Hu Lan, He Hui, Roberts Neil, Chen Jiajia, Yan Guojian, Pu Li, Song Xufeng, Luo Cheng
The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.
The Fourth People's Hospital of Chengdu, Chengdu, China.
Front Psychiatry. 2023 Sep 28;14:1273439. doi: 10.3389/fpsyt.2023.1273439. eCollection 2023.
Interoception plays a crucial role in maintaining bodily homeostasis and promoting survival, and is considered the basis of human emotion, cognition, and self-formation. A malfunction of interoception is increasingly suggested to be a fundamental component of different mental health conditions, and depressive disorders have been especially closely associated. Interoceptive signaling and processing depends on a system called the "interoceptive pathway," with the insula, located in the deep part of the lateral fissure, being the most important brain structure in this pathway. Neuroimaging studies have revealed alterations in the structure and function of the insula in a large number of individuals with depression, yet the precise relationship between these alterations and interoceptive dysfunction remains unclear. The goal of this review is to examine the evidence that exists for dysfunction of interoception in people with Major Depressive Disorder (MDD), and to determine the associated specific alterations in the structure and function of the insula revealed by neuroimaging. Overall, three aspects of the potential relationship between interoceptive dysfunction and alterations in insular function in people with depression have been assessed, namely clinical symptoms, quantitative measures of interoceptive function and ability, and interoceptive modulation. To conclude, several specific limitations of the published studies and important lines of enquiry for future research are offered.
内感受在维持身体内环境稳定和促进生存方面发挥着关键作用，被认为是人类情感、认知和自我形成的基础。越来越多的研究表明，内感受功能障碍是不同心理健康状况的一个基本组成部分，尤其是与抑郁症密切相关。内感受信号传导和处理依赖于一个称为“内感受通路”的系统，位于外侧裂深部的脑岛是该通路中最重要的脑结构。神经影像学研究显示，大量抑郁症患者的脑岛结构和功能存在改变，但这些改变与内感受功能障碍之间的确切关系仍不清楚。本综述的目的是研究重度抑郁症（MDD）患者内感受功能障碍的现有证据，并确定神经影像学揭示的脑岛结构和功能的相关具体改变。总体而言，评估了抑郁症患者内感受功能障碍与脑岛功能改变之间潜在关系的三个方面，即临床症状、内感受功能和能力的定量测量以及内感受调节。最后，指出了已发表研究的几个具体局限性以及未来研究的重要探究方向。
