: 63 years, age range: 45-81 years), who have participated in the UK Biobank Study, a very large-scale prospective epidemiological health study. Using canonical correlation analysis (CCA), allowing for the examination of associations between two sets of variables, we related the functional connectome of brain regions implicated in interoception to a selection of nonimaging health and lifestyle related phenotypes, exploring their relationship within modes of population co-variation. In one integrated and data driven analysis, we obtained four statistically significant modes. Modes could be categorised into domains of arousal and affect and cardiovascular health, respiratory health, body mass, and subjective health (all p < .0001) and were meaningfully associated with distinct neural circuits. Circuits represent specific neural "fingerprints" of functional domains and set the scope for future studies on the neurobiology of interoceptive involvement in different lifestyle and health-related phenotypes. Therefore, our research contributes to the conceptualisation of interoception and may lead to a better understanding of co-morbid conditions in the light of shared interoceptive structures.
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Affiliation(s)
- Alexander Luettich
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Carolin Sievers
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Fidel Alfaro Almagro
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Micah Allen
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
- Aarhus Institute of Advanced StudiesAarhus UniversityAarhusDenmark
- Cambridge PsychiatryUniversity of CambridgeCambridgeUK
| | - Saad Jbabdi
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Stephen M. Smith
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Kyle T. S. Pattinson
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
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60
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Revisiting uncertainty as a felt sense of unsafety: The somatic error theory of intolerance of uncertainty. J Behav Ther Exp Psychiatry 2023; 79:101827. [PMID: 36512913 DOI: 10.1016/j.jbtep.2022.101827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/24/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
Intolerance of uncertainty (IU) has gained widespread interest as a construct of broad interest from both transdiagnostic and trans-situational perspectives. We have approached this article inspired by the curiosity, clinical observation, consideration of different theoretical perspectives, speculation, optimism and indeed fun that can be seen in S. J. Rachman's work. We address some of what we know about IU before considering one way of conceptualizing IU from the standpoint of a felt sense or embodied experience. In the first part, we start with Woody and Rachman's (1994) observations of people with GAD. Second, we consider some key findings from the literature. Third, we consider two important perspectives on uncertainty, namely, Brosschot et al.'s (2016, 2018) influential Generalized Unsafety Theory of Stress and uncertainty as an emotion. In the second part, backing our clinical hunch about the importance of the felt sense of uncertainty, we consider IU from the perspective of interoception and the somatic error theory of anxiety (Khalsa & Feinstein, 2018). We propose the somatic error theory of intolerance of uncertainty, which places the experience of uncertainty at the heart of our understanding of intolerance of uncertainty. This is followed by predictions, unresolved questions, and potential clinical implications. Finally, we revisit Woody and Rachman's (1994) suggestions for treatment as internalizing "a sense of safety in a range of circumstances (p. 750)" and update this from the perspective of the felt sense of uncertainty. We finish by suggesting that uncertainty can be tolerated, perhaps accepted, and even embraced.
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61
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Villena-Gonzalez M, Rojas-Thomas F, Morales-Torres R, López V. Autonomous sensory meridian response is associated with a larger heartbeat-evoked potential amplitude without differences in interoceptive awareness. Psychophysiology 2023; 60:e14277. [PMID: 36841904 DOI: 10.1111/psyp.14277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/20/2022] [Accepted: 02/04/2023] [Indexed: 02/27/2023]
Abstract
Autonomous sensory meridian response (ASMR) describes the experience of a pleasant body sensation accompanied by a feeling of well-being and relaxation in response to specific audiovisual stimuli, such as whispers and personal attention. Previous work suggests a relationship between this experience with the processing of affective and body states; however, no research has explored differences in interoception between people experiencing ASMR and those who do not. We hypothesized that the ASMR experience is based on interoception processing. To test this, we assessed group differences across different dimensions of interoception: Interoceptive sensibility (IS), measured using the multidimensional assessment of interoceptive awareness (MAIA); Interoceptive accuracy score (IAS), measured by calculating performance in a heartbeat counting task (HCT), and the electrophysiological index of interoception, the heartbeat evoked potential (HEP), which was calculated during the HCT and an ASMR tingle reporting task (ASMR-TRT). Our results showed that IS and IAS, dimensions requiring conscious awareness, showed no differences between groups. However, HEP amplitude was larger in the ASMR group in both tasks. We concluded that the ASMR experience is based on an unconscious interoceptive mechanism, reflected by HEP, where exteroceptive social-affective stimuli are integrated to represent a body state of positive affective feelings and relaxation, as has been described for affective touch. The relevance of this finding relies on that interoceptive function, body regulation, and emotional/affective experiences are fundamental for well-being, and the relationship between ASMR and interoception opens the way to future research exploring the causal relationship between them and their potential clinical applications.
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Affiliation(s)
| | - Felipe Rojas-Thomas
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | | | - Vladimir López
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
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Nayok SB, Sreeraj VS, Shivakumar V, Venkatasubramanian G. A Primer on Interoception and its Importance in Psychiatry. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:252-261. [PMID: 37119217 PMCID: PMC10157017 DOI: 10.9758/cpn.2023.21.2.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 05/01/2023]
Abstract
Interoception is the perception of signals from inside the body. It plays a significant role in the nervous, cardiovascular, respiratory, gastrointestinal, genitourinary, and endocrine systems. It is also closely related to the autonomic nervous system and inflammatory pathways and plays a significant role in our optimal functioning. Recently, interoception has gained more attention in neuropsychiatric research. Anatomical and physiological aspects of interoception like relevant brain areas, the role of the vagus nerve, and the autonomic nervous system are gradually being understood. Different facets of interoception like interoceptive attention, detection, magnitude, discrimination, accuracy, awareness, and appraisal have been proposed and their assessments and importance are being evaluated. Further, interoception is often dysregulated or abnormal in psychiatric disorders. It has been implicated in the psychopathology, etiopathogenesis, clinical features and treatment of mood, anxiety, psychotic, personality and addiction-related disorders. This narrative review attempts to provide a nuanced understanding of the pathway(s), components, functions, assessments, and problems of interoception and will help us to detect its disturbances and evaluate its impact on psychiatric disorders, leading to a better perspective and management. This will also advance interoception-related research.
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Affiliation(s)
- Swarna Buddha Nayok
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Vanteemar S. Sreeraj
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Ganesan Venkatasubramanian
- Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
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Abstract
Frameworks of emotional development have tended to focus on how environmental factors shape children's emotion understanding. However, individual experiences of emotion represent a complex interplay between both external environmental inputs and internal somatovisceral signaling. Here, we discuss the importance of afferent signals and coordination between central and peripheral mechanisms in affective response processing. We propose that incorporating somatovisceral theories of emotions into frameworks of emotional development can inform how children understand emotions in themselves and others. We highlight promising directions for future research on emotional development incorporating this perspective, namely afferent cardiac processing and interoception, immune activation, physiological synchrony, and social touch.
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Affiliation(s)
- Kelly E Faig
- Department of Psychology, Hamilton College, 198 College Hill Road, Clinton, NY 13502
| | - Karen E Smith
- Department of Psychology, the University of Wisconsin, 1500 Highland Blvd, Madison, WI, 53705
| | - Stephanie J Dimitroff
- Department of Psychology, Universität Konstanz, Universitätsstraße 10, 78464 Konstanz, Germany
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The relationship between brain neural correlates, self-objectification, and interoceptive sensibility. Behav Brain Res 2023; 439:114227. [PMID: 36436730 DOI: 10.1016/j.bbr.2022.114227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/23/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022]
Abstract
Interoceptive sensibility refers to the tendency to focus on internal bodily states and the capacity to detect them. As the subjective dimension of interoception, interoceptive sensibility plays a key role in individuals' health. Self-objectification, a process by which individuals tend to adopt a third-person's perspective of their physical self, leads to decreased interoceptive sensibility. However, few studies regarding the neural basis of interoceptive sensibility and the underlying mechanism of the relationship between self-objectification and interoceptive sensibility have been conducted. In this study, we assessed the resting-state brain activity (fractional amplitude of low-frequency fluctuation, fALFF) and connectivity (resting-state functional connectivity, RSFC) of 442 college students. Whole-brain correlation analyses revealed that a higher level of interoceptive sensibility was linked to higher fALFF in the right inferior frontal gyrus (IFG) and left cerebellum and to lower fALFF in the left paracentral lobule and left superior/middle temporal gyrus. Interoceptive sensibility also was negatively associated with the RSFC between the right IFG and the right secondary somatosensory cortex (S2) and the right IFG and the ventral premotor cortex (VPC). These brain regions and connections are mainly responsible for switching attention to internal/external information and processing body-related somatosensory as well as sensory information. Mediation analyses suggested that the fALFF of the right IFG and the RSFC of IFG-S2 and IFG-VPC mediated the relationship between self-objectification and interoceptive sensibility. Overall, these results suggest that the IFG may be the neural marker of interoceptive sensibility and reveal several potential mediation models of the relationship between brain neural correlates and self-objectification and interoceptive sensibility.
