Interoception in Autism Spectrum Disorder: A review.
OBJECTIVE
This review article summarizes original scientific research published to date on interoception in individuals with Autism Spectrum Disorder (ASD). Sensory processing has been shown to be atypical in ASD, yet physiological processing and subjective experience of internal sensation processing, namely interoception, has not been reported sufficiently in research or clinical settings.


BACKGROUND
There is a small but growing body of scientific research on interoception in ASD, which is relevant to understanding the behavioral and cognitive characteristics inherent in this condition, and may provide a foundation for clinical interventions such as biofeedback, pain management, and brain stimulation techniques.


METHODS
A literature review of original research was performed using major scientific databases.


RESULTS
Interoception, which occurs due to multisensory connections and integration of internal afferents in cortical and subcortical areas, is atypical in ASD, but the degree and directionality of this abnormality is not yet clear due to the heterogeneity of the condition. Between-group interoceptive differences in individuals with and without ASD have been repeatedly demonstrated, with a slight tendency towards hyporeactivity in interoceptive awareness in individuals with ASD.


CONCLUSIONS
Multidimensional research combining neuroimaging with psychophysiological and self-report measures guided by a clear theoretical model is necessary to understand how interoceptive differences link to the behavioral and cognitive characteristics of ASD. Sensory processing models and autism theory should also be updated to incorporate these recent findings.
Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Science Institute, University of Toronto, Toronto, Ontario, Canada.
Denise
D
DuBois
Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Research Imaging Centre, Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Stephanie H
SH
Ameis
Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health and The Hospital for Sick Children, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Meng-Chuan
MC
Lai
Department of Psychiatry and Behavioral Sciences, University of Louisville, Louisville, KY, USA.
Manuel F
MF
Casanova
Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: pushpal.desarkar@camh.ca.
Pushpal
P
Desarkar
D000067877:Autism Spectrum Disorder / Q000150:complications*; D006801:Humans; D065812:Interoception / Q000502:physiology*; D010468:Perceptual Disorders / Q000209:etiology*
Autism Spectrum Disorder; Homeostatic afferent pathway; Insula; Internal sensation processing; Interoception