Attention to cardiac sensations enhances the heartbeat-evoked potential during exhalation

iScience, Journal Year: 2024, Volume and Issue: 27(4), P. 109586 - 109586

Published: March 27, 2024

Respiration and cardiac activity intricately interact through complex physiological mechanisms. The heartbeat-evoked potential (HEP) is an EEG fluctuation reflecting the cortical processing of signals. We recently found higher HEP amplitude during exhalation than inhalation a task involving attention to sensations. This may have been due reduced perception heightened attentional To investigate relationships between HEP, attention, respiration, we introduced experimental setup that included tasks related respiratory interoceptive exteroceptive attention. Results revealed increases over fronto-central electrodes. When phases were taken into account, primarily driven by heartbeats recorded exhalation, specifically task, while had minimal impact. These findings emphasize role respiration in could implications for interventions fine-tune interoception.

Language: Английский

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Highway to the danger zone? A cautionary account that GLP‐1 receptor agonists may be too effective for unmonitored weight loss

Obesity Reviews, Journal Year: 2024, Volume and Issue: 25(5)

Published: Feb. 6, 2024

Summary Glucagon‐like peptide 1 (GLP‐1) receptor agonists are revolutionizing obesity and type 2 diabetes treatment, delivering remarkable weight loss outcomes. These medications, leveraging the effects of insulin‐regulating hormone GLP‐1 via actions on peripheral central nervous system targets, have raised hopes with their bariatric surgery‐rivaling results. However, questions remain about long‐term safety efficacy. Drawing from our expertise in medicine psychiatry, we reflect upon experiences clinical use these medications delve into nuanced challenges risks they pose, particularly for those prone to disordered eating or diagnosed rare genetic diseases obesity. We contend that effectively managing within this “danger zone” necessitates (1) proactive screening continuous monitoring eating, (2) vigilant appetite‐related maladaptive responses, including food aversion dehydration, (3) ongoing assessment broader health impacts. A multifaceted, interdisciplinary approach melds medical, psychological, dietary, behavioral strategies is crucial tailored thorough care each patient.

Language: Английский

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There is no such thing as interoception

Frontiers in Psychology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 10, 2025

