Diseases, Disorders, and Comorbidities of Interoception

Interoception, the sense of the body’s internal physiological state, underpins homeostatic reflexes, motivational states, and sensations contributing to emotional experiences. The continuous nature of interoceptive processing, coupled to behavior, is implicated in the neurobiological construction of the sense of self. Aberrant integration and control of interoceptive signals, originating in the brain and/or the periphery, can perturb the whole system. Interoceptive abnormalities are implicated in the pathophysiology of psychiatric disorders and in the symptomatic expression of developmental, neurodegenerative, and neurological disorders. Moreover, interoceptive mechanisms appear central to somatic disorders of brain–body interactions, including functional digestive disorders, chronic pain, and comorbid conditions. The present article provides an overview of disorders of interoception and suggests future directions for better understanding, diagnosis, and management of these disorders. Interoception refers to the sense of the internal state of the body, mediated by body-to-brain signaling through neuronal and humoral afferent channels. Interoceptive information directs efferent brain-to-body control of physiology to maintain health and is integrated in sensory, emotional, cognitive, and motivational representations.Interoceptive dysfunction at any level of the neuraxis can affect the whole system and is implicated in the expression of psychological and physical symptoms across a spectrum of acquired, developmental, neurodegenerative, central, and peripheral conditions.Identification of interoceptive markers for diagnosis and prognosis, alongside new interventional targets, will advance psychological, behavioral, and pharmacological treatments and emergent approaches in bioelectronic medicine for managing complex symptoms.