Interoceptive accuracy and the heartbeat-evoked brain potential in adolescents

Background: The interplay of brain and bodily signals can be investigated using the heartbeat-evoked potential (HEP). The HEP is regarded as an index of the cortical reflection of cardiac interoceptive signals. Studies which have examined interoception in adolescents using the HEP are not known to the authors so far. This study aimed to investigate the processing of cardiovascular bodily signals in adolescents, represented by the HEP. We wanted to examine whether the HEP was modulated by interoceptive accuracy in heartbeat perception and wanted to shed further light on possible associations between the HEP and different dimensions of interoception. Methods: EEG and ECG were recorded in a sample of 46 adolescents aged 12 to 17 years while subjects performed a heartbeat detection task. According to their performance in heartbeat perception (interoceptive accuracy), subjects were categorized as good (n = 23) or poor (n = 23) heartbeat perceivers. Subjects were asked for metacognitive accuracy of interoception. Findings: Mean HEP amplitudes (360-500ms post R wave) were significantly higher at frontal and at right frontocentral electrode locations in good heartbeat perceivers as compared to poor heartbeat perceivers. A positive association between interoceptive accuracy and metacognitive accuracy was demonstrated only for the subgroup of poor heartbeat perceivers. Discussion: Our results illustrate the function of the HEP as a psychophysiological marker to study interoceptive processing in adolescents. Its use for clinical questions should be exploited in future studies.