Maintaining a well-balance of physiological responses at all times is important for people to achieve an optimal functioning of daily lives. This involves processing and integration of signals from both internal and external sources. Interoception is the ability allowing us to the process and integrate of signals originating from oneself internally including heartbeats and breathing patterns. Most recent empirical findings suggest that clinical cases with autism and individuals with subclinical features of autism both exhibit interoceptive abnormalities. However, most of these findings were mainly generated from individuals with established clinical diagnosis of autism. Even worse, almost all were based on findings from self-rating or simple behavioural measures. The underlying neural mechanism of interoception associating with autistics symptoms or traits remains largely unclear.

In order to bridge such an important gap of knowledge, Dr. Raymond Chan’s team from the Neuropsychology and Applied Cognitive Neuroscience (NACN) Laboratory, CAS key Laboratory of Mental Health, Institute of Psychology has conducted a study to examine the resting-state functional connectivity associating with interoception with autistic traits in healthy volunteers. They recruited 62 college students to undertake the resting-state functional brain scans. All participants were also requested to complete a specific heartbeat tracking test assessing interoceptive accuracy and a set of rating scales measuring interoceptive sensibility and awareness as well as autistic traits and difficulty in expressing emotional feelings. The authors demonstrated that autistic traits associated negatively with the resting-state functional connectivity between the lateral ventral anterior insula and anterior cingulate cortex.

They also showed that interoceptive accuracy and sensibility associated positively with the resting-state functional connectivity between interoceptive brain networks and the visual regions, supplementary motor area and cerebellum. However, its total effect was mediated by the difficulty in expression emotional feelings but not the resultant resting-state functional connectivity correlating with interoceptive accuracy or sensitivity. The present findings have important clinical implications for autism spectrum disorders. For instance, it is noteworthy that the existing clinical intervention for sensory integration does not systematically assess and target for interoception. The present findings highlight the necessity of including interoception in sensory integration intervention programme for clinical cases with autistic spectrum disorders.

This study was supported by a grant form National Science Foundation China, Scientific Foundation of Institute of Psychology, Chinese Academy of Sciences, and the Philip K. H. Wong Foundation.

The paper was online on July 3 from Journal of Autism and Developmental Disorders:

- Yang, H. X., Zhang, Y. J., Hu, H. X., Wang, L. L.m Yan, Y. J., Lui, S. S. Y., Wang, Y., Chan, R. C. K.* (2023). Relationship between interoception and autistic traits: A resting-state functional connectivity study. Journal of Autism and Developmental Disorders.

Figure 1. Resting-state functional connectivities related to the interoceptive brain network. Image by Dr. Raymond Chan.

Related publications:
- Yang, H. X., Zhou, H. Y., Li, Y., Cui, Y. H., Xiang, Y., Yuan, R. M., Lui, S. S. Y., Chan, R. C. K.* (2022). Decreased interoceptive accuracy in children with autism spectrum disorder and with comorbid attention deficit/hyperactivity disorder. Autism Research, 15(4), 729-739. 
- Yang, H. X., Zhou, H. Y., Wei, Z., Wan, G. B., Wang, Y., Wang, Y. Y., Yang, T. X., Lui, S. S. Y., Chan, R. C. K.* (2022). Multidimensional interoception and autistic traits across life stages: Evidence from a novel eye-tracking task. Journal of Autism and Developmental Disorders, 52, 2644-2655. DOI : 10.1007/s10803-021-05155-w
- Yang, H. X., Hu, H. X., Zhang, Y. J., Wang, Y., Lui, S. S. Y., Chan, R. C. K.* (2022). A network analysis of interoception, self-awareness, empathy, alexithymia, and autistic traits.European Archives of Psychiatry and Clinical Neuroscience, 272, 199-209.

LIU Chen
Institute of Psychology Chinese Academy of Sciences
Beijing 100101, China.
E-mail: liuc@psych.ac.cn