Abnormal body perception and neural activity in the insula in depression: An fMRI study of the depressed “material me”

Wiebking, Christine; Bauer, André; Greck, Moritz de; Duncan, Niall W.; Tempelmann, Claus; Northoff, Georg

doi:10.3109/15622970903563794

Cited by 139 publications

(124 citation statements)

References 56 publications

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“…Three studies involved a mental focus on perceiving and detecting single heartbeats [50,54,55]. Four studies [20,48,51,52] closely matched the heartbeat detection task coined by Schandry [9], which is used for assessing interoceptive accuracy/sensitivity. However, it is important to note that strictly speaking, none of the contrasts of IT .…”

Section: (B) Classification Of Studies By Interoceptive Taskmentioning

confidence: 99%

“…In the four studies using variants of the heartbeat detection task [20,48,51,52], participants had to count (all) tones presented in a given time interval. This interval was of variable length in three of the studies [20,48,52], and had a fixed length of 35 s in one study [51].…”

Section: (C) the Role Of Control Tasksmentioning

confidence: 99%

“…This interval was of variable length in three of the studies [20,48,52], and had a fixed length of 35 s in one study [51]. In two of these four studies [20,48], the presentation frequency of the tones was adapted to correspond to each participant's heart rate, but onset times of the tones were jittered to avoid synchrony with the actual heartbeat. Avery and coworkers [19] used a visual CT, where participants had to count how often the word 'TARGET' on a screen switched to lowercase in a given time interval.…”

Section: (C) the Role Of Control Tasksmentioning

confidence: 99%

“…1 Furthermore, it has been suggested that mood and anxiety disorders may root in issues related to interoception [17]. This view is supported by accumulating evidence in the domain of anxiety disorders [18] and depression [19,20]. For patients with panic disorder, interoceptive cues may be threatening or confusing.…”

Section: Introductionmentioning

confidence: 99%

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Neural correlates of heart-focused interoception: a functional magnetic resonance imaging meta-analysis

Schulz

2016

Phil. Trans. R. Soc. B

165

118

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Interoception is the ability to perceive one's internal body state including visceral sensations. Heart-focused interoception has received particular attention, in part due to a readily available task for behavioural assessment, but also due to accumulating evidence for a significant role in emotional experience, decision-making and clinical disorders such as anxiety and depression. Improved understanding of the underlying neural correlates is important to promote development of anatomical-functional models and suitable intervention strategies. In the present meta-analysis, nine studies reporting neural activity associated with interoceptive attentiveness (i.e. focused attention to a particular interoceptive signal for a given time interval) to one's heartbeat were submitted to a multilevel kernel density analysis. The findings corroborated an extended network associated with heart-focused interoceptive attentiveness including the posterior right and left insula, right claustrum, precentral gyrus and medial frontal gyrus. Right-hemispheric dominance emphasizes non-verbal information processing with the posterior insula presumably serving as the major gateway for cardioception. Prefrontal neural activity may reflect both top-down attention deployment and processing of feed-forward cardioceptive information, possibly orchestrated via the claustrum. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

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Section: (B) Classification Of Studies By Interoceptive Taskmentioning

confidence: 99%

Section: (C) the Role Of Control Tasksmentioning

confidence: 99%

Section: (C) the Role Of Control Tasksmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neural correlates of heart-focused interoception: a functional magnetic resonance imaging meta-analysis

Schulz

2016

Phil. Trans. R. Soc. B

165

118

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“…Depressed affect was related to both GABA values as well as neural activity during interoception in the insula. Since depression is characterized by a common pathophysiological pattern of GABAergic deficits [32,34,40,41] and altered states of internal and external awareness [18,25,42], it would be of high interest to target these points in future research about interoception and depression to provide further evidence for a connection between these factors.…”

Section: Neuroimaging In Interoceptive Awareness Combining Fmri Anmentioning

confidence: 99%

Interoceptive awareness and the insula - Application of Neuroimaging Techniques in Psychotherapy

Wiebking

Northoff

2014

GSTF J Psych

Self Cite

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Abstract-Interoceptive awareness is defined as the awareness of stimuli originating inside one's own body such as the heartbeat. The emergence of new brain imaging techniques like functional magnetic resonance imaging (fMRI) or magnetic resonance spectroscopy (MRS) has increased our knowledge of neural substrates underlying interoceptive awareness. In particular, the bilateral brain structure of the insula has been identified as a key region involved in interoceptive processes in healthy populations. In line with prominent theories of human emotion, the insula has an important function in connecting interoceptive awareness with affective experience. This connection hinging on the insula between interoception and emotional processing is suggestive of an involvement of the insula in mood disorders such as major depressive disorder (MDD). Multilayered deficits in the insula cortex of depressed individuals such as abnormal function, biochemistry, and anatomy support this hypothesis.The aim of the present article is a) to describe the importance of the insula for the interplay between interoception and emotional processing and b) how this might be figured into psychotherapeutic treatment of depressed patients using new imaging techniques like real-time fMRI.The article begins with a brief introduction about neuroanatomical settings of the insula (I. IntroductionNeuroanatomical background of the insula). Afterwards, early behavioral studies to investigate interoceptive awareness are described (II. A step Back-First attempts to investigate interoceptive awareness), followed by a description of more recent imaging studies outlining neural mechanisms underlying interoceptive awareness and emotional processing in the insula (III. The insula as key region involved in functional interoception and emotion.) Throughout, the article addresses the question of why the investigation of individuals suffering from depression might provide novel insights into the neural underpinnings of interoceptive awareness and its link to abnormal behavior (IV. Why study interoceptive awareness in depressed participants?).Following the description of a selected study that combines for the first time functional results of interoception (using fMRI) with biochemical results of the insula (using MRS) (V. Neuroimaging in interoceptive awareness combining fMRI and MRS -A specific study), the article concludes with a perspective outlining the potential for using imaging techniques like real-time fMRI to enhance neural activity in the insula during interoceptive awareness. This approach potentially leads to faster recovery in depressed patients and might be the first therapeutic application of functional imaging in psychiatry (VI. Perspectives: Neurofeedback in major depression using real-time fMRI).

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Anterior Insula Volume and Guilt

et al. 2015

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Abnormal body perception and neural activity in the insula in depression: An fMRI study of the depressed “material me”

Abstract: We demonstrate for the first time abnormal body perception and altered activity in the insula during rest in MDD. Our results suggest that these behavioural and neural abnormalities are closely related to these patients' somato-vegetative abnormalities and their abnormal "material me".

Cited by 139 publications

References 56 publications

Neural correlates of heart-focused interoception: a functional magnetic resonance imaging meta-analysis

Neural correlates of heart-focused interoception: a functional magnetic resonance imaging meta-analysis

Interoceptive awareness and the insula - Application of Neuroimaging Techniques in Psychotherapy

Anterior Insula Volume and Guilt

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