Interoception has emerged as a prominent construct in psychology, neuroscience, and medicine, referring to the perception processing of signals originating from within body (Craig, 2002;Khalsa et al., 2018). It is thought play crucial role emotional experience, self-regulation, various clinical conditions (Barrett & Simmons, 2015;Tsakiris Critchley, 2016). The notion interoception coherent system spanning different bodily domains gained traction, with researchers typically treating it unitary ability. However, mounting evidence challenges this conceptualization. In fact, large variability exists accuracy interoceptive channels (Vaitl, 1996;Ferentzi 2017;Ferentzi 2018: Harver 1993;Whitehead Drescher, 1980;Garfinkel 2016;Garfinkel 2017).While title article intentionally provocative, serves highlight critical issue field: namely that term "interoception" often used ways belie complexity diversity phenomena purports describe.The provided herein focuses primarily on across modalities, though we acknowledge encompasses multiple dimensions beyond (e.g., sensibility, awareness, attention, intensity). Even focused scope, data strongly suggests problematic. Such monolithic view mirrors both tension between categories (i.e., classes entities grouped by shared features) concepts mental representations capturing category's essence), reminiscent mosaic: afar, appears cohesive category or single image, but closer inspection reveals complex concept comprising distinct, unrelated subconcepts-akin individual tiles.In studies consistently find weak absent correlations behavioral performance tasks probing such cardiac, respiratory, gastrointestinal (Ferentzi 2018;Garfinkel 2016;Harver 1993).Associations indices affective variables also vary (Baranauskas 2017;Paulus Stein, 2010). next sections, review for dissociability abilities modalities. We focus more extensively studied perceptions: thermal signalsfoot_0 . Our central thesis progress training one domain does not necessarily translate others, contrary This akin athleticism sports: while proficiency tennis might transfer pickleball due similar demands, there's minimal skill disparate sports like golf water polo, which require vastly physical aptitudes. argue interoception, athleticism, best understood useful heuristic organizing distinct lines research, rather than empirical phenomenon. perspective important implications study treatment disorders involve aberrant interoception. Deficits modality may imply deficits necessitating development comprehensive multi-modal assessment, much how athletic potential sport doesn't guarantee success all sports. Interventions targeting specific be effective general training, just sport-specific yields better results fitness regimens. By embracing differentiated can develop precise valid models its health disease, acknowledging unique demands characteristics each modality.Interoceptive assessed through modality-specific tasks, designed measure sensitivity internal signals. these face several methodological impact their validity reliability. Heartbeat Counting Task (HCT) most widely cardioceptive (and mischaracterized "interoception"), been questioned. Studies have shown HCT influenced non-interoceptive processes, including time estimation prior knowledge heart rate (Desmedt 2018;Desmedt 2020;Ring Brener, 1996). Intelligence found mediate resting (Murphy Meta-analyses revealed non-significant associations outcomes 2022). Respiratory gastric are less studied, however instruments issues. Respiroceptive Resistance Sensitivity (RRST), where participants judge breathing difficulty under varying resistances (Nikoloa 2021). RRST factors anxiety asthma (Ritz 2020), limiting applicability certain populations. Water Load Test (WLT) measures having drink perceived fullness (Van Dyck test affected recent food intake, hydration status, differences stomach capacity (Mejia-Rivas, 2019). Thermoceptive accuracy, via classic temperature task dynamic matching task, based amount hair skin (Crucianelli 2021, Crucianelli 2022).Given limitations, considerable efforts made alternative accurately assess (review Garfinkel 2022;Schoeller 2024;Weng 2022;Desmedt 2023). For instance, Discrimination (HDT) minimizes reliance (Hickman 2022;Brener Kluvitse, 1988). Signal detection theory applied separate response biases (Garfinkel 2015, see Ring 2015;Larsson Furthermore, Occlusion Detection use balloon distension offer respiratory interoceptionfoot_2 , respectively (Faull 2017;Herbert 2012). Researchers turned examine relationships comprehensive, multimodal assessments interoception.A key line modalities comes examining (Schoeller 2024). If reflects ability, would expect individuals who excel perform well others. rarely case. al. (2016) cardiac using heartbeat discrimination resistance tasks. They no significant correlation scores two suggesting underlying abilities. Similar findings other comparing (Ehlers 2000;Pollatos lack concordance extends perception. Ferentzi (2018) administered battery gastrointestinal, pain sample. Correlations were mostly non-significant, indicating little variance. another study, (2022) relationship was thermoceptive accuracy. patterns when somatic visceral (Michael 2015;Steptoe Vögele, 1992). given domain, variants yield discrepant results. example, counting frequently show low (Schulz 2013;Ring Evidence differs males females (Fairlough Goodwin, 2007). even ostensibly tap into facets Alternatively, possible apparent convergence among limitations themselves, need rigorously validated sensitive measures, capture computations. Indeed, interventional methodologies actively modulate physiological states-such controlled loading satiation-have awareness related greater functions, there processes (see Herbert 2012).The striking neuroanatomical substrates underlie insula anterior cingulate cortex 2009;Critchley 2004). While regions integrate systems, integration give rise an oversimplification. heterogeneous structure supporting divergent neural pathways. Engelen (2023) showed fundamental rhythms-particularly cycles-entrain shape activity throughout brain. Their work highlights mechanoreceptors relay vagal spinal pathways integrative hubs cortex. These inputs, turn, widespread cortical subcortical networks, influencing perception, cognition, emotion. same mismatch conceptualization measurement reviewed Desmedt colleagues demonstrate routes sensing, further substantiating dissociations observed tasks.Another differential phenomena. phenomenon, domains. some heightened Breuer, 1992;Pollatos 2009), others reported reduced (Asmundson 1993;De Pascalis increased higher contrast, impaired (Paulus 2010;Van den Bergh discrepancies suggest likely modality-dependent. Similarly, depression linked domains, (Park 2022, Avery 2015) thermoception (Happel-Barlow 1999;Crucianelli 2024), cardioception (Dunn Eating patterns, reporting decreased (Pollatos 2008) (Klabunde 2013;Khalsa al 2015). symptoms psychopathology global deficit, selective impairments channels. Table 1 incongruent Importantly, objective subjective symptom reports dissociated (De 2021;Paulus Individuals high report sensations if unimpaired (Petersen Interestingly, discrepancy self-perceived objectively measured ability limited disorders. experienced meditators, despite belief enhanced abilities, controls (Khalsa 2008). importance distinguishing correlates (Heim 2023).If existed limited. Interoceptive interventions domain-specific effects without generalizing biofeedback improves (Goessl 2017) enhancing awareness.Meditation practices, offering illustrate transfer. Despite being associated insular grey matter (Hölzel 2011), varies traditions highlighting specificity training. Mindfulness-based emphasizing breath increase (Daubenmier 2013) inconsistent (Parkin 2014), underscoring nature improvements.The Khalsa (2008) provides additional Tibetan Buddhist Kundalini practitioners improvement confidence practices incorporate they don't explicitly emphasize it, present, tends heartbeat. meditation improvements emphasized training.It's worth noting full extent enhancements meditators yet fully captured current research methodologies. Meditators subtle (Mylius, 2023) experiences diminished boundaries altered during (Gutiérrez 2022;Thönes Wittmann, experiences, intriguing, do indicate skills systems.The consistent cognitive mechanisms aspects emphasizes applications. benefit dysfunctional (Meuret 2005), gastrointestinal-focused could relevant eating (Shibata targeted approaches modalities.The above conceptualization, measurement, application interoception.1. First, should cautious about Ideally, systematically profile individual's 2. Second, established proxies problematic cross-modal convergence. Multidimensional batteries tapping sensitivity, awareness) provide accurate assessment. 3. Third, move one-size-fits-all approach consider profiles Identifying selectively condition inform interventions. patients generalized disorder respiratory-focused those anorexia nervosa 4. Fourth, future investigate modality, involved influence Longitudinal tracking shed light divergence. 5. Fifth, somatosensory sensations, potentially leading misinterpretation Future aim disentangle expectation, actual populations modalities.While against discount value construct. showcased examines dissociate-as demonstrated showing argument non-unitary grounded opens broader questions experience.Interoception remains umbrella inner affect, behavior. clear level analysis operating at conflate claims interoception.FS NR supported grant Mordechai Walder Charitable Fund. past years, FS founded received compensation BeSound SAS Nested Minds LTD. funded European Commission, Joy Ventures, French Ministry Armed Forces (AID). All authors declare competing interests. funders had design, collection analysis, decision publish, preparation manuscript.

