Disrupted Dorsal Mid-Insula Activation During Interoception Across Psychiatric Disorders

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Bodily homeostasis relies on brain mechanisms for interoception (sensing internal body states).
• Altered neural activation during interoception is observed in various psychiatric disorders.
• A common brain region for transdiagnostic interoceptive differences remains unidentified.

Purpose of the Study:

• To identify a common neural locus of disrupted interoceptive processing across psychiatric disorders.
• To conduct a meta-analysis of neuroimaging studies on interoception in psychiatric populations.

Main Methods:

• Meta-analysis of 33 neuroimaging studies (306 foci) comparing psychiatric patients (n=626) with healthy controls (n=610).
• Searched bibliographic, neuroimaging, and preprint databases through May 2020.
• Utilized activation likelihood estimation (ALE) to pool data and identify convergent disrupted activation.

Main Results:

• Convergent disrupted activation specific to the left dorsal mid-insula was identified (Z=4.47, peak coordinates: -36, -2, 14).
• Included studies involved patients with schizophrenia, bipolar disorder, major depression, anxiety, and anorexia.
• The identified mid-insula cluster is anatomically distinct from regions involved in affect processing or treatment-related alterations.

Conclusions:

• Disrupted activation in the left dorsal mid-insula represents a transdiagnostic, domain-general difference in interoceptive processing.
• This finding suggests the left dorsal mid-insula may serve as a neural marker for psychopathology.
• The left dorsal mid-insula is a potential target for novel therapeutic interventions for psychiatric disorders.