Cardiac Interoception Research Articles

The relevance of accuracy of heartbeat perception in noncardiac and cardiac chest pain.

The development and course of noncardiac chest pain are assumed to be influenced by interoceptive processes. It was investigated whether heartbeat perception was enhanced in patients suffering from noncardiac chest pain and to what degree it was associated with self-reported cognitive-perceptual features and chest pain characteristics. A total of 42 patients with noncardiac chest pain (NCCP), 35 patients with cardiac chest pain, and 52 healthy controls were recruited. Heartbeat perception was assessed using the Schandry task and a modified Brener-Kluvitse task. Self-report measures assessed anxiety sensitivity, somatosensory amplification, heart-focused anxiety, and chest pain characteristics. Heartbeat perception was not more accurate in patients with NCCP, compared to patients with cardiac chest pain and healthy controls. However, in patients with NCCP, the error score (Schandry task) was significantly associated with stronger chest pain impairment, and the response bias (Brener-Kluvitse task) was associated with lower chest pain intensity. Against assumptions of current etiological models, heartbeat perception was not enhanced in patients with NCCP. Chest pain characteristics and particularly their appraisal as threatening might be more relevant to NCCP than the perceptional accuracy of cardiac sensations and should be focused in psychological interventions. However, associations with chest pain impairment suggest cardiac interoception to influence the course of NCCP.

Preliminary evidence about the effects of meditation on interoceptive sensitivity and social cognition

BackgroundInteroception refers to the conscious perception of body signals. Mindfulness is a meditation practice that encourages individuals to focus on their internal experiences such as bodily sensations, thoughts, and emotions. In this study, we selected a behavioral measure of interoceptive sensitivity (heartbeat detection task, HBD) to compare the effect of meditation practice on interoceptive sensitivity among long term practitioners (LTP), short term meditators (STM, subjects that completed a Mindfulness-Based Stress Reduction (MBSR) program) and controls (non-meditators). All participants were examined with a battery of different tasks including mood state, executive function and social cognition tests (emotion recognition, empathy and theory of mind).FindingsCompared to controls, both meditators’ groups showed lower levels of anxiety and depression, but no improvement in executive function or social cognition performance was observed (except for lower scores compared to controls only in the personal distress dimension of empathy). More importantly, meditators’ performance did not differ from that of nonmeditators regarding cardiac interoceptive sensitivity.ConclusionResults suggest no influence of meditation practice in cardiac interoception and in most related social cognition measures. These negative results could be partially due to the fact that awareness of heartbeat sensations is not emphasized during mindfulness/vipassana meditation and may not be the best index of the awareness supported by the practice of meditation.

Perception and pain thresholds for cutaneous heat and cold, and rectal distension: associations and disassociations

Hypersensitivity to somatic or visceral pain has been reported in numerous clinical conditions such as fibromyalgia or the irritable bowel syndrome, and general hypersensitivity has been proposed to be the underlying mechanism. However, cross-modal relationships especially between somatic and visceral pain have rarely been investigated even in healthy volunteers. Furthermore, psychological influences on pain have rarely been characterized across modalities. Sixty-one healthy participants underwent testing of perception and pain thresholds for cutaneous thermode heat and cold, as well as for rectal balloon distension. Psychological testing for anxiety, depression, and pain experience (including catastrophizing and coping) as well as cardiac interoception was performed. Measurement quality and the correlations between the different modalities were examined. Significant correlations existed between the perception thresholds for cold/heat (τB =-0.28, p=0.002) and cold/distension (τB = -0.21, p=0.03) and for the pain thresholds for cold/heat (r=-0.61, p<0.001) and heat/distension (r=0.33, p=0.01). No association was found between pain thresholds and anxiety, depression, psychological experience with and processing of pain, or cardiac interoception. Retest reliabilities for pain measurements were satisfying after short intertrial intervals (all intraclass correlation coefficients >0.8), but less so after longer intervals. The individuals contributing to the respective correlations differ between measurements. Moderate associations were found for pain thresholds across modalities. The strength of the associations and their stability over time warrants further investigation and might serve to increase the understanding of conditions affecting multiple pain modalities.