Language: Английский

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Parieto-occipital ERP indicators of gut mechanosensation in humans

Nature Communications, Journal Year: 2023, Volume and Issue: 14(1)

Published: June 13, 2023

Understanding the neural processes governing human gut-brain connection has been challenging due to inaccessibility of body's interior. Here, we investigated responses gastrointestinal sensation using a minimally invasive mechanosensory probe by quantifying brain, stomach, and perceptual following ingestion vibrating capsule. Participants successfully perceived capsule stimulation under two vibration conditions (normal enhanced), as evidenced above chance accuracy scores. Perceptual improved significantly during enhanced relative normal stimulation, which was associated with faster detection reduced reaction time variability. Capsule induced late in parieto-occipital electrodes near midline. Moreover, these 'gastric evoked potentials' showed intensity-dependent increases amplitude were correlated accuracy. Our results replicated separate experiment, abdominal X-ray imaging localized most stimulations gastroduodenal segments. Combined our prior observation that Bayesian model is capable estimating computational parameters mechanosensation, findings highlight unique form enterically-focused sensory monitoring within implications for understanding gut feelings interactions healthy clinical populations.

Language: Английский

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Ingestible pills reveal gastric correlates of emotions

eLife, Journal Year: 2024, Volume and Issue: 13

Published: June 4, 2024

Although it is generally held that gastrointestinal (GI) signals are related to emotions, direct evidence for such a link currently lacking. One of the reasons why internal milieu GI system poorly investigated because visceral organs difficult access and monitor. To directly measure influence endoluminal markers activity on emotional experience, we asked group healthy male participants ingest pill measured pH, pressure, temperature their tract while they watched video clips consistently induced disgust, fear, happiness, sadness, or control neutral state. In addition objective physiological activity, subjective ratings perceived emotions (i.e. gastric, respiratory cardiac) sensations were recorded, as well changes in heart rate (HR), variability (HRV) spontaneous eyes blinks non-gastric behavioral autonomic experience. We found when observed fearful disgusting clips, reported perceive not only cardiac but also gastric sensations, nausea. Moreover, there was clear relation between physiology stomach emotions. Specifically, displayed, more acidic feelings disgust fear; less happiness. Complementing results deep realm, stimuli significant increase HRV compared scenarios, together with decrease HR. Our findings suggest contribute unique states ingestible pills may open new avenues exploring deep-body

Language: Английский

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Interoceptive training with real‐time haptic versus visual heartbeat feedback

Psychophysiology, Journal Year: 2024, Volume and Issue: 61(11)

Published: Aug. 16, 2024

The perception of signals from within the body, known as interoception, is increasingly recognized a prerequisite for physical and mental health. This study dedicated to development effective technological approaches enhancing interoceptive abilities. We provide evidence effectiveness practical feasibility novel real-time haptic heartbeat supplementation technology combining principles biofeedback sensory augmentation. In randomized controlled study, we applied developed naturalistic feedback on group 30 adults, while another adults received more traditional visual feedback. A single session haptic, but not resulted in increased accuracy confidence, measured by heart rate discrimination task, shift attention toward body. Participants rated helpful pleasant than feedback, thus indicating high user satisfaction. highlights importance matching characteristics provided natural bodily prototype. Our work suggests that might be superior approach strengthening mind-body connection interventions

Language: Английский

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Gut markers of bodily self-consciousness in men

iScience, Journal Year: 2022, Volume and Issue: 25(10), P. 105061 - 105061

Published: Sept. 6, 2022

Bodily self-consciousness, the state of mind that allows humans to be aware their own body, forms backdrop for almost every human experience, yet its underpinnings remain elusive. Here we combine an ingestible, minimally invasive capsule with surface electrogastrography probe if gut physiology correlates bodily self-consciousness in a sample healthy men during virtual illusion. We discover specific patterns stomach and bowel activity (temperature, pressure, pH) covary facets (feelings body location, agency, disembodiment). These results uncover hitherto untapped potential probes study link between mental states show significance deep visceral organs self-conscious perception ourselves as embodied beings.

