Listen to your heart: Trade-off between cardiac interoceptive processing and visual exteroceptive processing

Internal bodily signals, such as heartbeats, can influence conscious perception of external sensory information. Spontaneous shifts of attention between interoception and exteroception have been proposed as the underlying mechanism, but direct evidence is lacking. Here, we used steady-state visual evoked potential (SSVEP) frequency tagging to independently measure the neural processing of visual stimuli that were concurrently presented but varied in heartbeat coupling in healthy participants. Although heartbeat coupling was irrelevant to participants' task of detecting brief color changes, we found decreased SSVEPs for systole-coupled stimuli and increased SSVEPs for diastole-coupled stimuli, compared to non-coupled stimuli. These results suggest that attentional and representational resources allocated to visual stimuli vary according to fluctuations in cardiac-related signals across the cardiac cycle, reflecting spontaneous and immediate competition between cardiac-related signals and visual events. Furthermore, frequent coupling of visual stimuli with stronger cardiac-related signals not only led to a larger heartbeat evoked potential (HEP) but also resulted in a smaller color change evoked N2 component, with the increase in HEP amplitude associated with a decrease in N2 amplitude. These findings indicate an overall or longer-term increase in brain resources allocated to the internal domain at the expense of reduced resources available for the external domain. Our study highlights the dynamic reallocation of limited processing resources across the internal-external axis and supports the trade-off between interoception and exteroception.