Interoceptive predictions in the brain

The brain is increasingly thought to predict sensory inputs, based on previous experience. In this Opinion article, Barrett and Simmons integrate this active inference account with an anatomical model of corticocortical connections, and describe how such a system may unify allostatic control and interoception within an integrated neural architecture. Intuition suggests that perception follows sensation and therefore bodily feelings originate in the body. However, recent evidence goes against this logic: interoceptive experience may largely reflect limbic predictions about the expected state of the body that are constrained by ascending visceral sensations. In this Opinion article, we introduce the Embodied Predictive Interoception Coding model, which integrates an anatomical model of corticocortical connections with Bayesian active inference principles, to propose that agranular visceromotor cortices contribute to interoception by issuing interoceptive predictions. We then discuss how disruptions in interoceptive predictions could function as a common vulnerability for mental and physical illness.