Language: Английский

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Eating Pathology and Interoceptive Sensibility Using the Brief Multidimensional Assessment of Interoceptive Awareness-2: Can There be Too Much of a Good Thing?

Journal of Personality Assessment, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 13

Published: Jan. 9, 2025

This study evaluated the factorial structure and invariance of Multidimensional Assessment Interoceptive Awareness-v2 (MAIA-2). We also investigated incremental validity MAIA-2 factors for predicting eating pathology beyond appetite-based interoception. US-based online respondents (N = 1294; Mage=48.7 ± 18.4; 63% cis women; 78% White) were sampled. conducted hierarchical stepwise regressions, dominance analysis, multiple-group confirmatory factor analyses across age, gender, disorder symptoms. An 8-factor, 24-item Brief (BMAIA-2) model showed optimal fit. Using strict criteria (Δ CFI > 0.002), configural, metric, scalar supported. After controlling interoception, higher scores on body listening, noticing, emotional awareness unexpectedly predicted worse pathology, while not worrying, distracting, trusting less as hypothesized. Dominance analysis no subscales contributed >2% unique variance to global disordered For loss control eating, however, worrying was dominant BMAIA-2 predictor, explaining 5% Research supported relevance multiple interoceptive sensibility dimensions captured by understanding eating-based pathology. Future studies should consider assessing its using behavioral tasks autonomic biomarkers interoception better understand complex interplay among skills behavior.

Language: Английский

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Diminished Interoceptive Accuracy in Attention‐Deficit/Hyperactivity Disorder: A Systematic Review

Psychophysiology, Journal Year: 2025, Volume and Issue: 62(2)

Published: Feb. 1, 2025

ABSTRACT Interoception is the perception of one's internal physiological state. Altered interoception may play a role in pathogenesis attention‐deficit/hyperactivity disorder (ADHD). We reviewed literature on and ADHD symptoms (inattention, hyperactivity/impulsivity, executive function, emotional dysregulation) individuals with without disorder. Studies included assessments (1) with/without diagnoses or (2) general population. objective measures (heartbeat‐tracking test) self‐report questionnaires. The search PubMed/MEDLINE, PsychINFO, CINAHL Scopus databases. A protocol was prospectively registered PROSPERO database (CRD #42022351726); PRISMA guidelines directed reporting. Newcastle–Ottawa scale adapted to evaluate study quality. Of 636 articles identified, 17 (based 18 studies) met inclusion criteria. Five studies compared participants ADHD, three found that reduced ADHD. One between presentations finding no differences. Twelve assessed association Overall, results suggested who reported higher inattention, hyperactivity, impulsivity, dysregulation, dysfunction. were moderate quality; issues small sample sizes inadequate Individuals have decreased without. negatively associated Interventions focused improving interoceptive abilities provide an avenue for treatment. Future work should consider culture interoception.

Language: Английский

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Reframing Refractory Chronic Cough: The Role of Interoception

Lung, Journal Year: 2025, Volume and Issue: 203(1)

Published: Feb. 12, 2025

Refractory chronic cough (RCC) remains a persistent clinical challenge, often resistant to traditional treatments. Emerging evidence now positions RCC as disorder rooted in hypersensitivity, driven primarily by central neural processes rather than external physiological causes. Central this understanding is the concept of interoception-the brain's ability perceive and interpret internal bodily signals. Neuroimaging research has identified abnormalities brain regions associated with interoception inhibitory control among patients. Interestingly, shares neurophysiological characteristics other disorders like overactive bladder urinary urge incontinence (OAB/UUI), which also involve dysregulated interoceptive mechanisms. Behavioral treatments for OAB/UUI are highly effective regarded first-line treatment many consensus guidelines. behavioral have been shown induce neuroplastic changes, further underscoring their efficacy potential parallel interventions. suppression therapy (BCST), an efficacious RCC, may leverage similar adaptations, enhancing processing control. Given multi-dimensional nature interoception, encompasses sensory perception shaped learning, memory, emotional context, BCST's engagement multiple pathways offers alternative therapeutic option compared single-mechanism pharmacological Future should prioritize exploring mechanistic underpinnings BCST interoception-based therapies developing more comprehensive options. Such holds promise improving patient outcomes, alleviating significant healthcare burden advancing our hypersensitivity disorders.

Language: Английский

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