Impaired Cardiac Interoception In Patients With Multiple Sclerosis

SEDEÑO ; SINAY V; BRUNO D; PAGANI F; COUTO B; ADOLFI F; MIKULAN E; KOZONO G; PIETTO M; MANES F ; ROCA M ; IBÁÑEZ A

Encuentro; 67° Annual Meeting; 2015

Objective: To evaluate the heartbeat evoked potential (HEP) in patients with multiple sclerosis (MS) and controls. Background: The HEP is a negative modulation between 200 and 400 ms and is associated with the perception of the heartbeat (cardiac interoception). The insular cortex is one of the main areas involved in the processing of bodily signal information and of emotional awareness. Regarding MS, several studies have described atrophy of this area; however, there are no reports about whether interoceptive processing is affected or not in these patients. Methods: Thirty three patients with MS and 40 controls were evaluated with a heartbeat detection (HBD) task during which a high density electroencephalogram (hd-EEG) was registered. The HBD task consisted of one condition where subjects paid attention to an external stimulus (control condition) and a second where they followed their own heartbeats without external help (interoceptive condition). Each condition lasted five minutes and was divided into two blocks. Results: Based on a Monte Carlo permutation test combined with bootstrapping, we found that controls showed a significantly more negative modulation of HEP than patients during the interoception condition. No differences were found in the control condition between groups. Conclusions: This study demonstrates that patients with MS could have an interoception processing deficit, which is consistent with the insular cortex damage reported by previous research. This is the first study that evaluates interoception in MS and results show the importance of considering the sensing of bodily signals as a possible altered mechanism in this pathology