title: Probing the Interoceptive Network by Listening to Heartbeats: An fMRI Study.
abstract: Exposure to cues of homeostatic relevance (i.e. heartbeats) is supposed to increase the allocation of attentional resources towards the cue, due to its importance for self-regulatory, interoceptive processes. This functional magnetic resonance imaging (fMRI) study aimed at determining whether listening to heartbeats is accompanied by activation in brain areas associated with interoception, particularly the insular cortex. Brain activity was measured with fMRI during cue-exposure in 36 subjects while listening to heartbeats vs. sinus tones. Autonomic markers (skin conductance) and subjective measures of state and trait anxiety were assessed. Stimulation with heartbeat sounds triggered activation in brain areas commonly associated with the processing of interoceptive information, including bilateral insular cortices, the inferior frontal operculum, and the middle frontal gyrus. A psychophysiological interaction analysis indicated a functional connectivity between the middle frontal gyrus (seed region) and bilateral insular cortices, the left amygdala and the supplementary motor area. The magnitude of neural activation in the right anterior insular cortex was positively associated with autonomic arousal. The present findings indicate that listening to heartbeats induced activity in areas of the interoception network as well as changes in psychophysiological arousal and subjective emotional experience. As this approach constitutes a promising method for studying interoception in the fMRI environment, a clinical application in anxiety prone populations should be addressed by future studies.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Department of Psychology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Nina I
authors.initials: NI
authors.lastname: Kleint
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Department of Psychology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Department of Psychology, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry, Psychosomatics, and Psychoatherapy, University Hospital Würzburg, Würzburg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lueken
mesh_terms: D000679:Amygdala / Q000502:physiology; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000502:physiology*; D001288:Attention / Q000502:physiology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000502:physiology; D003463:Cues; D004644:Emotions / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D005712:Galvanic Skin Response; D006326:Heart Auscultation / Q000523:psychology*; D006339:Heart Rate; D006706:Homeostasis; D006801:Humans; D065812:Interoception / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000502:physiology