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Mazzocco K, Milani A, Ciccarelli C, Marzorati C, Pravettoni G. Evidence for Choosing Qigong as an Integrated Intervention in Cancer Care: An Umbrella Review. Cancers (Basel) 2023; 15:1176. [PMID: 36831519 PMCID: PMC9954038 DOI: 10.3390/cancers15041176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Cancer is the second leading cause of noncommunicable disease death, with an increasing incidence. Qigong practice can moderate non-intrinsic, modifiable risk factors that act on the stress response using physical movements, breathing, and focused attention. The purpose of this umbrella review is to provide a concise summary to facilitate an evidence-based decision to integrate Qigong into cancer patients' care. Relevant systematic reviews and meta-analyses were identified and retrieved from the JBI database, Cochrane Library, PubMed, Embase, and CINAHL. Of all of the studies assessed, none found evidence of a risk to cancer patients, indicating that Qigong is a safe practice that can be used even by frail patients. The overall quality of life, cancer-related fatigue, and cognitive impairment were improved by Qigong. Different Qigong programs have different impacts on sleep quality and gastrointestinal problems, suggesting that longer practice sessions are required to achieve improvements. To maintain Qigong's effectiveness, an ordinary practice is essential, or such effectiveness will wear off. The use of biological markers in efficacy assessments needs to be more systematically studied. However, positive WBC, RBC, and CRP trends in Qigong practitioners are evident. Higher-quality clinical studies are necessary to measure variables more closely related to Qigong functioning and consider cancer's multifactorial nature.
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Affiliation(s)
- Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Via Santa Sofia 9/1, 20122 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IEO IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
| | - Alessandra Milani
- Nursing School, European Institute of Oncology, IEO IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
| | - Chiara Ciccarelli
- Nursing School, European Institute of Oncology, IEO IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IEO IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Via Santa Sofia 9/1, 20122 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IEO IRCCS, Via Giuseppe Ripamonti 435, 20141 Milan, Italy
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66
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Ueno D, Ohira H, Narumoto J. Editorial: Interoception and the autonomic nervous system: Investigating affect, decision-making, and mental health. Front Neurosci 2023; 16:1130324. [PMID: 36711126 PMCID: PMC9880537 DOI: 10.3389/fnins.2022.1130324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Daisuke Ueno
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan,*Correspondence: Daisuke Ueno ✉
| | - Hideki Ohira
- Department of Psychology, Graduate School of Informatics, Nagoya University, Nagoya, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Embodied empathy and abstract concepts' concreteness: Evidence from contemplative practices. PROGRESS IN BRAIN RESEARCH 2023. [DOI: 10.1016/bs.pbr.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
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Cardiac and Gastric Interoceptive Awareness Have Distinct Neural Substrates. eNeuro 2023; 10:ENEURO.0157-22.2023. [PMID: 36653188 PMCID: PMC9887674 DOI: 10.1523/eneuro.0157-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 12/15/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
Interoceptive awareness, an awareness of the internal body state, guides adaptive behavior by providing ongoing information on body signals, such as heart rate and energy status. However, it is still unclear how interoceptive awareness of different body organs are represented in the human brain. Hence, we directly compared the neural activations accompanying attention to cardiac (related to heartbeat) and gastric (related to stomach) sensations, which generate cardiac and gastric interoceptive awareness, in the same population (healthy humans, N = 31). Participants were asked to direct their attention toward heart and stomach sensations and become aware of them in a magnetic resonance imaging (MRI) scanner. The results indicated that the neural activations underlying gastric attention encompassed larger brain regions, including the occipitotemporal visual cortices, bilateral primary motor cortices, primary somatosensory cortex, left orbitofrontal cortex, and hippocampal regions. Cardiac attention, however, selectively activated the right anterior insula extending to the frontal operculum compared with gastric attention. Moreover, our detailed analyses focusing on the insula, the most relevant region for interoceptive awareness, revealed that the left dorsal middle insula encoded cardiac and gastric attention via different activation patterns, but the posterior insula did not. Our results demonstrate that cardiac and gastric attention evoke different brain activation patterns; in particular, the selective activation may reflect differences in the functional roles of cardiac and gastric interoceptive awareness.
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Crucianelli L, Ehrsson HH. The Role of the Skin in Interoception: A Neglected Organ? PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:224-238. [PMID: 35969893 PMCID: PMC9902974 DOI: 10.1177/17456916221094509] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In the past 2 decades, interoception has received increasing attention in the fields of psychology and cognitive science, as well as neuroscience and physiology. A plethora of studies adopted the perception of cardiac signals as a proxy for interoception. However, recent findings have cast doubt on the methodological and intrinsic validity of the tasks used thus far. Therefore, there is an ongoing effort to improve the existing cardiac interoceptive tasks and to identify novel channels to target the perception of the physiological state of the body. Amid such scientific abundancy, one could question whether the field has been partially neglecting one of our widest organs in terms of dimensions and functions: the skin. According to some views grounded on anatomical and physiological evidence, skin-mediated signals such as affective touch, pain, and temperature have been redefined as interoceptive. However, there is no agreement in this regard. Here, we discuss some of the anatomical, physiological, and experimental arguments supporting the scientific study of interoception by means of skin-mediated signals. We argue that more attention should be paid to the skin as a sensory organ that monitors the bodily physiological state and further propose thermosensation as a particularly attractive model of skin-mediated interoception.
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Affiliation(s)
- Laura Crucianelli
- Laura Crucianelli, Department of Neuroscience, Karolinska Institutet
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70
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Repetto C, Riva G. The neuroscience of body memory: Recent findings and conceptual advances. EXCLI JOURNAL 2023; 22:191-206. [PMID: 36998712 PMCID: PMC10043453 DOI: 10.17179/excli2023-5877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 04/01/2023]
Abstract
The body is a very special object, as it corresponds to the physical component of the self and it is the medium through which we interact with the world. Our body awareness includes the mental representation of the body that happens to be our own, and traditionally has been defined in terms of body schema and body image. Starting from the distinction between these two types of representations, the present paper tries to reconcile the literature around body representations under the common framework of body memory. The body memory develops ontogenetically from birth and across all the life span and is directly linked to the development of the self. Therefore, our sense of self and identity is fundamentally based on multisensory knowledge accumulated in body memory, so that the sensations collected by our body, stored as implicit memory, can unfold in the future, under suitable circumstances. Indeed, these sets of bodily information had been proposed as possible key factors underpinning several mental health illnesses. Following this perspective, the Embodied Medicine approach put forward the use of advanced technologies to alter the dysfunctional body memory to enhance people's well-being. In the last sections, recent experimental pieces of evidence will be illustrated that targeted specifically bodily information for increasing health and wellbeing, by means of two strategies: interoceptive feedback and bodily illusions. See also Figure 1(Fig. 1).
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Affiliation(s)
- Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- *To whom correspondence should be addressed: Claudia Repetto, Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy; Tel: + 39 02 7234 2585, E-mail:
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuropsychology Lab, Istituto Auxologico Italiano IRCCS, Milan, Italy
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71
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Cusack CE, Vanzhula IA, Levinson CA. The structure of eating disorder and somatic symptoms. J Affect Disord 2022; 319:397-406. [PMID: 36162678 DOI: 10.1016/j.jad.2022.09.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/18/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
Individuals with eating disorders (EDs) often present with somatic concerns in treatment, such as bloating, fullness, and feeling tight clothes on skin. However, most research generally focuses on general interoception (e.g., heartbeat) rather than sensations relevant to EDs (e.g., sensations related to the gastrointestinal system or body movement). In the current study (N = 181), we used network analysis to model the structure of ED symptoms and somatic concerns among individuals with anorexia nervosa, bulimia nervosa, and other specified feeding and eating disorder. Results showed that heightened sensitivity to somatic concerns had the highest strength centrality within a symptom network comprising ED and somatic symptoms. Exploratory graph analysis identified four symptom dimensions: cognitive-affective ED symptoms, behavioral ED symptoms, general interoception, and ED-specific proprioception. Findings suggest that heightened sensitivity to somatic concerns may maintain ED symptoms and mutually reinforce other somatic concerns. Implications concerning assessment and treatment of EDs are discussed.
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Affiliation(s)
- Claire E Cusack
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
| | - Irina A Vanzhula
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States of America.
