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research article

Behavioral and neurophysiological evidence for altered interoceptive bodily processing in chronic pain

Solcà, Marco  
•
Park, Hyeong Dong  
•
Bernasconi, Fosco  
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May 1, 2020
NeuroImage

Whereas impaired multisensory processing of bodily stimuli and distorted body representation are well-established in various chronic pain disorders, such research has focused on exteroceptive bodily cues and neglected bodily signals from the inside of the body (or interoceptive signals). Extending existing basic and clinical research, we investigated for the first time interoception and its neurophysiological correlates in patients with complex regional pain syndrome (CRPS). In three different experiments, including a total of 36 patients with CRPS and 42 aged-gender matched healthy controls, we measured interoceptive sensitivity (heart beat counting task, HBC) and neural responses to heartbeats (heartbeat evoked potentials, HEP). As hypothesized, we observed reduced sensitivity in perceiving interoceptive bodily stimuli, i.e. their heartbeat, in two independent samples of CRPS patients (studies 1 and 2). Moreover, the cortical processing of their heartbeat, i.e. the HEP, was reduced compared to controls (study 3) and reduced interoceptive sensitivity and HEPs were related to CRPS patients’ motor impairment and pain duration. By providing consistent evidence for impaired processing of interoceptive bodily cues in CRPS, this study shows that the perceptual changes occurring in chronic pain include signals originating from the visceral organs, suggesting changes in the neural body representation, that includes next to exteroceptive, also interoceptive bodily signals. By showing that impaired interoceptive processing is associated with clinical symptoms, our findings also encourage the use of interoceptive-related information in future rehabilitation for chronic pain.

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Type
research article
DOI
10.1016/j.neuroimage.2020.116902
Author(s)
Solcà, Marco  
Park, Hyeong Dong  
Bernasconi, Fosco  
Blanke, Olaf  
Date Issued

2020-05-01

Published in
NeuroImage
Article Number

116902

Note

This article is available under the Creative Commons CC-BY-NC-ND license.

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LNCO  
CNP  
Available on Infoscience
May 18, 2020
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/168807
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