The man who feels two hearts: the different pathways of interoception

Recent advances in neuroscience have provided new insights into the understanding of heart-brain interaction and communication. Cardiac information to the brain relies on two pathways, terminating in the insular cortex (IC) and anterior cingulate cortex (ACC), along with the somatosensory cortex (S1-S2). Interoception relying on these neuroanatomical pathways has been shown to modulate social cognition. We report the case study of C.S., a patient with an 'external heart' (an extracorporeal left-univentricular cardiac assist device, LVAD). The patient was assessed with neural/behavioral measures of cardiac interoception complemented by neuropsychological and social cognition measures. The patient's performance on the interoception task (heartbeat detection) seemed to be guided by signals from the artificial LVAD, which provides a somatosensory beat rather than by his endogenous heart. Cortical activity (HEP, heartbeat-evoked potential) was found decreased in comparison with normal volunteers, particularly during interoceptive states. The patient accurately performed several cognitive tasks, except for interoception-related social cognition domains (empathy, theory of mind and decision making). This evidence suggests an imbalance in the patient's cardiac interoceptive pathways that enhances sensation driven by the artificial pump over that from the cardiac vagal-IC/ACC pathway. A patient with two hearts, one endogenous and one artificial, presents a unique opportunity to explore models of interoception and heart-brain interaction.

Learn from your heart: dissociable neural markers for objective interoceptive performance and metacognitive awareness in auditory feedback

Event Abstract Back to Event Learn from your heart: dissociable neural markers for objective interoceptive performance and metacognitive awareness in auditory feedback Tristan A. Bekinschtein1*, Andrés Canales-Johnson1, Carolina Silva2, David Huepe2, Alvaro Rivera-Rei2, Valdas Noreika1, Maria Del Carmen Garcia3, Walter Silva4, Lucas Sedeño4, Lucila Kargieman4, Fabricio Baglivo4, Srivas Chennu5, Agustin Ibanez2, 4 and Eugenio F. Rodriguez6 1 University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, United Kingdom 2 Diego Portales University, Chile 3 Hospital Italiano de Buenos Aires, Argentina 4 Favaloro University, Argentina 5 University of Cambridge, Department of Clinical Neurosciences, United Kingdom 6 Pontificia Universidad Catolica de Chile, Chile Background: Internal bodily processes, such as blood pressure, continuously feed-forward the brain with information required for homeostatic balance While most of the body-brain communications take place unconsciously, some may become available for conscious access, guiding our motivational behaviour and decision-making. Interoception – or visceral perception – may cover such diverse processes, as perception of pain, temperature, hunger, as well as heartbeat cardiovascular awareness. Cardiac interoception can be enhanced by training using auditory feedback (Schandry & Weitkunat, 1990); however, little is known about the neural mechanisms of cardiac interoceptive learning. Here we show distinct neural markers of objective interoceptive performance and its metacognitive awareness when tapping to your own heartbeat. Method: EEG sensor and source spaces were used for the analysis of the Heart Evoked Potential (HEP) of 33 normal participants (and one epileptic patient) looking at the differences in EEG signal of the participants trying to tap to their heartbeats before and after auditory feedback. Results: EEG amplitude of the heartbeat evoked potential in interoceptive learners was higher compared to non-learners, showing that cardiovascular learning can modulate cortical signature of cardiac activity. Regarding metacognition of learning, participants showing agreement between objective interoceptive performance and metacognitive awareness revealed and increase in gamma phase synchrony (30-45 Hz) after listening to the auditory feedback of their heartbeat, demonstrating for the first time that the emergence of large-scale phase synchronization is associated with conscious access of interoceptive information. Discussion: Together, these findings suggest that interoceptive learning may be mediated by the localized cortical response to the heartbeat, whereas metacognitive awareness of learning seems associated to widespread cortical synchronization patterns. Keywords: Electroencephalography (EEG), Homeostasis, Heart Rate, interoception, gamma synchrony Conference: ACNS-2013 Australasian Cognitive Neuroscience Society Conference, Clayton, Melbourne, Australia, 28 Nov - 1 Dec, 2013. Presentation Type: Poster Topic: Attention Citation: Bekinschtein TA, Canales-Johnson A, Silva C, Huepe D, Rivera-Rei A, Noreika V, Del Carmen Garcia M, Silva W, Sedeño L, Kargieman L, Baglivo F, Chennu S, Ibanez A and Rodriguez EF (2013). Learn from your heart: dissociable neural markers for objective interoceptive performance and metacognitive awareness in auditory feedback. Conference Abstract: ACNS-2013 Australasian Cognitive Neuroscience Society Conference. doi: 10.3389/conf.fnhum.2013.212.00147 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 06 Oct 2013; Published Online: 25 Nov 2013. * Correspondence: Dr. Tristan A Bekinschtein, University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom, tristan.bekinschtein@mrc-cbu.cam.ac.uk Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Tristan A Bekinschtein Andrés Canales-Johnson Carolina Silva David Huepe Alvaro Rivera-Rei Valdas Noreika Maria Del Carmen Garcia Walter Silva Lucas Sedeño Lucila Kargieman Fabricio Baglivo Srivas Chennu Agustin Ibanez Eugenio F Rodriguez Google Tristan A Bekinschtein Andrés Canales-Johnson Carolina Silva David Huepe Alvaro Rivera-Rei Valdas Noreika Maria Del Carmen Garcia Walter Silva Lucas Sedeño Lucila Kargieman Fabricio Baglivo Srivas Chennu Agustin Ibanez Eugenio F Rodriguez Google Scholar Tristan A Bekinschtein Andrés Canales-Johnson Carolina Silva David Huepe Alvaro Rivera-Rei Valdas Noreika Maria Del Carmen Garcia Walter Silva Lucas Sedeño Lucila Kargieman Fabricio Baglivo Srivas Chennu Agustin Ibanez Eugenio F Rodriguez PubMed Tristan A Bekinschtein Andrés Canales-Johnson Carolina Silva David Huepe Alvaro Rivera-Rei Valdas Noreika Maria Del Carmen Garcia Walter Silva Lucas Sedeño Lucila Kargieman Fabricio Baglivo Srivas Chennu Agustin Ibanez Eugenio F Rodriguez Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. 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Heart beat interoception: A study of individual differences