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72
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Lv X, Gao F, Cao X. Skeletal interoception in bone homeostasis and pain. Cell Metab 2022; 34:1914-1931. [PMID: 36257317 PMCID: PMC9742337 DOI: 10.1016/j.cmet.2022.09.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/07/2022] [Accepted: 09/26/2022] [Indexed: 01/24/2023]
Abstract
Accumulating evidence indicates that interoception maintains proper physiological status and orchestrates metabolic homeostasis by regulating feeding behaviors, glucose balance, and lipid metabolism. Continuous skeletal remodeling consumes a tremendous amount of energy to provide skeletal scaffolding, support muscle movement, store vital minerals, and maintain a niche for hematopoiesis, which are processes that also contribute to overall metabolic balance. Although skeletal innervation has been described for centuries, recent work has shown that skeletal metabolism is tightly regulated by the nervous system and that skeletal interoception regulates bone homeostasis. Here, we provide a general discussion of interoception and its effects on the skeleton and whole-body metabolism. We also discuss skeletal interoception-mediated regulation in the context of pathological conditions and skeletal pain as well as future challenges to our understanding of these process and how they can be leveraged for more effective therapy.
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Affiliation(s)
- Xiao Lv
- Center for Musculoskeletal Research, Department of Orthopaedic Surgery and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21205, USA
| | - Feng Gao
- Center for Musculoskeletal Research, Department of Orthopaedic Surgery and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21205, USA
| | - Xu Cao
- Center for Musculoskeletal Research, Department of Orthopaedic Surgery and Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD 21205, USA.
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73
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Candia-Rivera D, Sappia MS, Horschig JM, Colier WNJM, Valenza G. Confounding effects of heart rate, breathing rate, and frontal fNIRS on interoception. Sci Rep 2022; 12:20701. [PMID: 36450811 PMCID: PMC9712694 DOI: 10.1038/s41598-022-25119-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies have established that cardiac and respiratory phases can modulate perception and related neural dynamics. While heart rate and respiratory sinus arrhythmia possibly affect interoception biomarkers, such as heartbeat-evoked potentials, the relative changes in heart rate and cardiorespiratory dynamics in interoceptive processes have not yet been investigated. In this study, we investigated the variation in heart and breathing rates, as well as higher functional dynamics including cardiorespiratory correlation and frontal hemodynamics measured with fNIRS, during a heartbeat counting task. To further investigate the functional physiology linked to changes in vagal activity caused by specific breathing rates, we performed the heartbeat counting task together with a controlled breathing rate task. The results demonstrate that focusing on heartbeats decreases breathing and heart rates in comparison, which may be part of the physiological mechanisms related to "listening" to the heart, the focus of attention, and self-awareness. Focusing on heartbeats was also observed to increase frontal connectivity, supporting the role of frontal structures in the neural monitoring of visceral inputs. However, cardiorespiratory correlation is affected by both heartbeats counting and controlled breathing tasks. Based on these results, we concluded that variations in heart and breathing rates are confounding factors in the assessment of interoceptive abilities and relative fluctuations in breathing and heart rates should be considered to be a mode of covariate measurement of interoceptive processes.
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Affiliation(s)
- Diego Candia-Rivera
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy.
| | - M Sofía Sappia
- Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW, Elst, The Netherlands
- Donders Institute for Brain, Behaviour and Cognition, Radboud University Nijmegen, 6525 EN, Nijmegen, The Netherlands
| | - Jörn M Horschig
- Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW, Elst, The Netherlands
| | - Willy N J M Colier
- Artinis Medical Systems, B.V., Einsteinweg 17, 6662 PW, Elst, The Netherlands
| | - Gaetano Valenza
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy
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74
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Migeot JA, Duran-Aniotz CA, Signorelli CM, Piguet O, Ibáñez A. A predictive coding framework of allostatic-interoceptive overload in frontotemporal dementia. Trends Neurosci 2022; 45:838-853. [PMID: 36057473 PMCID: PMC11286203 DOI: 10.1016/j.tins.2022.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/27/2022] [Accepted: 08/09/2022] [Indexed: 10/31/2022]
Abstract
Recent allostatic-interoceptive explanations using predictive coding models propose that efficient regulation of the body's internal milieu is necessary to correctly anticipate environmental needs. We review this framework applied to understanding behavioral variant frontotemporal dementia (bvFTD) considering both allostatic overload and interoceptive deficits. First, we show how this framework could explain divergent deficits in bvFTD (cognitive impairments, behavioral maladjustment, brain atrophy, fronto-insular-temporal network atypicality, aberrant interoceptive electrophysiological activity, and autonomic disbalance). We develop a set of theory-driven predictions based on levels of allostatic interoception associated with bvFTD phenomenology and related physiopathological mechanisms. This approach may help further understand the disparate behavioral and physiopathological dysregulations of bvFTD, suggesting targeted interventions and strengthening clinical models of neurological and psychiatric disorders.
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Affiliation(s)
- Joaquin A Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Claudia A Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Santiago, Chile
| | - Camilo M Signorelli
- Department of Computer Science, University of Oxford, Oxford, UK; Physiology of Cognition, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium; Cognitive Neuroimaging Unit, INSERM, Saclay, France
| | - Olivier Piguet
- The University of Sydney, School of Psychology and Brain & Mind Centre, Sydney, Australia
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California-San Francisco, San Francisco, CA, USA, and Trinity College Dublin, Dublin, Ireland.
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75
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Galvez-Pol A, Virdee P, Villacampa J, Kilner J. Active tactile discrimination is coupled with and modulated by the cardiac cycle. eLife 2022; 11:e78126. [PMID: 36222653 PMCID: PMC9671494 DOI: 10.7554/elife.78126] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 10/11/2022] [Indexed: 11/23/2022] Open
Abstract
Perception and cognition are modulated by the phase of the cardiac signal in which the stimuli are presented. This has been shown by locking the presentation of stimuli to distinct cardiac phases. However, in everyday life sensory information is not presented in this passive and phase-locked manner, instead we actively move and control our sensors to perceive the world. Whether active sensing is coupled and modulated with the cardiac cycle remains largely unknown. Here, we recorded the electrocardiograms of human participants while they actively performed a tactile grating orientation task. We show that the duration of subjects' touch varied as a function of the cardiac phase in which they initiated it. Touches initiated in the systole phase were held for longer periods of time than touches initiated in the diastole phase. This effect was most pronounced when elongating the duration of the touches to sense the most difficult gratings. Conversely, while touches in the control condition were coupled to the cardiac cycle, their length did not vary as a function of the phase in which these were initiated. Our results reveal that we actively spend more time sensing during systole periods, the cardiac phase associated with lower perceptual sensitivity (vs. diastole). In line with interoceptive inference accounts, these results indicate that we actively adjust the acquisition of sense data to our internal bodily cycles.
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Affiliation(s)
- Alejandro Galvez-Pol
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College LondonLondonUnited Kingdom
- Psychology Department, University of the Balearic IslandsPalma de MallorcaSpain
| | - Pavandeep Virdee
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College LondonLondonUnited Kingdom
| | - Javier Villacampa
- Psychology Department, University of the Balearic IslandsPalma de MallorcaSpain
| | - James Kilner
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College LondonLondonUnited Kingdom
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Wengrovius C, Zick S, Beltz AM, Wentz EE, Ulrich DA, Robinson LE. Relations among parent-reported physical activity and interoception in children. Physiol Behav 2022; 254:113895. [PMID: 35772479 DOI: 10.1016/j.physbeh.2022.113895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Interoception is the sense of one's internal body and emotional state; it plays a critical role in guiding self-regulatory behaviors. Physical activity (PA) can support interoceptive processes, but limited research has examined the association in children. This study explored the relations among parent-reported PA and several interoceptive domains in children aged 3 - 10 years old. METHODS Baseline data were analyzed from a cluster-randomized controlled study examining a yoga intervention (N = 122). Parents completed a questionnaire that included the Caregiver Questionnaire for Interoceptive Awareness, Second Edition (CQIA-2) and two measures of PA, the PROMIS Parent-Proxy Short Form (PROMIS-PA) and the adapted Burdette Proxy Report (aBPR-PA). Psychometrics of the CQIA-2 subscales were assessed and then used in subsequent analyses to examine the association between PA and interoceptive sensibility. RESULTS Seventy percent of the surveys were completed by mothers (30% by fathers), and their children (56% female, Mage = 5.81 ± 1.7 years) were predominately white. Across all children, PA had a significant positive relationship with interoceptive domains related to emotion and physical energy (p < 0.01). Children who met the PROMIS-PA "good" cutoff had a clearer sense of emotion and physical energy (F(2,115) = 4.30, p = 0.016, R2 = 0.070), compared to children who did not. Children's age predicted interoceptive sensibility of illness and toileting needs (F(1,116) = 14.16, p < 0.001, R2 = 0.109). CONCLUSION Children with higher PA levels were perceived to have better interoceptive sensibility of emotion and physical energy. Children's age was predictive of interoceptive domains representing the awareness of illness and toileting needs. Future work should consider incorporating direct measures of PA and child-reported interoceptive sensibility. A better understanding of their relationship will likely help guide the design of more effective interventions for health behavior development.
