TY - JOUR
T1 - Allostatic Interoceptive Overload Across Psychiatric and Neurological Conditions
AU - Santamaría-García, Hernando
AU - Migeot, Joaquin
AU - Medel, Vicente
AU - Hazelton, Jessica L.
AU - Teckentrup, Vanessa
AU - Romero-Ortuno, Roman
AU - Piguet, Olivier
AU - Lawor, Brian
AU - Northoff, George
AU - Ibanez, Agustin
N1 - Publisher Copyright:
© 2024 Society of Biological Psychiatry
PY - 2025/1/1
Y1 - 2025/1/1
N2 - Emerging theories emphasize the crucial role of allostasis (anticipatory and adaptive regulation of the body's biological processes) and interoception (integration, anticipation, and regulation of internal bodily states) in adjusting physiological responses to environmental and bodily demands. In this review, we explore the disruptions in integrated allostatic interoceptive mechanisms in psychiatric and neurological disorders, including anxiety, depression, Alzheimer's disease, and frontotemporal dementia. We assess the biological mechanisms associated with allostatic interoception, including whole-body cascades, brain structure and function of the allostatic interoceptive network, heart-brain interactions, respiratory-brain interactions, the gut-brain-microbiota axis, peripheral biological processes (inflammatory, immune), and epigenetic pathways. These processes span psychiatric and neurological conditions and call for developing dimensional and transnosological frameworks. We synthesize new pathways to understand how allostatic interoceptive processes modulate interactions between environmental demands and biological functions in brain disorders. We discuss current limitations of the framework and future transdisciplinary developments. This review opens a new research agenda for understanding how allostatic interoception involves brain predictive coding in psychiatry and neurology, allowing for better clinical application and the development of new therapeutic interventions.
AB - Emerging theories emphasize the crucial role of allostasis (anticipatory and adaptive regulation of the body's biological processes) and interoception (integration, anticipation, and regulation of internal bodily states) in adjusting physiological responses to environmental and bodily demands. In this review, we explore the disruptions in integrated allostatic interoceptive mechanisms in psychiatric and neurological disorders, including anxiety, depression, Alzheimer's disease, and frontotemporal dementia. We assess the biological mechanisms associated with allostatic interoception, including whole-body cascades, brain structure and function of the allostatic interoceptive network, heart-brain interactions, respiratory-brain interactions, the gut-brain-microbiota axis, peripheral biological processes (inflammatory, immune), and epigenetic pathways. These processes span psychiatric and neurological conditions and call for developing dimensional and transnosological frameworks. We synthesize new pathways to understand how allostatic interoceptive processes modulate interactions between environmental demands and biological functions in brain disorders. We discuss current limitations of the framework and future transdisciplinary developments. This review opens a new research agenda for understanding how allostatic interoception involves brain predictive coding in psychiatry and neurology, allowing for better clinical application and the development of new therapeutic interventions.
KW - Allostasis
KW - Alzheimer's disease
KW - Anxiety
KW - Depression
KW - Frontotemporal dementia
KW - Interoception
KW - Life span
UR - http://www.scopus.com/inward/record.url?scp=85200943948&partnerID=8YFLogxK
U2 - 10.1016/j.biopsych.2024.06.024
DO - 10.1016/j.biopsych.2024.06.024
M3 - Review article
C2 - 38964530
AN - SCOPUS:85200943948
SN - 0006-3223
VL - 97
SP - 28
EP - 40
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 1
ER -