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      Time Processing, Interoception, and Insula Activation: A Mini-Review on Clinical Disorders

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          Abstract

          Time processing is a multifaceted skill crucial for managing different aspects of life. In the current work, we explored the relationship between interoception and time processing by examining research on clinical models. We investigated whether time processing deficits are associated with dysfunction of the interoceptive system and/or insular cortex activity, which is crucial in decoding internal body signaling. Furthermore, we explored whether insular activation predicts the subjective experience of time (i.e., the subjective duration of a target stimulus to be timed). Overall, our work suggests that alteration of the interoceptive system could be a common psychophysiological hallmark of mental disorders affected by time processing deficits.

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          How do you feel--now? The anterior insula and human awareness.

          The anterior insular cortex (AIC) is implicated in a wide range of conditions and behaviours, from bowel distension and orgasm, to cigarette craving and maternal love, to decision making and sudden insight. Its function in the re-representation of interoception offers one possible basis for its involvement in all subjective feelings. New findings suggest a fundamental role for the AIC (and the von Economo neurons it contains) in awareness, and thus it needs to be considered as a potential neural correlate of consciousness.
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            Neural systems supporting interoceptive awareness.

            Influential theories of human emotion argue that subjective feeling states involve representation of bodily responses elicited by emotional events. Within this framework, individual differences in intensity of emotional experience reflect variation in sensitivity to internal bodily responses. We measured regional brain activity by functional magnetic resonance imaging (fMRI) during an interoceptive task wherein subjects judged the timing of their own heartbeats. We observed enhanced activity in insula, somatomotor and cingulate cortices. In right anterior insular/opercular cortex, neural activity predicted subjects' accuracy in the heartbeat detection task. Furthermore, local gray matter volume in the same region correlated with both interoceptive accuracy and subjective ratings of visceral awareness. Indices of negative emotional experience correlated with interoceptive accuracy across subjects. These findings indicate that right anterior insula supports a representation of visceral responses accessible to awareness, providing a substrate for subjective feeling states.
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              Interoception in anxiety and depression

              We review the literature on interoception as it relates to depression and anxiety, with a focus on belief, and alliesthesia. The connection between increased but noisy afferent interoceptive input, self-referential and belief-based states, and top-down modulation of poorly predictive signals is integrated into a neuroanatomical and processing model for depression and anxiety. The advantage of this conceptualization is the ability to specifically examine the interface between basic interoception, self-referential belief-based states, and enhanced top-down modulation to attenuate poor predictability. We conclude that depression and anxiety are not simply interoceptive disorders but are altered interoceptive states as a consequence of noisily amplified self-referential interoceptive predictive belief states.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                18 August 2020
                2020
                : 11
                : 1893
                Affiliations
                [1] 1Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e Degli Studi Culturali, Università di Messina , Messina, Italy
                [2] 2Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors , Dortmund, Germany
                [3] 3Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa , Genoa, Italy
                [4] 4Department of Clinical and Experimental Medicine, University of Messina , Messina, Italy
                Author notes

                Edited by: Anne Giersch, Institut National de la Santé et de la Recherche Médicale (INSERM), France

                Reviewed by: Marc Wittmann, Institute for Frontier Areas of Psychology and Mental Health (IGPP), Germany; Francesca Ferri, University of Studies G. d’Annunzio Chieti and Pescara, Italy

                *Correspondence: Carmelo Mario Vicario, cvicario@ 123456unime.it

                This article was submitted to Psychopathology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2020.01893
                7461974
                32973605
                76fe5ce7-da22-42ef-a578-ff1a2a85d4b7
                Copyright © 2020 Vicario, Nitsche, Salehinejad, Avanzino and Martino.

                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.

                History
                : 25 March 2020
                : 09 July 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 107, Pages: 8, Words: 0
                Categories
                Psychology
                Mini Review

                Clinical Psychology & Psychiatry
                time processing,clinical disorders,interoception,insula,timing deficits

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