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Affiliation(s)
| | - Suzanna Zick
- University of Michigan, Ann Arbor, MI, United States.
| | | | - Erin E Wentz
- Upstate Medical University, Syracuse, New York, United States.
| | - Dale A Ulrich
- University of Michigan, Ann Arbor, MI, United States.
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Lee KS, Murphy J, Catmur C, Bird G, Hobson H. Furthering the language hypothesis of alexithymia: An integrated review and meta-analysis. Neurosci Biobehav Rev 2022; 141:104864. [PMID: 36087760 DOI: 10.1016/j.neubiorev.2022.104864] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/26/2022] [Accepted: 09/04/2022] [Indexed: 11/27/2022]
Abstract
Alexithymia, including the inability to identify and express one's own feelings, is a subclinical condition responsible for some of the socioemotional symptoms seen across a range of psychiatric conditions. The language hypothesis of alexithymia posits a language-mediated disruption in the development of discrete emotion concepts from ambiguous affective states, exacerbating the risk of developing alexithymia in language-impaired individuals. To provide a critical evaluation, a systematic review and meta-analysis of 29 empirical studies of language functioning in alexithymia was performed. A modest association was found between alexithymia and multi-domain language deficits (r = -0.14), including structural language, pragmatics, and propensity to use emotional language. A more theoretically-relevant subsample analysis comparing alexithymia levels in language-impaired and typical individuals revealed larger effects, but a limited number of studies adopted this approach. A synthesis of 11 emotional granularity studies also found an association between alexithymia and reduced emotional granularity (r = -0.10). Language impairments seem to increase the risk of alexithymia. Heterogeneous samples and methods suggest the need for studies with improved alexithymia assessments.
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Affiliation(s)
- Ka Shu Lee
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom; Yale Child Study Center, Yale School of Medicine, United States.
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Caroline Catmur
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - Geoffrey Bird
- Department of Experimental Psychology, Medical Sciences Division, University of Oxford, United Kingdom
| | - Hannah Hobson
- Department of Psychology, University of York, United Kingdom
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78
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Katsumi Y, Theriault JE, Quigley KS, Barrett LF. Allostasis as a core feature of hierarchical gradients in the human brain. Netw Neurosci 2022; 6:1010-1031. [PMID: 38800458 PMCID: PMC11117115 DOI: 10.1162/netn_a_00240] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/11/2022] [Indexed: 05/29/2024] Open
Abstract
This paper integrates emerging evidence from two broad streams of scientific literature into one common framework: (a) hierarchical gradients of functional connectivity that reflect the brain's large-scale structural architecture (e.g., a lamination gradient in the cerebral cortex); and (b) approaches to predictive processing and one of its specific instantiations called allostasis (i.e., the predictive regulation of energetic resources in the service of coordinating the body's internal systems). This synthesis begins to sketch a coherent, neurobiologically inspired framework suggesting that predictive energy regulation is at the core of human brain function, and by extension, psychological and behavioral phenomena, providing a shared vocabulary for theory building and knowledge accumulation.
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Affiliation(s)
- Yuta Katsumi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Karen S. Quigley
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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79
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Jungilligens J, Paredes-Echeverri S, Popkirov S, Barrett LF, Perez DL. A new science of emotion: implications for functional neurological disorder. Brain 2022; 145:2648-2663. [PMID: 35653495 PMCID: PMC9905015 DOI: 10.1093/brain/awac204] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/28/2022] [Accepted: 05/20/2022] [Indexed: 01/11/2023] Open
Abstract
Functional neurological disorder reflects impairments in brain networks leading to distressing motor, sensory and/or cognitive symptoms that demonstrate positive clinical signs on examination incongruent with other conditions. A central issue in historical and contemporary formulations of functional neurological disorder has been the mechanistic and aetiological role of emotions. However, the debate has mostly omitted fundamental questions about the nature of emotions in the first place. In this perspective article, we first outline a set of relevant working principles of the brain (e.g. allostasis, predictive processing, interoception and affect), followed by a focused review of the theory of constructed emotion to introduce a new understanding of what emotions are. Building on this theoretical framework, we formulate how altered emotion category construction can be an integral component of the pathophysiology of functional neurological disorder and related functional somatic symptoms. In doing so, we address several themes for the functional neurological disorder field including: (i) how energy regulation and the process of emotion category construction relate to symptom generation, including revisiting alexithymia, 'panic attack without panic', dissociation, insecure attachment and the influential role of life experiences; (ii) re-interpret select neurobiological research findings in functional neurological disorder cohorts through the lens of the theory of constructed emotion to illustrate its potential mechanistic relevance; and (iii) discuss therapeutic implications. While we continue to support that functional neurological disorder is mechanistically and aetiologically heterogenous, consideration of how the theory of constructed emotion relates to the generation and maintenance of functional neurological and functional somatic symptoms offers an integrated viewpoint that cuts across neurology, psychiatry, psychology and cognitive-affective neuroscience.
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Affiliation(s)
- Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
- Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sara Paredes-Echeverri
- Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA, USA
- Psychiatric Neuroimaging Division, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David L Perez
- Functional Neurological Disorder Unit, Division of Cognitive Behavioral Neurology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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80
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Candia-Rivera D. Brain-heart interactions in the neurobiology of consciousness. CURRENT RESEARCH IN NEUROBIOLOGY 2022; 3:100050. [PMID: 36685762 PMCID: PMC9846460 DOI: 10.1016/j.crneur.2022.100050] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
Recent experimental evidence on patients with disorders of consciousness revealed that observing brain-heart interactions helps to detect residual consciousness, even in patients with absence of behavioral signs of consciousness. Those findings support hypotheses suggesting that visceral activity is involved in the neurobiology of consciousness, and sum to the existing evidence in healthy participants in which the neural responses to heartbeats reveal perceptual and self-consciousness. More evidence obtained through mathematical modeling of physiological dynamics revealed that emotion processing is prompted by an initial modulation from ascending vagal inputs to the brain, followed by sustained bidirectional brain-heart interactions. Those findings support long-lasting hypotheses on the causal role of bodily activity in emotions, feelings, and potentially consciousness. In this paper, the theoretical landscape on the potential role of heartbeats in cognition and consciousness is reviewed, as well as the experimental evidence supporting these hypotheses. I advocate for methodological developments on the estimation of brain-heart interactions to uncover the role of cardiac inputs in the origin, levels, and contents of consciousness. The ongoing evidence depicts interactions further than the cortical responses evoked by each heartbeat, suggesting the potential presence of non-linear, complex, and bidirectional communication between brain and heartbeat dynamics. Further developments on methodologies to analyze brain-heart interactions may contribute to a better understanding of the physiological dynamics involved in homeostatic-allostatic control, cognitive functions, and consciousness.
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Affiliation(s)
- Diego Candia-Rivera
- Bioengineering and Robotics Research Center E. Piaggio and the Department of Information Engineering, School of Engineering, University of Pisa, Pisa, Italy
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81
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Ren Q, Marshall AC, Kaiser J, Schütz-Bosbach S. Multisensory Integration of Anticipated Cardiac Signals with Visual Targets Affects Their Detection among Multiple Visual Stimuli. Neuroimage 2022; 262:119549. [DOI: 10.1016/j.neuroimage.2022.119549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
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Smith JA, Eikenberry SA, Scott KA, Baumer-Harrison C, de Lartigue G, de Kloet AD, Krause EG. Oxytocin and cardiometabolic interoception: Knowing oneself affects ingestive and social behaviors. Appetite 2022; 175:106054. [PMID: 35447163 DOI: 10.1016/j.appet.2022.106054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/22/2022] [Accepted: 04/14/2022] [Indexed: 01/22/2023]
Abstract
Maintaining homeostasis while navigating one's environment involves accurately assessing and interacting with external stimuli while remaining consciously in tune with internal signals such as hunger and thirst. Both atypical social interactions and unhealthy eating patterns emerge as a result of dysregulation in factors that mediate the prioritization and attention to salient stimuli. Oxytocin is an evolutionarily conserved peptide that regulates attention to exteroceptive and interoceptive stimuli in a social environment by functioning in the brain as a modulatory neuropeptide to control social behavior, but also in the periphery as a hormone acting at oxytocin receptors (Oxtr) expressed in the heart, gut, and peripheral ganglia. Specialized sensory afferent nerve endings of Oxtr-expressing nodose ganglia cells transmit cardiometabolic signals via the Vagus nerve to integrative regions in the brain that also express Oxtr(s). These brain regions are influenced by vagal sensory pathways and coordinate with external events such as those demanding attention to social stimuli, thus the sensations related to cardiometabolic function and social interactions are influenced by oxytocin signaling. This review investigates the literature supporting the idea that oxytocin mediates the interoception of cardiovascular and gastrointestinal systems, and that the modulation of this awareness likewise influences social cognition. These concepts are then considered in relation to Autism Spectrum Disorder, exploring how atypical social behavior is comorbid with cardiometabolic dysfunction.
