Multilevel convergence of interoceptive impairments in hypertension: New evidence of disrupted body–brain interactions. Yoris A, Abrevaya S, Esteves S, Salamone P, Lori N, Martorell M, Legaz A, Alifano F, Petroni A, Sánchez R, Sedeño L, García AM, Ibáñez A. 2017

AUTORES Yoris A, Abrevaya S, Esteves S, Salamone P, Lori N, Martorell M, Legaz A, Alifano F, Petroni A, Sánchez R, Sedeño L, García AM, Ibáñez A.
AÑO 2017
JOURNAL Hum Brain Mapp
VOLUMEN 21 December, 2017
ABSTRACT Interoception, the sensing of visceral body signals, involves an interplay between neural and autonomic mechanisms. Clinical studies into this domain have focused on patients with neurological and psychiatric disorders, showing that damage to relevant brain mechanisms can variously alter interoceptive functions. However, the association between peripheral cardiac-system alterations and neurocognitive markers of interoception remains poorly understood. To bridge this gap, we examined multidimensional neural markers of interoception in patients with early stage of hypertensive disease (HTD) and healthy controls. Strategically, we recruited only HTD patients without cognitive impairment (as shown by neuropsychological tests), brain atrophy (as assessed with voxel-based morphometry), or white matter abnormalities (as evidenced by diffusion tensor imaging analysis). Interoceptive domains were assessed through (a) a behavioral heartbeat detection task; (b) measures of the heart-evoked potential (HEP), an electrophysiological cortical signature of attention to cardiac signals; and (c) neuroimaging recordings (MRI and fMRI) to evaluate anatomical and functional connectivity properties of key interoceptive regions (namely, the insula and the anterior cingulate cortex). Relative to controls, patients exhibited poorer interoceptive performance and reduced HEP modulations, alongside an abnormal association between interoceptive performance and both the volume and functional connectivity of the above regions. Such results suggest that peripheral cardiac-system impairments can be associated with abnormal behavioral and neurocognitive signatures of interoception. More generally, our findings indicate that interoceptive processes entail bidirectional influences between the cardiovascular and the central nervous systems.
RESUMEN

La interocepción (o censado de señales viscerales del cuerpo), regula los afectos y la cognición, e implica interacción cerebral y autonómica. Si bien sabemos que la afectación cerebral de regiones interoceptivas impacta en la interocepción cardiaca, poco se sabe acerca de cómo el sistema cardiaco impacta en la neurocognición interoceptiva. Estudiamos a pacientes con estadio temprano de enfermedad hipertensiva (HTD) sin deterioro cognitivo, sin atrofia cerebral (VBM) ni anomalías de la sustancia blanca (DTI) y controles sanos. Los pacientes exhibieron peor rendimiento interoceptivo sus de correlatos cerebrales (medicas corticales cardíacas, volumen y conectividad funcional de ínsula y cingulado). Así, las alteraciones del sistema cardíaco periférico se asocian con patrones anormales neurocognitivos de intercepción.