Couto JB, Salles A, Sedeño L, Paradejordi M, Barttfeld P, Canales-Johnson AF, Dos Santos, YV., Huepe D,Bekinschtein T, Sigman M, Favaloro RR, Favaloro R, Manes F, Ibanez A.  The man who feels two hearts: The different pathways of interoception. Social Cognitive and Affective Neurosciences 2014 10.3389/fnagi.2014.00262

The man who feels two hearts: The different pathways of interoception.

Autores Couto JB, Salles A, Sedeño L, Paradejordi M, Barttfeld P, Canales-Johnson AF, Dos Santos, YV., Huepe D,Bekinschtein T, Sigman M, Favaloro RR, Favaloro R, Manes F, Ibanez A. 
Año 2014
Journal  Couto JB, Salles A, Sedeño L, Paradejordi M, Barttfeld P, Canales-Johnson AF, Dos Santos, YV., Huepe D,Bekinschtein T, Sigman M, Favaloro RR, Favaloro R, Manes F, Ibanez A. 
Volumen 9:1253-60
Abstract  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 (IC) and anterior cingulate (ACC) cortices, 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 (heart-evoked potential, HEP) decreased in comparison to normal volunteers, particularly during interoceptive states. The patient accurately performed several cognitive tasks, expect for 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-ICC-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
Otra información  Este es el primer trabajo que evidencia dos vías neuroanatómicas para la interocepción cardíaca (insular) y somatosensorial, mediante el estudio de medidas conductuales y neurofisiológicas interoceptivas de un paciente con dos corazones (una válvula artificial que emite pulsos somatosensoriales y su propio corazón biológico)