Interoception predicts empathy, social anxiety and quality of life in Huntington’s disease

Previous studies have documented impairments in social cognition and emotional reactivity in Huntington’s disease (HD), with a few highlighting the potential impact on daily functioning and quality of life (QoL). The aims of this study were to explore how patients’ self-reported social cognition was related to interoception, behavioural difficulties, carer burden and the QoL of both HD gene-carriers and their close others. A total of 36 patient-close-other dyads completed a range of scales to assess QoL, self-reported social cognition including affective empathy and perspective taking, social anxiety, interoception, patient apathy and functional capacity, and carer burden. Between group comparisons showed that gene-carriers exhibited lower QoL, emotional awareness, emotion contagion and perspective taking, as well as higher social anxiety and avoidance compared to close others. Patients’ QoL scores were predicted by specific aspects of interoception and affective empathy, but most consistently by social anxiety. Interoceptive attention regulation specifically, predicted patients’ functional capacity. While patient measures did not predict close-other QoL, carer burden was predicted by patients’ apathy and interoception in terms of bodily listening, attention regulation and emotional awareness. These findings suggest that HD is associated with interoceptive dysfunction, which contributes to impairments in emotional awareness and affective empathy, as well as carer burden, and behavioural difficulties as perceived by both patients themselves and their close others. While both impaired interoception and social anxiety directly impact QoL in HD, interoceptive dysfunction may exert a range of indirect influences through various affective symptoms from personal distress to apathy.