TY - JOUR
T1 - Feeling, learning from and being aware of inner states
T2 - Interoceptive dimensions in neurodegeneration and stroke
AU - García-Cordero, Indira
AU - Sedeño, Lucas
AU - de la Fuente, Laura
AU - Slachevsky, Andrea
AU - Forno, Gonzalo
AU - Klein, Francisco
AU - Lillo, Patricia
AU - Ferrari, Jesica
AU - Rodriguez, Clara
AU - Bustin, Julian
AU - Torralva, Teresa
AU - Baez, Sandra
AU - Yoris, Adrian
AU - Esteves, Sol
AU - Melloni, Margherita
AU - Salamone, Paula
AU - Huepe, David
AU - Manes, Facundo
AU - García, Adolfo M.
AU - Ibañez, Agustín
N1 - Publisher Copyright:
© 2016 The Author(s) Published by the Royal Society. All rights reserved.
PY - 2016/11/19
Y1 - 2016/11/19
N2 - 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’.
AB - 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’.
KW - Awareness
KW - Interoception
KW - Learning
KW - Neurodegenerative diseases
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=84991515544&partnerID=8YFLogxK
U2 - 10.1098/rstb.2016.0006
DO - 10.1098/rstb.2016.0006
M3 - Article
C2 - 28080965
AN - SCOPUS:84991515544
SN - 0962-8436
VL - 371
JO - Philosophical Transactions of the Royal Society B: Biological Sciences
JF - Philosophical Transactions of the Royal Society B: Biological Sciences
IS - 1708
M1 - 20160006
ER -