研究者詳細 - 寺澤　悠理

論文 - 寺澤　悠理

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Paradoxical somatic information processing for interoception and anxiety in alexithymia

Yuri Terasawa, Kentaro Oba, Yuki Motomura, Ruri Katsunuma, Hiroki Murakami, Yoshiya Moriguchi

European Journal of Neuroscience （Wiley） 54 （ 11 ） 8052 - 8068 2021年11月

研究論文（学術雑誌）, 共著, 査読有り, ISSN 0953816X

The concept of alexithymia has garnered much attention in an attempt to understand the psychological mechanisms underlying the experience of feeling an emotion. In this study, we aimed to understand how the interoceptive processing in an emotional context relates to problems of alexithymia in recognizing self-emotions. Therefore, we prepared experimental conditions to induce emotional awareness based on interoceptive information. As such, we asked participants to be aware of interoception under an anxiety-generating situation anticipating pain, having them evaluate their subjective anxiety levels in this context. High alexithymia participants showed attenuated functional connectivity within their ‘interoception network’, particularly between the insula and the somatosensory areas when they focused on interoception. In contrast, they had enhanced functional connectivity between these regions when they focused on their anxiety about pain. Although access to somatic information is supposed to be more strongly activated while attending to interoception in the context of primary sensory processing, high alexithymia individuals were biased as this process was activated when they felt emotions, suggesting they recognize primitive and unprocessed bodily sensations as emotions. The paradoxical somatic information processing may reflect their brain function pathology for feeling emotions and their difficulty with context-dependent emotional control.

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Effects of insular resection on interactions between cardiac interoception and emotion recognition

Terasawa Y., Motomura K., Natsume A., Iijima K., Chalise L., Sugiura J., Yamamoto H., Koyama K., Wakabayashi T., Umeda S.

Cortex （Cortex） 137 271 - 281 2021年04月

査読有り, ISSN 00109452

The insular cortex is considered an important region for feeling emotions through interoception. Most studies that report the role of the insula in integrating interoception and emotion have used neuroimaging techniques such as functional magnetic resonance imaging (fMRI); however, there are limited neuropsychological studies. The effects of insular lesions on emotion and interoception have not been suitably investigated. In this study, we examined the role of the insular cortex in cardiac interoception and recognizing emotions from facial expressions by comparing them pre- and post-operatively in patients with glial tumors or brain metastases associated with the insular lobe. Although no significant difference in interoceptive accuracy was observed between the two phases, there were significant associations between the changes in interoceptive accuracy and sensitivity to expressions of anger and happiness. An increased error rate in the heartbeat counting task in the post-operation phase was associated with a decreased accuracy in recognizing anger and happiness. Since most patients had left insula lesions, generalizability of the findings to patients with right lesions is a future subject. To the best of our knowledge, this is the first study to examine the change in interoception and emotion after insular resection in humans. The study results indicate that removal of the insula affects the recognition of emotions such as anger and happiness through interoceptive processing.

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Heartbeat evoked potentials reflect interoceptive awareness during an emotional situation

Tanaka Y., Ito Y., Shibata M., Terasawa Y., Umeda S.

Scientific Reports 15 （ 1 ） 8072 2025年12月

Interoception, the ability to perceive internal bodily signals, involves various mental processes. This study investigated moments when individuals experienced a change in their interoceptive state. Interoception affects the subjective feelings of emotions. However, whether changes in interoceptive processing occur when visceral changes are perceived as interoceptive sensations remains unclear. This study examined the psychophysiological markers of perceptual changes in the interoceptive state using heartbeat evoked potentials (HEP). Emotional photos were viewed by participants who were asked whether they experienced changes in their interoceptive state. The results showed that the HEP amplitude increased when participants had subjective awareness of changes in their interoceptive state. Notably, the HEP amplitude did not correlate with individual differences in interoceptive accuracy measured by the heartbeat counting task. When individuals perceive changes in their interoceptive state, this perception is reflected in the HEP amplitude. Multiple aspects of interoception are related to the emotional recognition and conscious attention to changing bodily states.

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Dynamic neural network modulation associated with rumination in major depressive disorder: a prospective observational comparative analysis of cognitive behavioral therapy and pharmacotherapy.

Katayama N, Shinagawa K, Hirano J, Kobayashi Y, Nakagawa A, Umeda S, Kamiya K, Tajima M, Amano M, Nogami W, Ihara S, Noda S, Terasawa Y, Kikuchi T, Mimura M, Uchida H

Translational psychiatry 15 （ 1 ） 267 2025年08月

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Reduced sensory attenuation is related to aberrant interoceptive influences on intentional binding in schizophrenia

Koreki A., Terasawa Y., Oi H., Mouri T., Takenaka A., Koizumi T., Onaya M., Yogarajah M., Critchley H., Nuruki A.

Psychiatry and Clinical Neurosciences Reports 4 （ 2 ） e70106 2025年06月

Aim: Schizophrenia (SZ) is characterized by abnormalities in self-representation, including an aberrant sense of agency (SoA). Experimentally observed abnormalities in force matching and intentional binding tasks suggest that the SoA in SZ is compromised at the implicit level. However, these task effects have been reported independently, leading to inconsistencies that complicate the understanding of SZ pathophysiology. Methods: Thirty-three patients with SZ and 37 nonclinical (healthy) controls (HCs) performed force matching and intentional binding tasks. The former task assessed sensory attenuation, while the latter evaluated an intentional binding effect, both measuring implicit levels of SoA. We previously observed that the cardiac phase (systole vs diastole) influences intentional binding. Therefore, we investigated the relationship between sensory attenuation and intentional binding, including this “cardiac effect,” which refers to the influence of cardiac interoceptive signals. Results: In SZ, significantly reduced sensory attenuation, a greater but nonsignificant intentional binding effect, and a significant opposite cardiac effect were observed compared with HCs. Sensory attenuation and intentional binding were significantly and positively correlated in the SZ group but not in the HC group. Across all participants, sensory attenuation correlated with the cardiac effect on intentional binding. This effect remained significant in the HC group but not in the SZ group. Conclusion: Group differences and task associations suggest shared mechanisms and pathophysiology in SZ, potentially involving impaired predictive processes and the failure of sensory attenuation. The cardiac effect may be explained by interoceptive sensory attenuation, and its failure could lead to a disturbed SoA in patients with SZ.

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特集関わり合う脳 Ⅰ.他者と関わる脳環境の変化に適応する脳-アロスタシスと内受容感覚を切り口として

寺澤悠理

生体の科学（株式会社医学書院） 76 （ 1 ） 31 - 34 2025年02月

ISSN 03709531

Common Neural Correlates for Subjective and Objective Sleepiness Indices: A Functional Connectivity Study

Motomura Y., Kitamura S., Oba K., Katsunuma R., