Self-control and interoception: Linking the neural substrates of craving regulation and the prediction of aversive interoceptive states induced by inspiratory breathing restriction.

Following the interoceptive inference framework, we set out to replicate our previously reported association of self-control and interoceptive prediction and strived to investigate the neural underpinnings subserving the relationship between self-control and aversive interoceptive predictive models. To this end, we used fMRI and a within-subject design including an inspiratory breathing-load task to examine the prediction of aversive interoceptive perturbation and a craving-regulation for palatable foods task to measure self-control. In this current study, we could successfully replicate previous effects with an independent sample (n ​= ​39) and observed that individuals who 'over-estimated' their upcoming interoceptive state with respect to experienced dyspnea (i.e., anticipated versus experienced) were more effective in the down-regulation of craving using negative future-thinking strategies. These individuals, again, obtained higher scores on a measure of trait self-control, i.e. self-regulation to achieve long-term goals. On a neural level, we found evidence that the anterior insula (AI) and the presupplementary motor area (preSMA), which were recruited in both tasks, partly accounted for these effects. Specifically, levels of AI activation during the anticipation of the aversive interoceptive state (breathing restriction) were associated with self-controlled behavior in the craving task, whereas levels of interoceptive prediction during the breathing task were conversely associated with activation in preSMA during the down-regulation of craving, whose anticipatory activity was correlated with self-control success. Moreover, during the self-control task, levels of interoceptive prediction were associated with connectivity in a spatially distributed network including among other areas the insula and regions of cognitive control, while during the interoceptive prediction task, levels of self-control were associated with connectivity in a spatially distributed network including among other regions the insula and preSMA. In sum, these findings consolidate the notion that self-control is directly linked to interoceptive inference and highlight the contribution of AI and preSMA as candidate regions underlying this relationship possibly creating processing advantages in self-control situations referring to the prediction of future internal states.