Investigating the relationship between cardiac interoception and autonomic cardiac control using a predictive coding framework

Predictive coding models, such as the ‘free-energy principle’ (FEP), have recently been discussed in relation to how interoceptive (afferent visceral feedback) signals update predictions about the state of the body, thereby driving autonomic mediation of homeostasis. This study appealed to ‘interoce...

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Vydáno v:Autonomic neuroscience Ročník 210; s. 65 - 71
Hlavní autoři: Owens, Andrew P., Friston, Karl J., Low, David A., Mathias, Christopher J., Critchley, Hugo D.
Médium: Journal Article
Jazyk:angličtina
Vydáno: Netherlands Elsevier B.V 01.03.2018
Témata:
Active inference
Autonomic nervous system
Dysautonomia
Free-energy principle
Heart rate variability
Homeostasis
Interoception
Interoceptive (active) inference
Predictive coding
Interoceptive (active) inference
Interoception
Autonomic nervous system
Active inference
Free-energy principle
Homeostasis
Predictive coding
Dysautonomia
Heart rate variability
ISSN:1566-0702, 1872-7484, 1872-7484
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Shrnutí:Predictive coding models, such as the ‘free-energy principle’ (FEP), have recently been discussed in relation to how interoceptive (afferent visceral feedback) signals update predictions about the state of the body, thereby driving autonomic mediation of homeostasis. This study appealed to ‘interoceptive inference’, under the FEP, to seek new insights into autonomic (dys)function and brain–body integration by examining the relationship between cardiac interoception and autonomic cardiac control in healthy controls and patients with forms of orthostatic intolerance (OI); to (i) seek empirical support for interoceptive inference and (ii) delineate if this relationship was sensitive to increased interoceptive prediction error in OI patients during head-up tilt (HUT)/symptom provocation. Measures of interoception and heart rate variability (HRV) were recorded whilst supine and during HUT in healthy controls (N = 20), postural tachycardia syndrome (PoTS, N = 20) and vasovagal syncope (VVS, N = 20) patients. Compared to controls, interoceptive accuracy was reduced in both OI groups. Healthy controls' interoceptive sensibility positively correlated with HRV whilst supine. Conversely, both OI groups' interoceptive awareness negatively correlated with HRV during HUT. Our pilot study offers initial support for interoceptive inference and suggests OI cohorts share a central pathophysiology underlying interoceptive deficits expressed across distinct cardiovascular autonomic pathophysiology. From a predictive coding perspective, OI patients' data indicates a failure to attenuate/modulate ascending interoceptive prediction errors, reinforced by the concomitant failure to engage autonomic reflexes during HUT. Our findings offer a potential framework for conceptualising how the human nervous system maintains homeostasis and how both central and autonomic processes are ultimately implicated in dysautonomia. •Afferent homeostatic interoceptive signals influence efferent autonomic outflow.•We use interoceptive inference to elucidate interoceptive and autonomic symbiosis.•Our data offers initial support for interoceptive inference.•We describe a framework for human nervous system homeostasis.•Central and autonomic processes are ultimately implicated in dysautonomia.
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ISSN:1566-0702
1872-7484
1872-7484
DOI:10.1016/j.autneu.2018.01.001