Feeling, learning from and being aware of inner states

interoceptive dimensions in neurodegeneration and stroke

Indira García-Cordero, Lucas Sedeño, Laura de la Fuente, Andrea Slachevsky, Gonzalo Forno, Francisco Klein, Patricia Lillo, Jesica Ferrari, Clara Rodriguez, Julian Bustin, Teresa Torralva, Sandra Baez, Adrian Yoris, Sol Esteves, Margherita Melloni, Paula Salamone, David Huepe, Facundo Manes, Adolfo M. García, Agustín Ibañez*

*Corresponding author for this work

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Interoception is acomplex process encompassing multiple dimensions, such as accuracy, learning and awareness. Here, we examined whether each of those dimensions relies on specialized neural regions distributed throughout the vast interoceptive network. To this end, we obtained relevant measures of cardiac interoception in healthy subjects and patients offering contrastive lesion models of neurodegeneration and focal brain damage: behavioural variant fronto-temporal dementia (bvFTD), Alzheimer’s disease (AD) and frontoinsular stroke. Neural correlates of the three dimensions were examined through structural and functional resting-state imaging, and online measurements of the heart-evoked potential (HEP). The three patient groups presented deficits in interoceptive accuracy, associated with insular damage, connectivity alterations and abnormal HEP modulations. Interoceptive learning was differentially impaired in AD patients, evidencing a key role of memory networks in this skill. Interoceptive awareness results showed that bvFTD and AD patients overestimated their performance; this pattern was related to abnormalities in anterior regions and associated networks subserving metacognitive processes, and probably linked to well-established insight deficits in dementia. Our findings indicate how damage to specific hubs in a broad fronto-temporo-insular network differentially compromises interoceptive dimensions, and how such disturbances affect widespread connections beyond those critical hubs. This is the first study in which a multiple lesion model reveals fine-grained alterations of body sensing, offering new theoretical insights into neuroanatomical foundations of interoceptive dimensions. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

Original languageEnglish
Article number20160006
Pages (from-to)1-10
Number of pages10
JournalPhilosophical Transactions of the Royal Society B: Biological Sciences
Volume371
Issue number1708
DOIs
Publication statusPublished - 19 Nov 2016
Externally publishedYes

Keywords

  • Awareness
  • Interoception
  • Learning
  • Neurodegenerative diseases
  • Stroke

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