Interoception of breathing and its relationship with anxiety

Olivia K Harrison; Laura Köchli; Stephanie Marino; Roger Luechinger; Franciszek Hennel; Katja Brand; Alexander J Hess; Stefan Frässle; Sandra Iglesias; Fabien Vinckier; Frederike H Petzschner; Samuel J Harrison; Klaas E Stephan

doi:10.1016/j.neuron.2021.09.045

Interoception of breathing and its relationship with anxiety

Neuron. 2021 Dec 15;109(24):4080-4093.e8. doi: 10.1016/j.neuron.2021.09.045. Epub 2021 Oct 20.

Affiliations

¹ Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Department of Psychology, University of Otago, Dunedin, New Zealand; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK. Electronic address: [email protected].
² Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.
³ Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.
⁴ Department of Psychology, University of Otago, Dunedin, New Zealand.
⁵ Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Université de Paris, Paris, France; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France.
⁶ Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
⁷ Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Max Planck Institute for Metabolism Research, Cologne, Germany.

Abstract

Interoception, the perception of internal bodily states, is thought to be inextricably linked to affective qualities such as anxiety. Although interoception spans sensory to metacognitive processing, it is not clear whether anxiety is differentially related to these processing levels. Here we investigated this question in the domain of breathing, using computational modeling and high-field (7 T) fMRI to assess brain activity relating to dynamic changes in inspiratory resistance of varying predictability. Notably, the anterior insula was associated with both breathing-related prediction certainty and prediction errors, suggesting an important role in representing and updating models of the body. Individuals with low versus moderate anxiety traits showed differential anterior insula activity for prediction certainty. Multi-modal analyses of data from fMRI, computational assessments of breathing-related metacognition, and questionnaires demonstrated that anxiety-interoception links span all levels from perceptual sensitivity to metacognition, with strong effects seen at higher levels of interoceptive processes.

Keywords: anxiety; breathing; inspiratory resistance; interoception.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
Anxiety Disorders
Heart Rate
Humans
Interoception*
Respiration