Large-scale neural systems linking bodily self-awareness and valuation in decision-making

Adaptive decision-making depends on the integration of reward valuation with internal bodily and action-related signals; yet, this broader neural architecture is not fully captured by reward-centric models. Emerging evidence suggests that bodily self-awareness - including interoception and sense of agency - may shape reward-driven behaviour, but its large-scale neural organization and clinical relevance remain unclear. Here, we integrated existing evidence to examine the systems-level relationship between neural circuits supporting bodily self-awareness and those involved in reward valuation. We combined three coordinate-based meta-analyses of functional neuroimaging studies investigating interoception, sense of agency, and cognitive impulsivity with a targeted re-analysis of previously published and publicly available resting-state datasets in healthy individuals and in participants with cocaine use disorder. Across meta-analyses, interoception and agency converged within insular and salience-network regions, whereas cognitive impulsivity engaged distinct fronto-striatal and default mode network regions. At the network level, these systems exhibited opposing functional connectivity profiles, consistent with a relative functional differentiation between bodily self-awareness and valuation-related processes. Critically, this organization was altered in cocaine use disorder: the caudate nucleus showed reduced integration with interoceptive and agency-related networks and increased coupling with cognitive impulsivity-related circuits. These findings identify a large-scale neural architecture linking bodily self-awareness and valuation systems and suggest that cocaine use disorder is associated with altered integration among these systems.