Interoception and activation in the anterior insula cortex in binge drinkers.

Abstract

Interoception refers to the sensory processing of internal bodily signals, guiding cognitive and motivational behaviours. In addiction, disturbances of interoception are expressed as altered insular cortex activation and have been described, for example through the phenomenon of craving. Studies focusing on substance use disorders report aberrant activation of the anterior insula cortex (AIC), during emotional processing. Among alcohol dependent subjects, reduced interoceptive ability has also been observed. In the present study, we investigated the neural correlates of interoception in social drinkers during an emotional processing task. A preliminary sample of 11 healthy male social drinkers evaluated their empathy for pain in response to emotional pictures during fMRI scanning. Questionnaires assessed Binge Drinking Score (BDS) and Interoceptive Sensibility (subjective measure of Interoception). Individuals scoring higher for binge drinking showed enhanced activation in the right AIC during emotional processing. Furthermore, the activation of the AIC was negatively correlated with interoceptive sensibility. These findings show that interoceptive processes are not only disrupted in drug or alcohol use disorders, but are further impaired in binge drinkers, both at subjective and objective levels. Paradoxically, AIC hypersensitivity observed in binge drinkers is associated with reduced interoceptive sensibility. This conclusion is in line with the emergent literature supporting the important role of interoception in addiction, which may inform the development of new therapies targeting interoceptive processes. Key words: Emotion, Addiction, Interoception, Binge Drinking, fMRI

Full text

Sophie Betka1,2,4, Gaby Pfeifer1, Sarah Garfinkel1,3, Jessica Eccles1, Cassandra Gould
Van Praag1, Henrique Sequeira4, Theodora Duka2, and Hugo Critchley1,3
1Brighton and Sussex Medical School, Clinical Imaging Science Centre, Brighton, BN1 9RR, England; 2University of Sussex,
Psychology Department, Brighton, BN1 9RR, England; 3Sackler Centre for Consciousness Science, University of Sussex, UK;
4University of Lille, SCALab, CNRS UMR 9193, Lille, 59045, France.
Interoception and activation in
the anterior insula cortex in
binge drinkers.
Introduction Results
Behavioral data
No correlation was observed between ratings of pictures and
questionnaire measures.
fMRI data
The activation of a cluster in the right AIC was positively correlated
with BDS (Figure 2).
Conclusion
Interoceptive processes are not only disrupted in drug or
alcohol use disorders, but are further impaired in binge
drinkers.
At the objective level, this disruption is underpinned by ahyper
activation of the anterior insular cortex, which could be
characterized as acompensation mechanism.
At the subjective level, binge drinking is associated with a
reduced interoceptive sensibility.
Interoception refers to the sensory processing of internal
bodily signals, guiding cognitive and motivational
behaviours.
In addiction, disturbances of interoception are
expressed as altered insular cortex activation
and have been described, for example through
the phenomenon of craving[1].
Contact: H.Critchley@bsms.ac.uk
S.Betka@bsms.ac.uk
References:[1] Naqvi et al., (2007). Science.26; 315(5811):531–
534.[2] Berk et al., (2017). Addiction.110,2025-2036. [3] Ates Col et al.,
(2016). Arch Neuropsychiatr;53:17-22.[4] Jackson et al., (2005).
Neuroimage.24,771-779.
Acknowledgements:
Rotary Foundation
Society for the Study of Addictions
However, our findings are in line with the emergent literature
supporting the important role of interoception in addiction,
which may inform the development of new therapies targeting
interoceptive processes.
Figure 1. Empathy for pain paradigm
Objective: Investigating the neural correlates of interoception
in social drinkers during an emotional processing task.
Protocol and Preprocessing
We used an event-related design, including 64 pictures of a hand in
painful contexts and 64 pictures of a hand in non painful contexts[4].
~900 volumes were obtained using a T2*weighted multiband echo
planar imaging (EPI) sequence; Acceleration Factor=2; TR=1379ms,
TE=42ms, flip angle 90˚.All functional images were slice-time and
motion corrected, unwarped, coregistered to participants’ individual
structural volume, and spatially normalised. All data were acquired
using a 1,5 T scanner.
Statistical Analyses
Using SPM12,we correlated the BDS with contrast images for Pain
and No Pain. Non-parametric two-tailed correlations between
questionnaire scores, behavioural ratings and extracted insular
activations were computed, using SPSS 22.
Figure 2. A positive correlation was observed between the activation of cluster in the
right AIC and BD scores. [MNI 45 20 -1] Height threshold T=4.91,p<0.05 (FWE)
The activation of the AIC cluster was negatively correlated with
interoceptive sensibility (τ=-.59,p<0.05; Figure 3).
Figure 3. A negative
correlation was observed
between the extracted
cluster activation and the
BPQ scores.
Further studies should investigate
the causal relationship between
Interoception and Addiction
should be.
Methods
Participants & Procedure
11 male participants (Age: M=24.82;SD=4.45) filled in the Body
Perception Questionnaire (BPQ), measuring the Interoceptive
Sensibility. Participants indicated their awareness of 45 bodily
sensations (e.g. stomach and gut pains) using a five point scale
ranging from ‘never’ coded as 1to ‘always’ coded as 5. The BPQ
score was the mean of all the answers. The completion of the
Alcohol Use Questionnaire allowed the computation of the Binge
Drinking Score (BDS). Then, subjects performed an emotional
empathy task during fMRI scanning (Figure 1).
fMRI
Task
Studies focusing on substance use disorders report
aberrant activation of the anterior insula cortex (AIC),
during emotional processing[2]. Among alcohol
dependent subjects, reduced interoceptive ability has
also been observed [3].