Altered Patterns of Heartbeat-Evoked Potentials in Depersonalization/Derealization Disorder

Abstract

These results suggest altered cortical representation of afferent signals originating from the cardiovascular system in patients with DPD, which may be associated with higher sympathetic tone. These findings may reflect difficulties of patients with DPD to attend to their actual bodily experiences.

Attention, in and Out: Scalp-Level and Intracranial EEG Correlates of Interoception and Exteroception

“…In line with this result, several studies have reported HEP modulations, not only in right electrodes (Pollatos and Schandry, 2004), but also extended to left (Schandry and Weitkunat, 1990; Gray et al, 2007) and central (Schandry and Weitkunat, 1990; Pollatos and Schandry, 2004; Schulz et al, 2015) topographies. Thus, it would seem that interoception and exteroception imply different neural mechanisms indexing attentional processes at very fast ongoing cycles.…”

“…Studies on various psychiatric and neurological conditions have shown alterations in this ERP relative to healthy controls (Terhaar et al, 2012; Muller et al, 2015; Schulz et al, 2015; García-Cordero et al, 2016). However, in all of these studies, HEP results emerged from contrasts between samples with resting-state activity (Muller et al, 2015) or a basal interoceptive condition—i.e., none of them examined differences relative to exteroceptive performance.…”

“…Given these properties, measurements of the HEP may afford critical insights into the cortical monitoring of internal signals, potentially shedding light on two relevant yet underexplored issues: (i) the specificity of internally driven (relative to externally driven) attentional processes; and (ii) its susceptibility to interoceptive training. A systematic assessment of such matters could afford valuable normative or reference parameters for clinical research, given that the HEP alterations during interoceptive tasks have been reported in patients with various psychiatric and neurological conditions (Terhaar et al, 2012; Muller et al, 2015; Schulz et al, 2015; García-Cordero et al, 2016). To foster progress in this direction, here we report the first joint assessment of the two abovementioned issues through a combination of behavioral measures, high-density electroencephalography (hd-EEG), and intracranial recordings.…”

“…In fact, knowing whether exteroceptive and interoceptive processing rely on different or shared mechanisms could contribute to our understanding of body-brain interactions in healthy subjects and in neuropsychiatric disorders. However, the vast majority of interoceptive research in neurotypicals (Pollatos and Schandry, 2004; Pollatos et al, 2005; Canales-Johnson et al, 2015) (except for Montoya et al, 1993) and patients with neuropsychiatric diseases (Terhaar et al, 2012; Muller et al, 2015; Schulz et al, 2015; García-Cordero et al, 2016), has overlooked contrasts between interoceptive and exteroceptive conditions. Thus, the ensuing results do not establish whether the observed effects reflect modulations of general attentional mechanisms or the specific dynamics of internally-driven processes.…”

Neural correlates of heart-focused interoception: a functional magnetic resonance imaging meta-analysis

“…From the view that interoception mediates between the perception of somatic states and domains that are highly relevant for successful coping with the challenges of everyday life, such as intuition, emotion and (decision) behaviour, it follows that improved understanding of the underlying functional anatomy may aid understanding and interventions for a wide array of issues including maladaptive response to somatic cues in panic disorder [21,33], somatoform disorder [34,35], dissociative disorders [36][37][38] or eating disorders [39,40]. Maladaptive stress reactivity in terms of cognitive and emotional response to issues in processing interoceptive information may contribute to poor somatic health [41].…”