Altered functional connectivity of interoception in illness anxiety disorder

Grossi, Dario; Longarzo, Mariachiara; Quarantelli, Mario; Salvatore, Elena; Cavaliere, Carlo; Luca, Paolo Di; Trojano, Luigi; Aiello, Marco

doi:10.1016/j.cortex.2016.10.018

Cited by 25 publications

(11 citation statements)

References 78 publications

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“…However, it should be noted that interoceptive processing more than likely involves a wide neural network, including among others the somatosensory cortex, insula, anterior cingulate cortex and vmPFC 4 , 22 . Accordingly, several recent studies have reported that the functional connectivity of interoceptive neural network varied with illness anxiety 46 and tactile attention 47 . Therefore, future studies examining the neural bases underlying the relationship between interoception and anxiety at a network level are certainly needed.…”

Section: Discussionmentioning

confidence: 99%

The role of mid-insula in the relationship between cardiac interoceptive attention and anxiety: evidence from an fMRI study

Tan

Wei

Zhang

et al. 2018

Sci Rep

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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.

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Section: Discussionmentioning

confidence: 99%

The role of mid-insula in the relationship between cardiac interoceptive attention and anxiety: evidence from an fMRI study

Tan

Wei

Zhang

et al. 2018

Sci Rep

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“…The mechanisms through which cognitive and motor rehabilitation could improve cognition in MS are not well-understood, although it has been proposed that specific interventions might stimulate neural pathways through neuroplasticity ( Penner et al, 2007 ). On the basis of the “mind/brain full correspondence principle” ( Grossi et al, 2017 ) it is possible to act simultaneously on multiple dimensions through psychotherapy, cognitive training, pharmacology and neurostimulation techniques, in order to modulate activity of altered networks. Neurofunctional studies recently demonstrated that rapid-onset plasticity and functionally relevant chronic reorganization processes are preserved even in progressive form of MS and that these phenomena are functionally relevant to preserve motor and cognitive functions ( Schoonheim et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study

Barbarulo

Lus

Signoriello

et al. 2018

Front. Behav. Neurosci.

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Background: Few studies examined the effects of combined motor and cognitive rehabilitation in patients with multiple sclerosis (MS). The present prospective, multicenter, observational study aimed to determine the efficacy of an integrated cognitive and neuromotor rehabilitation program versus a traditional neuromotor training on walking, balance, cognition and emotional functioning in MS patients.Methods: Sixty three MS patients were selected and assigned either to the Integrated Treatment Group (ITG; n = 32), receiving neuropsychological treatment (performed by ERICA software and paper–pencil tasks) complemented by conventional neuromotor rehabilitation, or to the Motor Treatment Group (n = 31) receiving neuromotor rehabilitation only. The intervention included two 60-min sessions per week for 24 weeks. At baseline and at end of the training all patients underwent a wide-range neuropsychological, psychological/emotional, and motor assessment.Results: At baseline the two groups did not differ for demographic, neuropsychological, psychological/emotional, and motor features significantly. After rehabilitation, only ITG group significantly (p-corrected for False Discovery Rate) improved on test tapping spatial memory, attention and cognitive flexibility, as well as on scales assessing depression and motor performance (balance and gait). A regression analysis showed that neuropsychological and motor improvement was not related to improvements in fatigue and depression.Conclusion: The present study demonstrated positive effects in emotional, motor, and cognitive aspects in MS patients who received an integrated cognitive and neuromotor training. Overall, results are supportive of interventions combining motor and cognitive training for MS.

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“…Interestingly, objective measures of IA are not always correlated with subjective measures of IS [Ceunen et al, ; Forkmann et al, ; Garfinkel et al, ; Khalsa et al, ; Meessen et al, ; Mehling, ; Whitehead et al, ]. For example, depression is associated with reduced IA (heartbeat detection accuracy) [Limmer et al, ; Pollatos et al, ] but increased self‐reported IS [Grossi et al, ; Limmer et al, ], a dissociation that has also been found in autism spectrum disorder [Garfinkel et al, ]. These data highlight the important role of subjective appraisals of interoception in psychopathology, yet little is known about the neural correlates of self‐reported IS.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, two studies have examined the relationship between IS and resting‐state functional connectivity, both using samples that included patients with hypothetical abnormalities of body sensitivity. Grossi et al [] found a relationship between increased IS as measured with the SAQ and connectivity between ACC and orbitofrontal cortex (OFC) in a sample that included healthy adults and patients with illness anxiety disorder. Also using the SAQ, Longarzo et al [] found a correlation between IS and connectivity between anterior insula and somatosensory regions in a sample that included healthy adults and patients with irritable bowel syndrome.…”

Section: Introductionmentioning

confidence: 99%

Neural correlates of interoception: Effects of interoceptive focus and relationship to dimensional measures of body awareness

Stern

Grimaldi

Muratore

et al. 2017

Human Brain Mapping

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Interoception has been defined as the sensing of the physiological condition of the body, with interoceptive sensibility (IS) characterizing an individual's self-reported awareness of internal sensation. IS is a multidimensional construct including not only the tendency to be aware of sensation, but also how sensations are interpreted, regulated, and used to inform behavior, with different dimensions relating to different aspects of health and disease. Here we investigated neural mechanisms of interoception when healthy individuals attended to their heartbeat and skin temperature, and examined the relationship between neural activity during interoception and individual differences in self-reported IS using the Multidimensional Scale of Interoceptive Awareness (MAIA). Consistent with prior work, interoception activated a network involving insula and sensorimotor regions but also including occipital, temporal, and prefrontal cortex. Differences based on interoceptive focus (heartbeat vs. skin temperature) were found in insula, sensorimotor regions, occipital cortex, and limbic areas. Factor analysis of MAIA dimensions revealed 3 dissociable components of IS in our dataset, only one of which was related to neural activity during interoception. Reduced scores on the third factor, which reflected reduced ability to control attention to body sensation and increased tendency to distract from and worry about aversive sensations, was associated with greater activation in many of the same regions as those involved in interoception, including insula, sensorimotor, anterior cingulate, and temporal cortex. These data suggest that self-rated interoceptive sensibility is related to altered activation in regions involved in monitoring body state, which has implications for disorders associated with abnormality of interoception.

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Altered functional connectivity of interoception in illness anxiety disorder

Cited by 25 publications

References 78 publications

The role of mid-insula in the relationship between cardiac interoceptive attention and anxiety: evidence from an fMRI study

The role of mid-insula in the relationship between cardiac interoceptive attention and anxiety: evidence from an fMRI study

Integrated Cognitive and Neuromotor Rehabilitation in Multiple Sclerosis: A Pragmatic Study

Neural correlates of interoception: Effects of interoceptive focus and relationship to dimensional measures of body awareness

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