Impact of intranasal oxytocin on interoceptive accuracy in alcohol users: an attentional mechanism?

Abstract

Interoception, i.e. the perception and appraisal of internal bodily signals, is related to the phenomenon of craving, and is reportedly disrupted in alcohol use disorders. The hormone oxytocin influences afferent transmission of bodily signals and, through its potential modulation of craving, is proposed as a possible treatment for alcohol use disorders. However, oxytocin’s impact on interoception in alcohol users remains unknown. Healthy alcohol users (n = 32) attended two laboratory sessions to perform tests of interoceptive ability (heartbeat tracking: attending to internal signals and, heartbeat discrimination: integrating internal and external signals) after intranasal administration of oxytocin or placebo. Effects of interoceptive accuracy, oxytocin administration and alcohol intake, were tested using mixed-effects models. On the tracking task, oxytocin reduced interoceptive accuracy, but did not interact with alcohol consumption. On the discrimination task, we found an interaction between oxytocin administration and alcohol intake: Oxytocin, compared with placebo, increased interoceptive accuracy in heavy drinkers, but not in light social drinkers. Our study does not suggest a pure interoceptive impairment in alcohol users but instead potentially highlights reduced flexibility of internal and external attentional resource allocation. Importantly, this impairment seems to be mitigated by oxytocin. This attentional hypothesis needs to be explicitly tested in future research.

Preliminary evidence for altered interoceptive processing in smokers

“…However, significant differences in smoking habits were also present, and additionally, participants were undergoing inpatient treatment for addiction (including pharmacological therapies that may affect bodily states) at the point of testing. In contrast, a recent study conducted by Betka et al (2018; smoking status of participants unknown) found that heavy (non-clinical) alcohol consumption was not associated with IS. Together, the findings from these studies suggest that addiction specifically, rather than nonclinical consumption of a substance, is associated with impaired IS.…”

“…Whilst some previous studies have found correlations between the heartbeat perception tasks (Hart, McGowan, Minati & Critchley, 2013;Knoll & Hodapp, 1992) others have not (Betka et al, 2018;Forkmann et al, 2016;Michal et al, 2014;Schulz, Lass-Hennemann, Sütterlin, Schächinger & Vögele, 2013). The tasks are assumed to measure IS in fairly equivalent ways, but actually require quite distinct psychological processing (Forkmann et al, 2016).…”

Feeling the beat: Temporal and spatial perception of heartbeat sensations

“…We hypothesized that BMI impact neither temporal nor spatial aspect of heartbeat sensations (Brener and Kluvitse 1988;Brener et al 1993;Brener 1992, 2018). However, we predict that individual differences in affective functioning (Anxiety, Depression, Alexithymia) will influence both aspects of heartbeat sensation (Betka et al 2017(Betka et al , 2018Khalsa et al 2018;Paulus and Stein 2010). Finally, we expect that heart rate will impact heartbeat perception -namely, slower heart rate (i.e.…”

“…Consequently, research has focused on the objective measurement of interoception, using behavioral tasks through which interoceptive accuracy can be quantified from performance (Garfinkel et al 2015). Most widely, such tasks use the perception cardiac sensations at rest: heartbeats are clear and discrete events, which are easily measurable (Betka et al, 2018) and relevant -the changing strength and timing of heartbeats are signatures of changing physiological arousal that accompany relevant emotions, exercise, injury, or illness. Hence, tests of heartbeat perception tasks dominate, providing a baseline metric of interoceptive sensitivity.…”

“…Interestingly, interoceptive abilities are likely impaired across different mental health conditions. It is likely that both temporal and spatial locations of heartbeat sensations may be affected in these groups (Betka et al 2017(Betka et al , 2018Khalsa et al 2018;Paulus and Stein 2010;Quadt et al 2018). Similarly, individual differences in physical constitution, notably body mass index (BMI) (Brener and Kluvitse 1988;Brener et al 1993;Michael et al 2015;Brener 1992, 2018;Rouse, Jones, and Jones 1988;Wiens and Palmer 2001) and cardiovascular parameters (e.g.…”