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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00616

Altered interoceptive inference modulates resting state heartbeat-evoked potentials in generalized anxiety disorder

 Jiaoyan Pang1,  Xiaochen Tang1,  Hui Li1, Qiang Hu1, Huiru Cui1, Lanlan Zhang2,  Wei Li1,  Jijun Wang1* and Chunbo Li1*
  • 1Shanghai Mental Health Center (SMHC), China
  • 2Suzhou Guangji Hospital, China

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders. Interoception, particularly heartbeat perception, plays an important role in the pathophysiology of anxiety disorders. However, the neural mechanisms underlying abnormal heartbeat perception in GAD remain insufficiently understood. In the present study, patients with GAD and healthy control subjects underwent an eye-close (EC) resting state (interoceptive) and eye-open (EO) resting state (exteroceptive) without paying conscious attention to heartbeat. Electrocardiography (ECG) and electroencephalography (EEG) signals were recorded at the same time. Our results show that interoceptive and exteroceptive state changes fail to modulate the amplitude of heartbeat-evoked brain potentials (HEPs) in patients with GAD. Further analysis revealed a marginally larger HEP in the EO states than in the EC states only in patients with GAD. Finally, the right prefrontal HEP amplitude was significantly correlated with anxiety levels of the patients only in the interoceptive state. Our results suggest that deficient adaptation to interoceptive signals and altered interoception inference play important roles in the manifestation of anxiety.

Keywords: generalized anxiety disorder, resting state, heartbeat-evoked brain potentials, neural mechanisms, deficient interoception adaptation, altered interoception inference

Received: 30 Jan 2019; Accepted: 01 Aug 2019.

Copyright: © 2019 Pang, Tang, Li, Hu, Cui, Zhang, Li, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Jijun Wang, Shanghai Mental Health Center (SMHC), Shanghai, China,
Prof. Chunbo Li, Shanghai Mental Health Center (SMHC), Shanghai, China,