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Interoception in insula subregions as a possible state marker for depression - an exploratory fMRI study investigating healthy, depressed and remitted participants

  • Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored. Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups. Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups.Background: Interoceptive awareness, the awareness of stimuli originating inside the body, plays an important role in human emotions and psychopathology. The insula is particularly involved in neural processes underlying iA. However, iA-related neural activity in the insula during the acute state of major depressive disorder (MDD) and in remission from depression has not been explored. Methods: A well-established fMRI paradigm for studying interoceptive awareness (iA; heartbeat counting) and exteroceptive awareness (eA; tone counting) was used. Study participants formed three independent groups: patients suffering from MDD, patients in remission from MDD or healthy controls. Task-induced neural activity in three functional subdivisions of the insula was compared between these groups. Results: Depressed participants showed neural hypo-responses during iA in anterior insula regions, as compared to both healthy and remitted participants. The right dorsal anterior insula showed the strongest response to iA across all participant groups. In depressed participants there was no differentiation between different stimuli types in this region (i.e., between iA, eA and noTask). Healthy and remitted participants in contrast showed clear activity differences. Conclusions: This is the first study comparing iA and eA-related activity in the insula in depressed participants to that in healthy and remitted individuals. The preliminary results suggest that these groups differ in there being hypo-responses across insula regions in the depressed participants, whilst healthy participants and patients in remission from MDD show the same neural activity during iA in insula subregions implying a possible state marker for MDD. The lack of activity differences between different stimulus types in the depressed group may account for their symptoms of altered external and internal focus.show moreshow less

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Author details:Christine Wiebking, Moritz de Greck, Niall W. Duncan, Claus Tempelmann, Malek Bajbouj, Georg Northoff
DOI:https://doi.org/10.3389/fnbeh.2015.00082
ISSN:1662-5153
Pubmed ID:https://pubmed.ncbi.nlm.nih.gov/25914633
Title of parent work (English):Frontiers in behavioral neuroscience
Publisher:Frontiers Research Foundation
Place of publishing:Lausanne
Publication type:Article
Language:English
Year of first publication:2015
Publication year:2015
Release date:2017/03/27
Tag:fMRI; insula; interoceptive awareness; major depressive disorder; neuroimaging; remission
Volume:9
Number of pages:33
Funding institution:Lilly Germany; Salus Foundation; Hope of Depression Research Foundation; German Research Foundation (DFG) [Sonderforschungsbereich 779-A6]; IMHR Postdoctoral Fellowship
Organizational units:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften
Peer review:Referiert
Publishing method:Open Access
Institution name at the time of the publication:Humanwissenschaftliche Fakultät / Exzellenzbereich Kognitionswissenschaften
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