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Affiliation(s)
- Justin A Smith
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Sophia A Eikenberry
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Karen A Scott
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Caitlin Baumer-Harrison
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA
| | - Annette D de Kloet
- Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Department of Physiology and Functional Genomics, College of Medicine, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Eric G Krause
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Diseases, University of Florida, Gainesville, FL, USA; Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
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83
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Tan Y, Yan R, Gao Y, Zhang M, Northoff G. Spatial-topographic nestedness of interoceptive regions within the networks of decision making and emotion regulation: Combining ALE meta-analysis and MACM analysis. Neuroimage 2022; 260:119500. [PMID: 35872175 DOI: 10.1016/j.neuroimage.2022.119500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 05/28/2022] [Accepted: 07/20/2022] [Indexed: 10/17/2022] Open
Abstract
Prominent theories propose that interoception modulates our behavioral and emotional responses involving decision-making and emotion regulation. Are the regions implicated in interoception also spatially related to and possibly nested within the networks of decision making and emotion regulation? Addressing this question, we performed three meta-analyses of functional magnetic resonance imaging studies to identify the regions that are commonly activated by the three domains using activation likelihood estimation (ALE). Additionally, we assessed the coactivation pattern of identified common regions using meta-analytic connectivity modeling (MACM). The results showed major overlaps of interoception with both decision making and emotion regulation in specifically the right dorsal anterior insula. The pairwise contrast analyses confirmed this finding and revealed conjunction-based activities in decision making and emotion regulation in the dorsal anterior cingulate cortex (dACC). MACM based on the identified insula revealed a widespread convergent coactivation pattern with the left anterior insula, dACC, and bilateral thalamus which, together, constitute the salience network. Among these co-activated regions, bilateral insula and the dACC were shared among all three domains. These results suggest that the regions mediating interoception including intero-exteroceptive integration and salience attribution are contained and thus spatially nested within the more extensive networks recruited during decision making and emotion regulation.
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Affiliation(s)
- Yafei Tan
- School of Psychology, Central China Normal University, Wuhan 430079, Hubei Province, China; Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan 430079, Hubei Province, China
| | - Ranran Yan
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610000, Sichuan Province, China
| | - Yuan Gao
- School of Psychology, South China Normal University, Guangzhou, Guangdong Province, China
| | - Meng Zhang
- Department of Psychology, Xinxiang Medical University, Xinxiang 453003, Henan Province, China; Mental Illness and Cognitive Neuroscience Key Laboratory of Xinxiang (Xinxiang Medical University), Xinxiang 453003, Henan Province, China
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, Institute of Mental Health, Royal Ottawa Mental Health Centre and University of Ottawa, Ottawa, Ontario K1Z 7K4, Canada; Mental Health Center, Zhejiang University School of Medicine, Hangzhou 310013, Zhejiang Province, China; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou 310013, Zhejiang Province, China
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84
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Sun W, Ueno D, Narumoto J. Brain Neural Underpinnings of Interoception and Decision-Making in Alzheimer's Disease: A Narrative Review. Front Neurosci 2022; 16:946136. [PMID: 35898412 PMCID: PMC9309692 DOI: 10.3389/fnins.2022.946136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
This study reviews recent literature on interoception directing decision-making in Alzheimer's disease (AD). According to the somatic marker hypothesis, signals from the internal body direct decision-making and involve the ventromedial prefrontal cortex (vmPFC). After reviewing relevant studies, we summarize the brain areas related to interoception and decision-making (e.g., vmPFC, hippocampus, amygdala, hypothalamus, anterior cingulate cortex, and insular cortex) and their roles in and relationships with AD pathology. Moreover, we outline the relationship among interoception, the autonomic nervous system, endocrine system, and AD pathology. We discuss that impaired interoception leads to decreased decision-making ability in people with AD from the perspective of brain neural underpinning. Additionally, we emphasize that anosognosia or reduced self-awareness and metacognition in AD are remarkably congruent with the malfunction of the autonomic nervous system regulating the interoceptive network. Furthermore, we propose that impaired interoception may contribute to a loss in the decision-making ability of patients with AD. However, there still exist empirical challenges in confirming this proposal. First, there has been no standardization for measuring or improving interoception to enhance decision-making ability in patients with AD. Future studies are required to better understand how AD pathology induces impairments in interoception and decision-making.
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85
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Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, Fittipaldi S, Duran-Aniotz C, Slachevsky A, Santibañez R, Sigman M, García AM, Whelan R, Moguilner S, Ibáñez A. Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biol Psychiatry 2022; 92:54-67. [PMID: 35491275 PMCID: PMC11184918 DOI: 10.1016/j.biopsych.2022.02.955] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. METHODS We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). RESULTS Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. CONCLUSIONS Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
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Affiliation(s)
- Agustina Birba
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Hernando Santamaría-García
- PhD Neuroscience Program, Physiology and Psychiatry Departments, Pontificia Universidad Javeriana, Bogotá, Colombia; Memory and Cognition Center Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Pavel Prado
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Josefina Cruzat
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile
| | | | - Agustina Legaz
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Sol Fittipaldi
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Center for Geroscience, Brain Health and Metabolism, Santiago, Chile; Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Institute of Biomedical Sciences, Santiago, Chile; Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Santibañez
- Neurology Service, Hospital Dr. Sótero del Río, Santiago, Chile; Neurology Department, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mariano Sigman
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina; Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Adolfo M García
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland
| | - Robert Whelan
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sebastián Moguilner
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Agustín Ibáñez
- Latin American Brain Health Institute, Universidad Adolfo Ibáñez, Santiago, Chile; National Scientific and Technical Research Council, Buenos Aires, Argentina; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; Global Brain Health Institute, University of California San Francisco, San Francisco, California, and Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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86
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Schmitt CM, Schoen S. Interoception: A Multi-Sensory Foundation of Participation in Daily Life. Front Neurosci 2022; 16:875200. [PMID: 35757546 PMCID: PMC9220286 DOI: 10.3389/fnins.2022.875200] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of this article is to examine evidence that broadens the clinical perspective on interoception as an imperative consideration for individuals with mental health and sensory processing challenges. The central supposition is that interoception is broader than just signals from the viscera. Rather, interoception refers to perceptions of bodily signals and bodily states that construct a subjective representation of the experience. These representations are then utilized for categorizing the sensory attributes and constructing meaning. Thus, this updated conceptualization presents interoception as a complex multidimensional system, with bidirectional features. The interplay between the brain and the body is necessary to maintain homeostasis as well as respond adaptively to the changes in one's internal and external environment. As a sensory capacity, interoceptive information must be processed and interpreted before it can be integrated into a personal experiential history. Interoception supports both body and mental functions and as such, interoceptive processes support health and wellness by establishing a felt sense of psychological and physiological safety that is foundational to meaningful participation in life. The information presented in this article is central to the pursuit of evidence-based best practices for any professional wishing to integrate consideration of interoception into their clinical practice.
