The neurobiology of interoception in health and disease.

Author: Quadt L1, Critchley HD1,2, Garfinkel SN1,2
Affiliation: <sup>1</sup>Department of Psychiatry and Neuroscience, Brighton and Sussex Medical School (BSMS), Trafford Centre, University of Sussex, Brighton, United Kingdom. <sup>2</sup>Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom.
Conference/Journal: Ann N Y Acad Sci.
Date published: 2018 Jul 5
Other: Special Notes: doi: 10.1111/nyas.13915. [Epub ahead of print] , Word Count: 214

Interoception is the sensing of internal bodily sensations. Interoception is an umbrella term that encompasses (1) the afferent (body-to-brain) signaling through distinct neural and humoral (including immune and endocrine) channels; (2) the neural encoding, representation, and integration of this information concerning internal bodily state; (3) the influence of such information on other perceptions, cognitions, and behaviors; (4) and the psychological expression of these representations as consciously accessible physical sensations and feelings. Interoceptive mechanisms ensure physiological health through the cerebral coordination of homeostatic reflexes and allostatic responses that include motivational behaviors and associated affective and emotional feelings. Furthermore, the conscious, unitary sense of self in time and space may be grounded in the primacy and lifelong continuity of interoception. Body-to-brain interactions influence physical and mental well-being. Consequently, we show that systematic investigation of how individual differences, and within-individual changes, in interoceptive processing can contribute to the mechanistic understanding of physical and psychological disorders. We present a neurobiological overview of interoception and describe how interoceptive impairments at different levels relate to specific physical and mental health conditions, including sickness behaviors and fatigue, depression, eating disorders, autism, and anxiety. We frame these findings in an interoceptive predictive processing framework and highlight potential new avenues for treatments.

KEYWORDS: anxiety; autism; depression; eating disorders; health; interoception; mental health; predictive processing

PMID: 29974959 DOI: 10.1111/nyas.13915