Physical Exercise to Redynamize Interoception in Substance use Disorders

Abstract

Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an “interoception booster”, namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.

Sarcoidosis and frailty: recognizing factors that foster holistic resilience

“…Exercise also redirects the mind's attention from psychologically deteriorative thoughts towards connectedness and the curiosity of physical sensations. This phenomenon strengthens a platform for self-evaluation and is also tied to increased healthier choices, sense of purpose, self-efficacy, cognition, self-worth and the ability to better cope with external factors and circumstance as well as decreased loneliness, distraction and perseveration on unhelpful thoughts [37 ▪▪ ,47 ▪ ,53 ▪ ,59 ▪▪ ,60–62,63 ▪▪ ,64–66].…”

“…In addition to muscle appearing to act as a system-wide endocrine organ, exercise is an embodiment practice that provides opportunities to strengthen self-regulatory avenues that benefit neurocognitive, psychological and physical function with an impact on long and short-term global health outcomes. Exercise, as a conscious or unconscious, mindfulness practice may be one of the most comprehensive avenues to enhance intero-/extero/proprioception, which constitutively re-dynamizes one's interactive awareness and responsive adaptation with self, other and our surroundings [59 ▪▪ ,60,61].…”

“…Further, exercise and self-awareness practices increase a person's familiarization with stress-induced somatic markers/signals and cultivate a predictive control allowing the body to respond to changes in an adaptive manner [59 ▪▪ ,61], whereby not reading/responding to cues can over-tax a person mentally or physically. The more practiced these functions are, one is more able to maintain psychological and physical symptom management – this is key for diseases such as sarcoidosis with many and diverse symptoms.…”

Brain mechanisms discriminating enactive mental simulations of running and plogging

“…Due to its involvement in homeostatic control and conscious interoception (Craig, 2002(Craig, , 2009, the insular cortex constitutes a "gating system" in the dynamic interplay between neurocognitive processes (Droutman et al, 2015a(Droutman et al, , 2015bMolnar-Szakacs & Uddin, 2022;Zhao et al, 2023). fMRI studies have already allowed us to specify how the insula interacts with other brain regions to regulate physical efforts (for a review, see Brevers et al, 2024). For example, Hilty and colleagues (2011) observed that connectivity between the insula and the primary motor cortex increased from the beginning to the end of a cycling exercise.…”