Abstract
Interoception refers to the perception of the internal bodily states. Recent accounts highlight the role of the insula in both interoception and the subjective experience of anxiety. The current study aimed to delve deeper into the neural correlates of cardiac interoception; more specifically, the relationship between interoception-related insular activity, interoceptive accuracy, and anxiety. This was done using functional magnetic resonance imaging (fMRI) in an experimental design in which 40 healthy volunteers focused on their heartbeat and anxious events. Interoceptive accuracy and anxiety levels were measured using the Heartbeat Perception Task and State Trait Anxiety Inventory, respectively. The results showed posterior, mid and anterior insular activity during cardiac interoception, whereas anxiety-related activation showed only anterior insular activity. Activation of the anterior insula when focused on cardiac interoception was positively correlated to state and trait anxiety levels, respectively. Moreover, the mid-insular activity during the cardiac attention condition not only related to individuals’ interoceptive accuracy but also to their levels of state and trait anxiety, respectively. These findings confirm that there are distinct neural representations of heartbeat attention and anxious experience across the insular regions, and suggest the mid-insula as a crucial link between cardiac interoception and anxiety.
Highlights
Interoception refers to the phenomenological perception of the physiological state of the body, resulting from the multimodal integration of sensory input[1,2,3]
In the literature on the neural correlates of cardiac interoception, one subset of functional magnetic resonance imaging studies preceding our own can be classified as belonging to our ‘attention only’ category
Through comparing signal change between the heartbeat attention and the anxiety attention conditions, we found that cardiac interoception disproportionally activated the bilateral insular cortex, left precentral gyrus, bilateral supramarginal gyrus, bilateral thalamus and right supplementary motor area compared with anxiety attention condition (Fig. 3b)
Summary
Interoception refers to the phenomenological perception of the physiological state of the body, resulting from the multimodal integration of sensory input[1,2,3]. A different subset of studies using fMRI to find the neural correlates of cardiac perception directly measured interoceptive accuracy In other words, these studies required participants to track or detect their heartbeats while measures of accuracy were obtained[7,19,22,28,29,30,31]. These studies required participants to track or detect their heartbeats while measures of accuracy were obtained[7,19,22,28,29,30,31] These studies found that the activity in the anterior insula was associated with cardiac interoception. Accuracy measures obtained outside of the neuroimaging sessions are still useful, but more so to profile participants according to their level of interoceptive accuracy
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