The pathways of interoceptive awareness

Nat Neurosci. 2009 Dec;12(12):1494-6. doi: 10.1038/nn.2411. Epub 2009 Nov 1.


A network of cortical brain regions, including the insula and anterior cingulate cortex (ACC), has been proposed as the critical and sole substrate for interoceptive awareness. Combining lesion and pharmacological approaches in humans, we found that the insula and ACC were not critical for awareness of heartbeat sensations. Instead, this awareness was mediated by both somatosensory afferents from the skin and a network that included the insula and ACC. Together, these pathways enable the core human experience of the cardiovascular state of the body.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Awareness / physiology*
  • Brain Diseases / pathology
  • Brain Diseases / physiopathology*
  • Cerebral Cortex / cytology
  • Cerebral Cortex / physiology
  • Gyrus Cinguli / cytology
  • Gyrus Cinguli / physiology*
  • Heart / innervation
  • Heart Rate / physiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Skin / innervation
  • Somatosensory Cortex / cytology
  • Somatosensory Cortex / physiology*
  • Visceral Afferents / physiology*