The heartbeat-evoked brain potential in patients suffering from diabetic neuropathy and in healthy control persons

Leopold, Christian; Schandry, Rainer

doi:10.1016/s1388-2457(01)00480-1

Cited by 79 publications

(88 citation statements)

References 28 publications

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“…The polarity of the peak of this waveform varies across electrode locations. However, in the latency range from 250 to 350 ms, which has repeatedly been shown (Leopold & Schandry, 2001;Schandry et al, 1986) to be closely related to heart activity, the picture becomes more unequivocal. The distribution of the mean HEP amplitude for the latency range of 250-350 ms is depicted in Figure 2.…”

Section: Hep Morphology and Scalp Distributionmentioning

confidence: 96%

Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat‐evoked brain potential

2004

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Neurotransmission from the heart to the brain results in a heartbeat-evoked potential (HEP). In this study, the influence of the ability to detect one's heartbeats based on the HEP was examined. According to their results in a heartbeat perception task, subjects were classified as good (n 5 18) or poor (n 5 26) heartbeat perceivers. EEG, EOG, and ECG were recorded while participants attended to their heartbeats. The R-wave of the ECG served as a trigger for EEG averaging. In the latency range of 250-350 ms after the ECG R-wave, the HEP amplitude at the right central location was significantly higher in good heartbeat perceivers. A significantly positive correlation was observed between the heartbeat perception score and the mean HEP amplitude. Our results confirm that the accuracy of heartbeat perception is reflected in the amplitude of the HEP. Thus, the HEP may be a suitable research tool for the study of brain processes related to visceral perception.

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Section: Hep Morphology and Scalp Distributionmentioning

confidence: 96%

Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat‐evoked brain potential

2004

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“…The right-insular cortex has also been considered particularly important for cerebral regulation of cardiac functions [101,102]. For example, after strokes involving the rightinsular cortex the risk of cardio-autonomic dysfunction was enhanced [103], and right-sided stroke was associated with reduced heart rate variability [104].…”

Section: (B) On Hemispheric Specializationmentioning

confidence: 99%

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

Schulz

2016

Phil. Trans. R. Soc. B

175

118

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Interoception is the ability to perceive one's internal body state including visceral sensations. Heart-focused interoception has received particular attention, in part due to a readily available task for behavioural assessment, but also due to accumulating evidence for a significant role in emotional experience, decision-making and clinical disorders such as anxiety and depression. Improved understanding of the underlying neural correlates is important to promote development of anatomical-functional models and suitable intervention strategies. In the present meta-analysis, nine studies reporting neural activity associated with interoceptive attentiveness (i.e. focused attention to a particular interoceptive signal for a given time interval) to one's heartbeat were submitted to a multilevel kernel density analysis. The findings corroborated an extended network associated with heart-focused interoceptive attentiveness including the posterior right and left insula, right claustrum, precentral gyrus and medial frontal gyrus. Right-hemispheric dominance emphasizes non-verbal information processing with the posterior insula presumably serving as the major gateway for cardioception. Prefrontal neural activity may reflect both top-down attention deployment and processing of feed-forward cardioceptive information, possibly orchestrated via the claustrum. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.

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“…Significant differences in heartbeat perception ability were also observed in different clinical samples: Mussgay et al [1999] demonstrated a tendency towards lower perception scores in patients with depressive, somatoform, and personality disorders, whereas Ehlers et al [1992Ehlers et al [ , 2000 reported more accurate heartbeat perception in panic patients. Patients suffering from arrhythmias and benign palpitations [Ehlers et al, 2000], and patients with diabetic neuropathy [Leopold and Schandry, 2001] showed a decreased heartbeat perception ability compared to healthy controls. Thus, differences in heartbeat perception are of clinical relevance and may be used for describing and classifying patients suffering from various somatoform and psychological problems.…”

Section: Introductionmentioning

confidence: 99%

“…They demonstrated that insula, somatomotor, and cingulated cortices are activated when subjects focus attention on their heartbeats. Except for the mentioned fMRI study, the cortical processing of signals from the cardiovascular system has frequently been studied using the heartbeat-evoked potential (HEP), a brain wave that appears contingent on the heartbeat [Schandry et al, 1986;Jones et al, 1986;Dirlich et al, 1997Dirlich et al, , 1998Montoya et al, 1993;Riordan et al, 1990;Schandry and Montoya, 1996;Leopold and Schandry, 2001;Pollatos and Schandry, 2004]. Concerning the scalp distribution of the HEP, congruent results exist, showing highest HEP activity primarily at frontocentral electrodes [Pollatos and Schandry, 2004;Montoya et al, 1993;Schandry and Montoya, 1996;Leopold and Schandry, 2001].…”

Section: Introductionmentioning

confidence: 99%

Brain structures involved in interoceptive awareness and cardioafferent signal processing: A dipole source localization study

Pollatos¹,

Kirsch²,

Schandry³

2005

Human Brain Mapping

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225

198

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Afferent signals from the body play an important role for emotional and motivational aspects of behavior. Nevertheless, little is known about the cortical and subcortical structures involved in interoceptive processes. Recently, a functional MRI study demonstrated that insula, somatomotor, and cingulated cortices are activated when subjects focus attention on their heartbeats. Aside from the use of imaging data, cardiac awareness has frequently been studied by using the heartbeat-evoked potential (HEP), a brain wave that appears contingent on the heartbeat. The present study aimed at localizing sources of the HEP. Multichannel EEG was recorded in 44 subjects while they performed a heartbeat perception task. This task was used to quantify interoceptive awareness and to subdivide the subjects into good and poor heartbeat perceivers. Analyses showed highest HEP amplitudes over frontal and frontocentral electrode locations in the time range of later than 200 ms after R-wave onset. By means of a BESA dipole-source-analysis, four sources of the HEP were identified which were located in the anterior cingulate, the right insula, the prefrontal cortex, and the left secondary somatosensory cortex. Good heartbeat perceivers showed both significantly higher HEP amplitudes and higher dipole strength than poor heartbeat perceivers in all four cortical sources. We conclude that the identified structures are involved in the processing of cardiac signals, whereby anterior cingulate and right insula seem to serve as interoceptive centers for cardioception.

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The heartbeat-evoked brain potential in patients suffering from diabetic neuropathy and in healthy control persons

Cited by 79 publications

References 28 publications

Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat‐evoked brain potential

Accuracy of heartbeat perception is reflected in the amplitude of the heartbeat‐evoked brain potential

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

Brain structures involved in interoceptive awareness and cardioafferent signal processing: A dipole source localization study

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