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Affiliation(s)
- Carolyn M. Schmitt
- Sensory Therapies and Research (STAR) Institute, Centennial, CO, United States
| | - Sarah Schoen
- Sensory Therapies and Research (STAR) Institute, Centennial, CO, United States
- Rocky Mountain University of Health Professions, Provo, UT, United States
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87
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Gianaros PJ, Rasero J, DuPont CM, Kraynak TE, Gross JJ, McRae K, Wright AG, Verstynen TD, Barinas-Mitchell E. Multivariate Brain Activity while Viewing and Reappraising Affective Scenes Does Not Predict the Multiyear Progression of Preclinical Atherosclerosis in Otherwise Healthy Midlife Adults. AFFECTIVE SCIENCE 2022; 3:406-424. [PMID: 36046001 PMCID: PMC9382946 DOI: 10.1007/s42761-021-00098-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 12/17/2021] [Indexed: 06/03/2023]
Abstract
Cognitive reappraisal is an emotion regulation strategy that is postulated to reduce risk for atherosclerotic cardiovascular disease (CVD), particularly the risk due to negative affect. At present, however, the brain systems and vascular pathways that may link reappraisal to CVD risk remain unclear. This study thus tested whether brain activity evoked by using reappraisal to reduce negative affect would predict the multiyear progression of a vascular marker of preclinical atherosclerosis and CVD risk: carotid artery intima-media thickness (CA-IMT). Participants were 176 otherwise healthy adults (50.6% women; aged 30-51 years) who completed a functional magnetic resonance imaging task involving the reappraisal of unpleasant scenes from the International Affective Picture System. Ultrasonography was used to compute CA-IMT at baseline and a median of 2.78 (interquartile range, 2.67 to 2.98) years later among 146 participants. As expected, reappraisal engaged brain systems implicated in emotion regulation. Reappraisal also reduced self-reported negative affect. On average, CA-IMT progressed over the follow-up period. However, multivariate and cross-validated machine-learning models demonstrated that brain activity during reappraisal failed to predict CA-IMT progression. Contrary to hypotheses, brain activity during cognitive reappraisal to reduce negative affect does not appear to forecast the progression of a vascular marker of CVD risk. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-021-00098-y.
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Affiliation(s)
- Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA
| | - Javier Rasero
- Department of Psychology, Carnegie Mellon University, 3131 Sennott Square, 210 S. Bouquet St, Pittsburgh, PA USA
| | - Caitlin M. DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA
| | - Thomas E. Kraynak
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA
| | - James J. Gross
- Department of Psychology, Stanford University, Stanford, CA USA
| | - Kateri McRae
- Department of Psychology, University of Denver, Denver, CO USA
| | - Aidan G.C. Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA
| | - Timothy D. Verstynen
- Department of Psychology, Carnegie Mellon University, 3131 Sennott Square, 210 S. Bouquet St, Pittsburgh, PA USA
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88
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Feldman MJ, Siegel E, Barrett LF, Quigley KS, Wormwood JB. Affect and Social Judgment: The Roles of Physiological Reactivity and Interoceptive Sensitivity. AFFECTIVE SCIENCE 2022; 3:464-479. [PMID: 36046009 PMCID: PMC9382998 DOI: 10.1007/s42761-022-00114-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 03/11/2022] [Indexed: 06/03/2023]
Abstract
Humans imbue the objects of their perception with affective meaning, a phenomenon called affective realism. The affective realism hypothesis proposes that a brain continually predicts the meaning of sensations (e.g., identifying a sound as a siren, or a visual array as a face) in part by representing the current state of the body and the immediate physiological impact that similar sensory events have entailed in the past. However, the precise contribution of physiological activity to experiences of affective realism remains unknown. In the present study, participants' peripheral physiological activity was recorded while they made social evaluative judgments of target faces displaying neutral expressions. Target faces were shown concurrent with affective images that were suppressed from reportable awareness using continuous flash suppression. Results revealed evidence of affective realism-participants judged target faces more positively when paired with suppressed positive stimuli than suppressed negative stimuli-but this effect was significantly less pronounced among individuals higher in cardiac interoceptive sensitivity. Moreover, while some modest differences in peripheral physiological activity were observed across suppressed affective stimulus conditions, physiological reactivity to affective stimuli did not directly predict social evaluative judgments. We explore the implications of these findings with respect to both theories of emotion and theories detailing a role for interoception in experiences of first-person subjectivity. Supplementary Information The online version contains supplementary material available at 10.1007/s42761-022-00114-9.
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Affiliation(s)
- Mallory J. Feldman
- University of North Carolina at Chapel Hill, 231 E. Cameron Ave, Chapel Hill, NC 27514 USA
| | | | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA 02115 USA
- Department of Psychiatry and the Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, Boston, MA USA
| | - Karen S. Quigley
- Department of Psychology, Northeastern University, Boston, MA 02115 USA
| | - Jolie B. Wormwood
- Department of Psychology, University of New Hampshire, Durham, NH 03824 USA
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89
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Disentangling the role of interoceptive sensibility in alexithymia, emotion dysregulation, and depression in healthy individuals. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractInteroception, a multifaceted concept defined as the perception of internal bodily signals, is crucially involved in mental health in general and in emotion regulation in particular, being interoceptive sensibility (IS) one of the most studied interoceptive processes. The main objective of this study was to explore the relationships between IS and emotion regulation processes, analyzing the role of the eight IS dimensions assessed by the Multidimensional Assessment of Interoceptive Awareness-2 (MAIA-2) in alexithymia, emotion dysregulation, and depression. Additionally, this study also aimed to validate the MAIA-2 in a Spanish sample. To do so, 391 healthy adults, native Peninsular Spanish speakers (61.0% women, Mage = 29.00, SDage = 11.40), completed the MAIA-2 and other self-reported questionnaires to measure alexithymia, emotion dysregulation, and depressive symptoms. Results showed that lower scores on the IS dimensions that involve an accepting attitude toward the bodily signals (e.g., not-worrying) were related to alexithymia and emotion dysregulation, which, in turn, predicted depression. Moreover, the eight-factor structure of the MAIA-2 was confirmed with acceptable fit indices. This study highlights the multidimensional nature of the IS and the relevance of IS dimensions that involve a positive appraisal of the body in regulating emotions.
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90
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Shaffer C, Westlin C, Quigley KS, Whitfield-Gabrieli S, Barrett LF. Allostasis, Action, and Affect in Depression: Insights from the Theory of Constructed Emotion. Annu Rev Clin Psychol 2022; 18:553-580. [PMID: 35534123 PMCID: PMC9247744 DOI: 10.1146/annurev-clinpsy-081219-115627] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The theory of constructed emotion is a systems neuroscience approach to understanding the nature of emotion. It is also a general theoretical framework to guide hypothesis generation for how actions and experiences are constructed as the brain continually anticipates metabolic needs and attempts to meet those needs before they arise (termed allostasis). In this review, we introduce this framework and hypothesize that allostatic dysregulation is a trans-disorder vulnerability for mental and physical illness. We then review published findings consistent with the hypothesis that several symptoms in major depressive disorder (MDD), such as fatigue, distress, context insensitivity, reward insensitivity, and motor retardation, are associated with persistent problems in energy regulation. Our approach transforms the current understanding of MDD as resulting from enhanced emotional reactivity combined with reduced cognitive control and, in doing so, offers novel hypotheses regarding the development, progression, treatment, and prevention of MDD.
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Affiliation(s)
- Clare Shaffer
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA; ,
| | - Christiana Westlin
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA; ,
| | - Karen S Quigley
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA; ,
- VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Susan Whitfield-Gabrieli
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA; ,
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA; ,
- Department of Psychiatry and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
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91
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Abstract
SignificanceThe capacity to sense interoceptive signals is thought to be fundamental to broad functions including, but not limited to, homeostasis and the experience of the self. While neuroanatomical evidence suggests that nonhuman animals-namely, nonhuman primates-may possess features necessary for interoceptive processing in a way that is similar to humans, behavioral evidence of this capacity is slim. We presented macaques with audiovisual stimuli that were either synchronous or asynchronous with their heartbeat and demonstrated that they view asynchronous stimuli, whether faster or slower, for a significantly longer period than they do synchronous stimuli.
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92
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Cazzato V, Vicario CM, Urgesi C. ‘When hunger makes everything better looking!’: The effect of hunger on the aesthetic appreciation of human bodies, faces and objects. BMC Psychol 2022; 10:98. [PMID: 35410301 PMCID: PMC8996537 DOI: 10.1186/s40359-022-00807-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Research evidence suggests that physiological state of hunger might affect preference for female body weight, such that hungrier, compared to satiate, men prefer heavier body weight and rate as more attractive heavier female figures. Here, we seek to extend these findings by comparing the effects of fasting and snack on aesthetics judgements of the bodies and faces of conspecifics and of objects in a sample of female and male participants.
Methods
Forty-four participants (women: n = 21, mean age = 23.70 yrs ± 0.62) provided aesthetic liking judgments of round and slim human bodies, faces and objects, under at least 12 h of overnight fasting and immediately after having eaten a snack (i.e., bananas). An anthropometric measure of adiposity (i.e., Body Mass Index, BMI) was also collected from each observer.
Results
Overall, we found that participants’ aesthetic judgements were higher for slim stimuli compared to round ones. However, after fasting, participants rated round stimuli as more attractive compared to when they had a snack. This hunger-based shift in ratings not only was apparent when stimuli depicted a human body or face, but also when they depicted an object, thus suggesting a general modification of observers’ aesthetic preference related to hunger. Importantly, this effect was modulated by participants’ BMI so that only participants with a high BMI provided higher aesthetic judgements for round stimuli after fasting than after a snack.
