Intrinsic functional brain connectivity patterns underlying enhanced interoceptive sensibility

Background: Cumulative evidence has suggested that brain regions including the bilateral insula and the anterior cingulate cortex play critical roles in the processing of interoceptive information. However, the brain functional connectivity patterns underlying interoceptive sensibility (IS) and their role in the relationship between IS and self-reported bodily symptoms remain unknown. We aimed to investigate the intrinsic functional connectivity patterns associated with IS and how this modulates the relationship between IS and self-reported bodily symptoms. Methods: Resting-state functional magnetic resonance imaging was used to test the intrinsic large-scale functional connectivity in 459 healthy subjects. IS and self reported bodily symptoms were assessed by questionnaires. Results: Individuals with greater IS had a stronger tendency to report bodily symptoms. Higher IS was correlated with decreased ventral anterior insula-superior temporal gyrus, dorsal anterior cingulate cortex-middle frontal cortex and amygdala-medioventral occipital cortex connectivity. The large-scale functional connectivity of cingulo-opercular task control network (CON)-default mode network, CON-subcortical network and CON-dorsal attention network moderated the association between IS and bodily symptoms. Limitations: The Body Perception Questionnaire mainly reflects the self-perceived tendency to focus on negatively-valenced interoceptive sensations. Future research should distinguish neutral and negative IS in order to make the definition of IS clearer. Conclusions: This study suggests that IS may be related to impaired intrinsic functional connectivity between brain areas related to multisensory integration and cognitive-affective control, resulting in increased vigilance-attention to bodily signals. These findings offer new empirical evidence for a better understanding of the intricate relationships between interoception and symptom reporting.