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Insights into interoceptive and emotional processing: Lessons from studies on insular HD-tDCS.

Miriam Kipping1, Sandra A Mai-Lippold1, Beate M Herbert2,3

  • 1Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.

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Summary

High-definition transcranial direct current stimulation (HD-tDCS) applied to the right insula did not enhance interoception or emotion in healthy adults. Physical preactivation showed some improvements in interoceptive sensibility, but not from direct brain stimulation.

Keywords:
HD‐tDCSemotioninsular cortexinteroceptionneurostimulationphysical activation

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Area of Science:

  • Neuroscience
  • Psychophysiology
  • Brain Stimulation

Background:

  • Interoception, the perception of internal bodily signals, is crucial for emotional experiences and is often impaired in psychiatric disorders.
  • The neural underpinnings of interoception and emotion require further elucidation, particularly concerning potential interventions.
  • The right anterior insula is a key region implicated in both interoceptive and emotional processing.

Purpose of the Study:

  • To investigate the feasibility of enhancing interoception and emotional processing using high-definition transcranial direct current stimulation (HD-tDCS) targeting the right anterior insula.
  • To assess the impact of HD-tDCS, with and without physical preactivation, on various dimensions of interoceptive abilities and emotional processing in healthy individuals.

Main Methods:

  • Two studies were conducted using a single-blind, cross-over, online design with HD-tDCS applied to the right anterior insula or sham stimulation.
  • Study one (N=52) assessed interoceptive sensibility, confidence, accuracy, and emotional evaluation.
  • Study two (N=39) incorporated ergometer cycling pre-stimulation to examine effects on interoception and emotion.

Main Results:

  • HD-tDCS applied to the right insula did not yield significant improvements in interoceptive dimensions in study one.
  • In study two, physical preactivation led to improvements in interoceptive sensibility and confidence over time, independent of sham or insula stimulation.
  • No significant enhancement of interoceptive or emotional processing was observed directly attributable to HD-tDCS of the right insula in either study.

Conclusions:

  • Targeting the right anterior insula with HD-tDCS does not consistently enhance interoceptive or emotional processing in healthy adults.
  • Improvements in interoceptive sensibility observed with physical preactivation may stem from network activation or training effects, not direct insula stimulation.
  • Future HD-tDCS research may benefit from targeting broader regions within the interoceptive network rather than isolated structures like the insula.