Interoception and theory of mind in Multiple Sclerosis

SOL ESTEVES; INDIRA GARCÍA-CORDERO; SOFÍA ABREVAYA; VLADIMIR SINAY; DIANA BRUNO; FATIMA PAGANI; BLAS COUTO; FEDERICO ADOLFI; EZEQUIEL MIKULAN; ADOLFO M. GARCÍA; AGUSTÍN IBÁÑEZ; LUCAS SEDEÑO

Congreso; 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis; 2016

European Committee for Treatment and Research in Multiple Sclerosis

The Heart-Evoked Potential (HEP) is a negative event-related potential associated with the attention of internal bodily signals (named interoception). Its main neural basis are the insular, anterior cingulate (ACC) and somatosensory cortex. Interoception is related to emotional awareness as shown by its influence on socio-cognitive domains, and by the overlap of brain networks between processes. Regarding Multiple Sclerosis (MS), although several studies have described atrophy in the insular cortex and alterations in theory of mind, none of them have assessed whether interoceptive processing is affected in patients, neither its potential impact in social cognitive domains. Our objectives were: (i) to evaluate the HEP modulations and its cortical correlates in patients with MS and healthy controls; (ii) to assess the possible association between HEP modulation and patients performance in a theory of mind (ToM) task. Methods: Thirty three patients with MS and 40 controls ?matched for age, gender and level of education? were asked to follow their own heartbeats without any external cues (interoceptive condition). During the task, neurophysiological and cardiac signals were recorded via a high density electroencephalography (EEG) and electrocardiography (ECG). Neural correlates were examined through structural imaging. ToM was evaluated via the Faux pas task. Results: Regarding HEP, healthy controls showed a significant more negative modulation compared to MS. The atrophy pattern of patients showed damage extended throughout right ACC, bilateral insular cortex and basal ganglia. In the control group, HEP was associated with two interoceptive hubs: the ACC and the insular cortex. These association was absent in the MS patients. However, the somatosensory cortex, other area linked with the perception of body information, was related to HEP in the MS patients and not in the control sample. Regarding ToM, only the last group presented a positive correlation with the HEP. Discussion: Our findings suggest that MS patients may present deficits in interoceptive processing. This is support by their atrophy patter that involves interoceptive areas. In patients, only the somatosensory cortex was correlated with HEP, which indicates a possible compensatory role. Finally, the relationship between interoception and ToM supports the link between the sensing of body signals and social cognition.