There were two principal aims of the study: (1) to carry out preliminary evaluation of a novel heartbeat tracking technique for objectively measuring cardiac interoception; and (2) to determine whether good and poor heartbeat perceivers could be differentiated with respect to other parameters reflecting individual differences in emotionality, including gender and ‘emotional character’. Subjects first completed a battery of self-report questionnaires designed to measure characteristics of emotional experience, and then underwent a series of heartbeat tracking trials in which they used the index finger to tap in synchrony with their ongoing heartbeat activity (interoceptive tracking) and also with an audiotape of pre-recorded heartbeat sounds (exteroceptive tracking). The perceptual index was based on the variability of beat to tap latency. Concurrent validity findings suggested that the tracking index reflects a promising measure of cardiac interoceptive acuity. Good perceivers were found to have higher heart-rate measures than poor perceivers. With regard to ‘emotional character’ good perceivers had higher state anxiety, and were less emotionally expressive, although these differences were only marginally significant ( P<0.08) with multivariate testing. Applications of the heartbeat tracking technique for further empirical evaluation of the role of interoception in emotion are discussed.

Cardiac perception and the voluntary control of heart rate

Twenty-four men and twenty-four women participated in an experiment designed to examine the relationships among cardiac interoception, external feedback, and the voluntary control of heart rate. The concept of cardiac interoception was operationalized as heart-rate estimation in Experiment 1 and as heart-rate discrimination in Experiment 2. The heart-rate estimation task proved to be the more reliable and productive of the two operations in assessing perception of internal cues associated with cardiac activity. The cardiac estimation data suggested that instructional set and type of feedback did influence the learning of cues related to cardiac perception but that feedback did not enable subjects to learn to perceive their cardiac activity accurately. Analysis of the relationship between cardiac awareness and heart-rate control indicated that the facilitating effects of feedback on voluntary control are not mediated by cardiac awareness and that this model of biofeedback is inappropriate.