Interoception Dysfunction Contributes to the Negative Emotional Bias in Major Depressive Disorder

Hongliang Zhou; Haowen Zou; Zhongpeng Dai; Shuai Zhao; Lingling Hua; Yi Xia; Yingling Han; Rui Yan; Hao Tang; Yinghong Huang; Yishan Du; Xiaoqin Wang; Zhijian Yao; Qing Lu

doi:10.3389/fpsyt.2022.874859

Interoception Dysfunction Contributes to the Negative Emotional Bias in Major Depressive Disorder

Front Psychiatry. 2022 Apr 11:13:874859. doi: 10.3389/fpsyt.2022.874859. eCollection 2022.

Authors

Hongliang Zhou¹, Haowen Zou², Zhongpeng Dai³, Shuai Zhao¹, Lingling Hua², Yi Xia¹, Yingling Han², Rui Yan², Hao Tang¹, Yinghong Huang², Yishan Du¹, Xiaoqin Wang¹, Zhijian Yao^{1

2}, Qing Lu^{3

4}

Affiliations

¹ Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
² Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing, China.
³ School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China.
⁴ Key Laboratory of Child Development and Learning Science of Ministry of Education, Nanjing, China.

Abstract

Background: Previous research studies have demonstrated that impaired interoception is involved in emotional information processing in major depressive disorder (MDD). Heartbeat-evoked potential (HEP) amplitudes, an index for interoception, could be manipulated by emotional faces in healthy people. Considering negative emotional bias is the core characteristic in MDD, we hypothesized that interoception dysfunction was associated with the negative emotional bias in MDD.

Methods: An electroencephalogram (EEG) study under an emotional faces task was applied to explore the relationship between interoception and emotional bias. HEPs before emotional faces stimuli were used to predict the late positive potential (LPP) amplitudes and it worked as an index of emotional bias. Twenty-seven patients with MDD and 27 healthy controls (HCs) participated in this study. Source analysis gave an auxiliary description for results in sensory level.

Results: Major depressive disorders (MDDs) had poor performance in the heartbeat count task (HCT) and attenuate HEP average amplitudes (455-550 ms). Compared with HCs, cluster-based permutation t-tests revealed that MDDs had attenuated LPP amplitudes (300-1,000 ms) over centroparietal regions and enhanced LPP amplitudes over frontocentral regions. Furthermore, abnormal attenuated HEPs could predict aberrant LPPs under sad face stimuli in MDDs, which could be associated with the dysfunction of the anterior cingulate cortex (ACC) and right insula.

Conclusion: Mediated by ACC and insula, interoception dysfunction contributes to the negative emotional bias of MDD, highlighting the importance of interoception in the disorder.

Keywords: HEP (heartbeat evoked potential); interoception; major depressive disorders; negative emotional bias; predictive coding.