Interoception, the perception and integration of physiological signals, is a fundamental aspect of self-awareness and homeostasis. While previous work has explored interoceptive processing in the cardiac system, research in the respiratory domain, particularly in relation to brain structure and function, is limited. To address this gap, we utilised a Bayesian psychophysical model to quantify perceptual, metacognitive, and affective dimensions of respiratory interoception in a sample of over 200 healthy participants of both genders. Hierarchical modelling revealed that respiratory metacognition was associated with higher somatic and lower cognitive anxiety, respectively. Whole-brain microstructural indices of myelin content and cortical iron were measured using quantitative brain imaging. Whole-brain voxel based quantification revealed distinct microstructural patterns in the insular, cingulate, and primary sensory cortices that underlie interoceptive sensitivity and precision. Myelination in the cingulate cortex and periaqueductal grey was associated with confidence bias, while metacognitive sensitivity correlated with myelination in the midline prefrontal cortex. Our findings highlight key brain pathways involved in respiratory interoception and its perceptual, metacognitive, and emotional dimensions. Significance statement This study contributes to the understanding of the neural basis of respiratory interoception by employing sophisticated quantitative imaging and behavioural techniques to explore brain microstructures associated with individual differences in interoception in the largest study to date. Our findings provide a clearer picture of how respiratory signals contribute to self-awareness and regulatory processes, enhancing our knowledge of interoceptive processing. Moreover, this research identifies neural pathways that may serve as targets for future clinical research, offering new directions for investigating and understanding respiratory-related conditions. This work adds valuable insights to the field of interoception and its neural underpinnings, suggesting pathways for further research in psychiatry, neurology and respiratory medicine.
Nikolova et al. (Fri,) studied this question.