Objective:

Maintenance of bodily homeostasis relies on interoceptive mechanisms in the brain to predict and regulate bodily state. While altered neural activation during interoception in specific psychiatric disorders has been reported in many studies, it is unclear whether a common neural locus underpins transdiagnostic interoceptive differences.

Methods:

The authors conducted a meta-analysis of neuroimaging studies comparing patients with psychiatric disorders with healthy control subjects to identify brain regions exhibiting convergent disrupted activation during interoception. Bibliographic, neuroimaging, and preprint databases through May 2020 were searched. A total of 306 foci from 33 studies were extracted, which included 610 control subjects and 626 patients with schizophrenia, bipolar or unipolar depression, posttraumatic stress disorder, anxiety, eating disorders, or substance use disorders. Data were pooled using a random-effects model implemented by the activation likelihood estimation algorithm. The preregistered primary outcome was the neuroanatomical location of the convergence of peak voxel coordinates.

Results:

Convergent disrupted activation specific to the left dorsal mid-insula was found (Z=4.47, peak coordinates: −36, −2, 14; volume: 928 mm³). Studies directly contributing to the cluster included patients with bipolar disorder, anxiety, major depression, anorexia, and schizophrenia, assessed with task probes including pain, hunger, and interoceptive attention. A series of conjunction analyses against extant meta-analytic data sets revealed that this mid-insula cluster was anatomically distinct from brain regions involved in affective processing and from regions altered by psychological or pharmacological interventions for affective disorders.

Conclusions:

These results reveal transdiagnostic, domain-general differences in interoceptive processing in the left dorsal mid-insula. Disrupted mid-insular activation may represent a neural marker of psychopathology and a putative target for novel interventions.

中文翻译：

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精神疾病内感受期间背侧中岛叶激活中断

客观的：

身体稳态的维持依赖于大脑中的内感受机制来预测和调节身体状态。虽然许多研究都报道了特定精神疾病的内感受过程中神经激活的改变，但尚不清楚是否有一个共同的神经位点支撑着跨诊断的内感受差异。

方法：

作者对神经影像学研究进行了荟萃分析，将精神疾病患者与健康对照受试者进行比较，以确定内感受期间表现出收敛性破坏激活的大脑区域。检索了截至 2020 年 5 月的书目、神经影像和预印本数据库。从 33 项研究中总共提取了 306 个病灶，其中包括 610 名对照受试者和 626 名患有精神分裂症、双相或单相抑郁症、创伤后应激障碍、焦虑、饮食失调或物质使用障碍的患者。使用由激活似然估计算法实现的随机效应模型来汇集数据。预先登记的主要结果是峰值体素坐标收敛的神经解剖学位置。

结果：

发现了左背中岛叶特异性的会聚破坏激活（Z=4.47，峰值坐标：-36,-2,14；体积：928 mm ³）。直接对该集群做出贡献的研究包括患有双相情感障碍、焦虑症、重度抑郁症、厌食症和精神分裂症的患者，并通过包括疼痛、饥饿和内感受注意力在内的任务探针进行评估。针对现有荟萃分析数据集的一系列联合分析表明，这个岛中部簇在解剖学上与涉及情感处理的大脑区域以及因情感障碍的心理或药物干预而改变的区域不同。

结论：

这些结果揭示了左背中岛叶内感受处理的跨诊断、领域一般差异。中岛岛激活中断可能代表精神病理学的神经标志，也是新干预措施的假定目标。