Conclusions
Our results demonstrated that both the modification of the physiological state and the individual differences in adiposity level of the observers might affect the aesthetic appreciation of the external world.
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93
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Labrenz F, Spisák T, Ernst TM, Gomes CA, Quick HH, Axmacher N, Elsenbruch S, Timmann D. Temporal dynamics of fMRI signal changes during conditioned interoceptive pain-related fear and safety acquisition and extinction. Behav Brain Res 2022; 427:113868. [PMID: 35364111 DOI: 10.1016/j.bbr.2022.113868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/14/2022] [Accepted: 03/28/2022] [Indexed: 12/18/2022]
Abstract
Associative learning and memory mechanisms drive interoceptive signaling along the gut-brain axis, thus shaping affective-emotional reactions and behavior. Specifically, learning to predict potentially harmful, visceral pain is assumed to succeed within very few trials. However, the temporal dynamics of cerebellar and cerebral fMRI signal changes underlying early acquisition and extinction of learned fear signals and the concomitant evolvement of safety learning remain incompletely understood. 3T fMRI data of healthy individuals from three studies were uniformly processed across the whole brain and the cerebellum including an advanced normalizing method of the cerebellum. All studies employed differential delay conditioning (N=94) with one visual cue (CS+) being repeatedly paired with visceral pain as unconditioned stimulus (US) while a second cue remained unpaired (CS-). During subsequent extinction (N=51), all CS were presented without US. Behavioral results revealed increased CS+-aversiveness and CS--pleasantness after conditioning and diminished valence ratings for both CS following extinction. During early acquisition, the CS- induced linearly increasing neural activation in the insula, midcingulate cortex, hippocampus, precuneus as well as cerebral and cerebellar somatomotor regions. The comparison between acquisition and extinction phases yielded a CS--induced linear increase in the posterior cingulate cortex and precuneus during early acquisition, while there was no evidence for linear fMRI signal changes for the CS+ during acquisition and for both CS during extinction. Based on theoretical accounts of discrimination and temporal difference learning, these results suggest a gradual evolvement of learned safety cues that engage emotional arousal, memory, and cortical modulatory networks. As safety signals are presumably more difficult to learn and to discriminate from learned threat cues, the underlying temporal dynamics may reflect enhanced salience and prediction processing as well as increasing demands for attentional resources and the integration of multisensory information. Maladaptive responses to learned safety signals are a clinically relevant phenotype in multiple conditions, including chronic visceral pain, and can be exceptionally resistant to modification or extinction. Through sustained hypervigilance, safety seeking constitutes one key component in pain and stress-related avoidance behavior, calling for future studies targeting the mechanisms of safety learning and extinction to advance current cognitive-behavioral treatment approaches.
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Affiliation(s)
- Franziska Labrenz
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Tamás Spisák
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas M Ernst
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Carlos A Gomes
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Harald H Quick
- High-Field and Hybrid Magnetic Resonance Imaging, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for MR Imaging, University of Duisburg-Essen, Essen, Germany
| | - Nikolai Axmacher
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Timmann
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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94
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Rodríguez Villar AJ. A Neuroscientific and Cognitive Literary Approach to the Treatment of Time in Calderón's Autos sacramentales. Front Integr Neurosci 2022; 16:780701. [PMID: 35418840 PMCID: PMC8996133 DOI: 10.3389/fnint.2022.780701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/24/2022] [Indexed: 11/14/2022] Open
Abstract
Time processing is a fundamental subject in cognitive sciences and neuroscience. Current research is deepening how our brains process time, revealing its essential role in human functionality and survival. In his autos sacramentales, Early Modern Spanish playwright Pedro Calderón de la Barca portrays the relationships between human inner workings and the Christian concept of time. These plays portray the experience of the present, the perception of the flow of time, the measure of time raging from seconds to eternity, and the mental travel necessary to inhabit the past and future with the help of memory and imagination. Calderón explores how the dramatic form can portray all these temporal phenomena and how that portrait of time can constrain the dramatic structure. The different parts of the brain in charge of executive decisions, projections, memories, computation, and calibration are the basis that leads these characters to make the choices that will take them to the future they have cast for themselves. This paper analyzes how the processes that Calderón ascribed to the soul of his characters in the 17th century relate to ongoing cognitive and neuroscientific findings.
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95
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People can identify the likely owner of heartbeats by looking at individuals’ faces. Cortex 2022; 151:176-187. [DOI: 10.1016/j.cortex.2022.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/21/2021] [Accepted: 03/01/2022] [Indexed: 02/07/2023]
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96
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Quadt L, Critchley H, Nagai Y. Cognition, emotion, and the central autonomic network. Auton Neurosci 2022; 238:102948. [PMID: 35149372 DOI: 10.1016/j.autneu.2022.102948] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/05/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
The demands of both mental and physical activity are integrated with the dynamic control of internal bodily states. The set of neural interactions that supports autonomic regulation extends beyond afferent-efferent homeostatic reflexes (interoceptive feedback, autonomic action) to encompass allostatic policies reflecting more abstract and predictive mental representations, often accessed as conscious thoughts and feelings. Historically and heuristically, reason is contrasted with passion, cognition with emotion, and 'cold' with 'hot' cognition. These categories are themselves arbitrary and blurred. Investigations of psychological processes have been generally pursued during states of musculoskeletal quiescence and are thus relatively insensitive to autonomic interaction with attentional, perceptual, mnemonic and decision-making processes. Autonomic psychophysiology has nevertheless highlighted the bidirectional coupling of distinct cognitive domains to the internal states of bodily arousal. More powerfully perhaps, in the context of emotion, autonomically mediated changes in inner bodily physiological states are viewed as intrinsic constituents of the expression of emotions, while their feedback representation is proposed to underpin emotional and motivational feelings. Here, we review the brain systems, encapsulated by the notion of central autonomic network, that provide the interface between cognitive, emotional and autonomic state. These systems span the neuraxis, overlap with the more general governance of behaviour, and represent district levels of proximity to survival-related imperatives. We touch upon the conceptual relevance of prediction and surprise to understanding the integration of cognition and emotion with autonomic control.
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Affiliation(s)
- Lisa Quadt
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK
| | - Hugo Critchley
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK; Sackler Centre for Consciousness Science, University of Sussex, UK; Sussex Partnership NHS Foundation Trust, UK.
| | - Yoko Nagai
- BSMS Department of Neuroscience, University of Brighton and University of Sussex, UK; Sussex Neuroscience, University of Sussex, UK
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97
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Candia-Rivera D, Catrambone V, Barbieri R, Valenza G. Functional assessment of bidirectional cortical and peripheral neural control on heartbeat dynamics: a brain-heart study on thermal stress. Neuroimage 2022; 251:119023. [PMID: 35217203 DOI: 10.1016/j.neuroimage.2022.119023] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
The study of functional brain-heart interplay (BHI) from non-invasive recordings has gained much interest in recent years. Previous endeavors aimed at understanding how the two dynamical systems exchange information, providing novel holistic biomarkers and important insights on essential cognitive aspects and neural system functioning. However, the interplay between cardiac sympathovagal and cortical oscillations still has much room for further investigation. In this study, we introduce a new computational framework for a functional BHI assessment, namely the Sympatho-Vagal Synthetic Data Generation Model, combining cortical (electroencephalography, EEG) and peripheral (cardiac sympathovagal) neural dynamics. The causal, bidirectional neural control on heartbeat dynamics was quantified on data gathered from 26 human volunteers undergoing a cold-pressor test. Results show that thermal stress induces heart-to-brain functional interplay sustained by EEG oscillations in the delta and gamma bands, primarily originating from sympathetic activity, whereas brain-to-heart interplay originates over central brain regions through sympathovagal control. The proposed methodology provides a viable computational tool for the functional assessment of the causal interplay between cortical and cardiac neural control.
