Abstract
A network of cortical brain regions, including the insula and anterior cingulate cortex (ACC), has been proposed as the critical and sole substrate for interoceptive awareness. Combining lesion and pharmacological approaches in humans, we found that the insula and ACC were not critical for awareness of heartbeat sensations. Instead, this awareness was mediated by both somatosensory afferents from the skin and a network that included the insula and ACC. Together, these pathways enable the core human experience of the cardiovascular state of the body.
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Acknowledgements
We thank J. Bruss for figure assistance, S. Schubert and M. Bosch for isoproterenol administration, C. Sandesara, E. St. Louis, B. Olshansky and H. Shim for medical supervision, T. Grabowski for neurological expertise and J. Martins for safety monitoring. This work was supported by the US National Center for Complementary & Alternative Medicine (F31-AT003061), the US National Institute on Drug Abuse (R01-DA022549) and the US National Center for Research Resources, General Clinical Research Center Program (M01-RR-59).
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S.S.K. and D.R. designed the study with help from J.S.F. S.S.K. collected the data. S.S.K. and D.R. analyzed the data. S.S.K. and D.R. wrote the paper with the help of J.S.F. and D.T.
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Khalsa, S., Rudrauf, D., Feinstein, J. et al. The pathways of interoceptive awareness. Nat Neurosci 12, 1494–1496 (2009). https://doi.org/10.1038/nn.2411
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DOI: https://doi.org/10.1038/nn.2411
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