Interoception in acute stress and stress-associated diseases

The interaction between interoception and stress can be
construed as bi- directional communication between the
brain and the body. The current study set aimed to: 1)
Understand the bi- directional communication between
the brain and the body in a healthy state and 2) reveal the
potential role of dysregulated brain- body communication
in stress- associated diseases. To address these aims, different
stages of interoceptive signal processing, as well
as their interpretation, were studied. Specific attention is
paid to the activity of both physiological stress axes, the
hypothalamic- pituitary- adrenocortical (HPA) and the
sympatho- adreno- medullary (SAM) axis. First, a number
of studies applying laboratory stress tests and pharmacological
designs showed that an activation of the SAM axis
stimulates the cardiovascular system and affects attentional
resources for interoceptive signals. Second, cortisol
amplifies brain- body communication on the stage of cortical
CNS representation of interoceptive signals. A number
of mental disorders are characterized by a specific pattern
of dysregulation with regard to interoception and physiological
stress axes, which may account for the heterogeneity
of somatic symptoms associated with these diseases.
Third, the course of chronic diseases can be predicted
by indicators of interoception. These findings, as well as
studies showing a reduction of somatic symptom distress
after an interoceptive training, suggest that normalizing
bi- directional brain- body communication may help to
improve mental and physical health in stress- associated
diseases.