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Affiliation(s)
- Diego Candia-Rivera
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy.
| | - Vincenzo Catrambone
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy
| | - Riccardo Barbieri
- Department of Electronics, Informatics, and Bioengineering, Politecnico di Milano, 20133, Milano, Italy
| | - Gaetano Valenza
- Bioengineering and Robotics Research Center E. Piaggio & Department of Information Engineering, School of Engineering, University of Pisa, 56122, Pisa, Italy
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98
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Zhou H, Gao Q, Chen W, Wei Q. Action Understanding Promoted by Interoception in Children: A Developmental Model. Front Psychol 2022; 13:724677. [PMID: 35264994 PMCID: PMC8900726 DOI: 10.3389/fpsyg.2022.724677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Action understanding of children develops from simple associative learning to mentalizing. With the rise of embodied cognition, the role of interoception in action observation and action understanding has received more attention. From a developmental perspective, this study proposes a novel developmental model that explores how interoception promotes action understanding of children across ages. In early infancy, most actions observed in infants come from interactions with their caregivers. Babies learn about action effects through automatic interoceptive processing and interoceptive feedback. Interoception in early infancy is not fully developed, such as the not fully developed gastrointestinal tract and intestinal nervous system. Therefore, in early infancy, action understanding is based on low-level and original interoceptive information. At this stage, after observing the actions of others, infants can create mental representations or even imitate actions without external visual feedback, which requires interoception to provide internal reference information. By early childhood, children begin to infer action intentions of other people by integrating various types of information to reach the mentalizing level. Interoception processing requires the integration of multiple internal signals, which promotes the information integration ability of children. Interoception also provides inner information for reasoning about action intention. This review also discussed the neural mechanisms of interoception and possible ways by which it could promote action understanding of children. In early infancy, the central autonomic neural network (CAN) automatically processes and responds to the actions of caregivers on infants, providing interoceptive information for action understanding of infants. In infancy, the growth of the somatomotor system provides important internal reference information for observing and imitating the actions of infants. In early childhood, the development of interoception of children facilitates the integration of internal and external information, which promotes the mentalization of action understanding of children. According to the proposed developmental model of action understanding of children promoted by interoception, there are multilevel and stage-dependent characteristics that impact the role of interoception in action understanding of children.
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Affiliation(s)
- Hui Zhou
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing, China
- Department of Psychology, Shaoxing University, Shaoxing, China
| | - Qiyang Gao
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing, China
- Department of Psychology, Shaoxing University, Shaoxing, China
| | - Wei Chen
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing, China
- Department of Psychology, Shaoxing University, Shaoxing, China
| | - Qiaobo Wei
- Center for Brain, Mind and Education, Shaoxing University, Shaoxing, China
- Department of Psychology, Shaoxing University, Shaoxing, China
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99
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Terpou BA, Lloyd CS, Densmore M, McKinnon MC, Théberge J, Neufeld RWJ, Jetly R, Lanius RA. Moral wounds run deep: exaggerated midbrain functional network connectivity across the default mode network in posttraumatic stress disorder. J Psychiatry Neurosci 2022; 47:E56-E66. [PMID: 35177485 PMCID: PMC8865964 DOI: 10.1503/jpn.210117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/22/2021] [Accepted: 12/05/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND A moral injury occurs when a deeply held moral code has been violated, and it can lead to the development of symptoms of posttraumatic stress disorder (PTSD). However, the neural correlates that differentiate moral injury and PTSD remain largely unknown. Intrinsic connectivity networks such as the default mode network (DMN) appear to be altered in people with PTSD who have experienced moral injury. However, brainstem, midbrain and cerebellar systems are rarely integrated into the intrinsic connectivity networks; this is a critical oversight, because these systems display marked differences in people with PTSD and are thought to underlie strong moral emotions such as shame, guilt and betrayal. METHODS We conducted an independent component analysis on data generated during script-driven memory recall of moral injury in participants with military- or law enforcement-related PTSD (n = 28), participants with civilian-related PTSD (n = 28) and healthy controls exposed to a potentially morally injurious event (n = 18). We conducted group-wise comparisons of functional network connectivity differences across a DMN-correlated independent component, with a particular focus on brainstem, midbrain and cerebellar systems. RESULTS We found stronger functional network connectivity in the midbrain periaqueductal grey (t 71 = 4.95, p FDR = 0.028, k = 39) and cerebellar lobule IX (t 71 = 4.44, p FDR = 0.046, k = 49) in participants with civilian-related PTSD as compared to healthy controls. We also found a trend toward stronger functional network connectivity in the midbrain periaqueductal grey (t 71 = 4.22, p FDR = 0.076, k = 60) in participants with military- or law enforcement-related PTSD as compared to healthy controls. LIMITATIONS The significant clusters were large, but resolution is generally lower for subcortical structures. CONCLUSION In PTSD, the DMN appears to be biased toward lower-level, midbrain systems, which may drive toxic shame and related moral emotions that are common in PTSD, highlighting the depth at which moral injuries are represented neurobiologically.
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Affiliation(s)
- Braeden A Terpou
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Chantelle S Lloyd
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Maria Densmore
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Margaret C McKinnon
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Jean Théberge
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Richard W J Neufeld
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Rakesh Jetly
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont
| | - Ruth A Lanius
- From the Department of Neuroscience (Terpou, Neufeld), the Department of Psychiatry (Lloyd, Densmore, Théberge, Neufeld, Lanius), the Department of Medical Biophysics (Théberge), the Department of Psychology (Neufeld), Western University, London, Ont.; the Imaging Division, Lawson Health Research Institute (Densmore, Lanius), the Department of Psychology, Neuroscience, and Behaviour (Lloyd), the Department of Psychiatry and Behavioural Neurosciences (McKinnon), McMaster University, Hamilton, Ont.; Mood Disorders Program, St. Joseph's Healthcare (McKinnon), Hamilton, Ont.; Homewood Research Institute (McKinnon, Lanius), Guelph, Ont.; Canadian Forces, Health Services (Jetly), Ottawa, Ont.
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Csecs JLL, Iodice V, Rae CL, Brooke A, Simmons R, Quadt L, Savage GK, Dowell NG, Prowse F, Themelis K, Mathias CJ, Critchley HD, Eccles JA. Joint Hypermobility Links Neurodivergence to Dysautonomia and Pain. Front Psychiatry 2022; 12:786916. [PMID: 35185636 PMCID: PMC8847158 DOI: 10.3389/fpsyt.2021.786916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/20/2021] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Autism, attention deficit hyperactivity disorder (ADHD), and tic disorder (Tourette syndrome; TS) are neurodevelopmental conditions that frequently co-occur and impact psychological, social, and emotional processes. Increased likelihood of chronic physical symptoms, including fatigue and pain, are also recognized. The expression of joint hypermobility, reflecting a constitutional variant in connective tissue, predicts susceptibility to psychological symptoms alongside recognized physical symptoms. Here, we tested for increased prevalence of joint hypermobility, autonomic dysfunction, and musculoskeletal symptoms in 109 adults with neurodevelopmental condition diagnoses. METHODS Rates of generalized joint hypermobility (GJH, henceforth hypermobility) in adults with a formal diagnosis of neurodevelopmental conditions (henceforth neurodivergent group, n = 109) were compared to those in the general population in UK. Levels of orthostatic intolerance and musculoskeletal symptoms were compared to a separate comparison group (n = 57). Age specific cut-offs for GJH were possible to determine in the neurodivergent and comparison group only. RESULTS The neurodivergent group manifested elevated prevalence of hypermobility (51%) compared to the general population rate of 20% and a comparison population (17.5%). Using a more stringent age specific cut-off, in the neurodivergent group this prevalence was 28.4%, more than double than the comparison group (12.5%). Odds ratio for presence of hypermobility in neurodivergent group, compared to the general population was 4.51 (95% CI 2.17-9.37), with greater odds in females than males. Using age specific cut-off, the odds ratio for GJH in neurodivergent group, compared to the comparison group, was 2.84 (95% CI 1.16-6.94). Neurodivergent participants reported significantly more symptoms of orthostatic intolerance and musculoskeletal skeletal pain than the comparison group. The number of hypermobile joints was found to mediate the relationship between neurodivergence and symptoms of both dysautonomia and pain. CONCLUSIONS In neurodivergent adults, there is a strong link between the expression of joint hypermobility, dysautonomia, and pain, more so than in the comparison group. Moreover, joint hypermobility mediates the link between neurodivergence and symptoms of dysautonomia and pain. Increased awareness and understanding of this association may enhance the management of core symptoms and allied difficulties in neurodivergent people, including co-occurring physical symptoms, and guide service delivery in the future.
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Affiliation(s)
- Jenny L. L. Csecs
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Valeria Iodice
- Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Charlotte L. Rae
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Alice Brooke
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Rebecca Simmons
- Neurodevelopmental Service, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Lisa Quadt
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Georgia K. Savage
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Nicholas G. Dowell
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Centre for Regenerative Medicine and Devices, University of Brighton, Brighton, United Kingdom
| | - Fenella Prowse
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Department of Medicine, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Kristy Themelis
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Christopher J. Mathias
- Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, United Kingdom
- Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
- Pickering Unit, Neurovascular Medicine, St Mary's Hospital, Imperial College London, London, United Kingdom
| | - Hugo D. Critchley
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
- Neurodevelopmental Service, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
| | - Jessica A. Eccles
- Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
- Research and Development, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
- Neurodevelopmental Service, Sussex Partnership NHS Foundation Trust, Sussex, United Kingdom
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