TY - JOUR
T1 - The man who feels two hearts
T2 - The different pathways of interoception
AU - Couto, Blas
AU - Salles, Alejo
AU - Sedeño, Lucas
AU - Peradejordi, Margarita
AU - Barttfeld, Pablo
AU - Canales-Johnson, Andrés
AU - Dos Santos, Yamil Vidal
AU - Huepe, David
AU - Bekinschtein, Tristán
AU - Sigman, Mariano
AU - Favaloro, Roberto
AU - Manes, Facundo
AU - Ibanez, Agustin
N1 - Publisher Copyright:
© The Author (2013). Published by Oxford University Press.
PY - 2013/4/2
Y1 - 2013/4/2
N2 - 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.
AB - 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.
KW - HEP
KW - Heart-brain
KW - Insula
KW - Interoception
KW - Social cognition
UR - http://www.scopus.com/inward/record.url?scp=84908689465&partnerID=8YFLogxK
U2 - 10.1093/scan/nst108
DO - 10.1093/scan/nst108
M3 - Article
C2 - 23887813
AN - SCOPUS:84908689465
SN - 1749-5016
VL - 9
SP - 1253
EP - 1260
JO - Social Cognitive and Affective Neuroscience
JF - Social Cognitive and Affective Neuroscience
IS - 9
ER -