Department of Psychiatry, University of California, San Diego, CA, USA.
VA San Diego Healthcare System, San Diego, CA, USA.
Transl Psychiatry. 2018 Aug 16;8(1):161. doi: 10.1038/s41398-018-0218-3.
Interoception, or the sensing and integration of bodily state signals, has been implicated in anorexia nervosa (AN), given that the hallmark symptoms involve food restriction and body image disturbance. Here we focus on brain response to the anticipation and experience of affective interoceptive stimuli. Women remitted from AN (RAN; N = 18) and healthy comparison women (CW; N = 26) underwent a pleasant affective touch paradigm consisting of gentle strokes with a soft brush administered to the forearm or palm during functional neuroimaging. RAN had a lower brain response relative to CW during anticipation of touch, but a greater response when experiencing touch in the right ventral mid-insula. In RAN, this reduced anticipatory response was associated with higher levels of harm avoidance. Exploratory analyses in RAN also suggested that lower response during touch anticipation was associated with greater body dissatisfaction and higher perceived touch intensity ratings. This reduced responsivity to the anticipation of pleasant affective interoceptive stimuli in association with higher harm avoidance, along with an elevated response to the experience of touch, suggests an impaired ability in AN to predict and interpret incoming physiological stimuli. Impaired interoception may thus impact one's sense of self, thereby supporting observations of disturbed body image and avoidance of affective and social stimuli. Therapeutic approaches that help AN to better anticipate and interpret salient affective stimuli or improve tolerance of interoceptive experiences may be an important addition to current interventions.
内感受，即对身体状态信号的感知和整合，与神经性厌食症（AN）有关，因为其标志性症状涉及食物限制和身体形象障碍。在这里，我们专注于大脑对情感内感受刺激的预期和体验的反应。从 AN 中缓解的女性（RAN；N = 18）和健康对照组女性（CW；N = 26）在功能神经影像学期间接受了愉快的情感触觉范式，包括用软刷轻柔地刷前臂或手掌。与 CW 相比，RAN 在触摸预期时的大脑反应较低，但在右腹内侧中脑区域体验触摸时的反应更大。在 RAN 中，这种减少的预期反应与更高的回避伤害水平有关。在 RAN 中的探索性分析还表明，在触摸预期期间反应较低与更大的身体不满和更高的感知触摸强度评分有关。与较高的回避伤害相关联的对愉快情感内感受刺激的预期减少，以及对触摸体验的反应增加，表明 AN 预测和解释传入生理刺激的能力受损。因此，内感受可能会影响一个人的自我意识，从而支持对身体形象障碍和对情感和社会刺激的回避的观察。帮助 AN 更好地预测和解释重要情感刺激或改善对内感受体验的耐受性的治疗方法可能是当前干预措施的重要补充。
