Interoception and alexithymia are related to differences between the self-reported and the objectively measured physical activity in patients with chronic musculoskeletal pain

Learning from addiction: Craving of prescription opioids in chronic pain sufferers

Prescription opioids are a primary driver of opioid-related deaths. Although craving is a substantial component of OUD, the degree to which craving leads to misuse among chronic pain patients on long-term prescription opioids is unknown. A clear understanding of the factors that lead to misuse in this vulnerable population is needed for the development of safe and effective practices for opioid taper. This narrative review summarizes the relevant literature on the role of craving in addiction and chronic pain through epidemiological and behavioral studies. The first part of this review examines the role of craving in predicting opioid use/misuse in individuals with chronic pain with and without OUD. The second part covers methods on how craving is evaluated experimentally using both subjective and objective measures and provides related findings. The overall goal of this review is to facilitate the development of a population-specific description of craving in those who use opioids to control chronic pain and to describe how it may be mechanistically linked to patterns of opioid (mis)use.

Heartbeat tracking task performance, an indicator of interoceptive accuracy, is associated with improvement of exercise tolerance in patients undergoing home-based cardiac rehabilitation

Aims

Interoception is the sensing function of physiological conditions and is crucial in self-regulation and decision-making. We examined the association of heartbeat tracking task performance, an indicator of interoceptive accuracy, with the degree of improvement in exercise tolerance in patients undergoing home-based cardiac rehabilitation.

Methods and results

Participants underwent baseline peak oxygen uptake (VO₂) measurements and a heartbeat tracking task. The heartbeat tracking task score varies between 0 and 1, with higher scores indicating a better heartbeat perception. After 6 months of home-based exercise training, peak VO₂ was measured again, and the percentage change (%Δ peak VO₂) relative to the peak VO₂ at baseline was calculated. Univariate regression analysis was performed to examine the association between %Δ peak VO₂ and the heartbeat tracking task score. Multiple regression analysis was performed to determine the predictors of %Δ peak VO₂. Of 120 participants, 100 patients (age 65.9 ± 11.9 years; 86% male) were included. There was a significant positive association between %Δ peak VO₂ and the heartbeat tracking task score at baseline (R ² = 0.236, P < 0.001). In multiple regression analysis, the percentage of measured peak VO₂ to the predicted value (%predicted peak VO₂) (β = -0.248, P = 0.002), exercise adherence (β = 0.364, P < 0.001), and heartbeat tracking task score at baseline (β = 0.372, P < 0.001) were significantly associated with %Δ peak VO₂.

Conclusions

Heartbeat tracking task performance, an indicator of interoceptive accuracy, at baseline is associated with the degree of improvement in exercise tolerance.