Neural correlates of cardiac interoceptive accuracy across development: implications for social symptoms in autism spectrum disorders

Abstract

BackgroundInteroception involves the processing of sensory information relevant to physiological functioning and is integral to building self-awareness, emotional states, and modulating social behaviors. With the role of interoception in emotional processing and social functioning, there is growing interest in characterizing interoception in autism spectrum disorder (ASD), yet, there are mixed results regarding cardiac interoceptive accuracy in ASD.\n\nMethodsIn this study, we explored the neural basis of cardiac interoception using an fMRI heartbeat counting task in order to assess neural correlates of primary interoception. We predicted that interoceptive-specific response in the insula, a \"hub\" for interoception, would be related to ASD symptomatology. We investigated the relationship of insula responses during cardiac interoceptive accuracy and a self/caregiver-reported autism-related symptom scale (Social Responsiveness Scale-2 (SRS)). Participants included 46 individuals with autism spectrum disorder (ASD) (age 8-54, mean= 19.43{+/-}10.68 years) and 54 individuals with typical development for comparison (TC, age 8-53, mean= 21.43{+/-}10.41 years).\n\nResultsWe found no significant difference in cardiac interoceptive accuracy or neural response to cardiac interoception in ASD. Several insula sudivisons had a curvilinear relationship to age, peaking in early adulthood. Interoceptive-specific insula response was associated with adult self-report SRS scores; this association differed by diagnostic group and self/other report.\n\nConclusionsThis work suggests that 1) there is no global deficit in interoception in ASD, but that integrating interoceptive cues with social information may distinguish individuals with ASD, and 2) there is a developmental trajectory for interoceptive processing in the insula that may be relevant for socio-emotional health.