Interoception, Functional Connectivity and Emotional Processing inDepersonalization-Derealization Disorder

Abstract

Depersonalization-Derealization Disorder (DD) typically manifests as a disruption of body self-awareness. Interoception (namely, cognitive processing of body signals) has been extensively considered as a key processing for body self-awareness. Against this background, this study aimed to investigate whether there are systematic differences in interoception between a patient with DD and controls that might explain the disembodiment symptoms of this disease. To assess interoception, we utilized a heartbeat detection task and measures of functional connectivity derived from fMRI networks in interoceptive/exteroceptivo/mind-wandering states. Additionally, we evaluated empathic abilities to test the association between interoception and emotional experience. The patient evinced impaired performance in the heartbeat detection task, alongside lower global brain connectivity only in the interoceptive state. He also presented a particular pattern of impairments in affective empathy. To our knowledge, this is the first experimental study on the relationship between interoception and DD combining behavioral and neurobiological measures. Our results suggest that altered neural mechanisms and cognitive processes regarding body signaling might be engaged in DD phenomenology. Moreover, our study contributes experimental data to the comprehension of brain-body interactions and the emergence of self-awareness and emotional feelings.