Exploring typical and atypical interoceptive patterns in Hypertension and Gastrointestinal Disorders: Clinical Relevance and Insights for interventions

Interoception, i.e. the process through which the brain perceives, interprets, and integrates signals originating from the viscera has profound implications not only for cognition and behaviour, but also for physical and mental health. Although research has focused on interoceptive impairments in psychiatric disorders, a variety of medical conditions may show altered perception of visceral signals. Borderline hypertensive (BH) patients, for example, may exhibit increased pain threshold, suggesting abnormal interoceptive processes. In a similar vein, patients with functional gastrointestinal disorders (FGID), a condition in which chronic gastrointestinal symptoms and visceral pain are present without apparent structural abnormalities, may show interoceptive alterations. We conducted two studies to explore interoception in a sample of BH patients and individuals suffering from FGID. We assessed interoceptive accuracy (gastric for FGID, cardiac for BH patients) and sensibility, exploring the relationship between interoception and symptomatologic domains, such as altered pain perception in BH and visceral sensitivity in FGID. Results show that: i) even if BH patients do not have decreased interoceptive accuracy (compared to healthy controls), their pain threshold was negatively associated with interoceptive sensibility; ii) FGID patients exhibited altered gastric interoceptive accuracy (compared to healthy controls) that negatively correlated with anxiety towards gastric symptomatology. These preliminary findings highlight the role of interoception in shaping the symptomatology of BH and FGID patients and suggest that future studies could focus on novel therapeutic targets aimed at enhancing interoception ultimately improving symptoms.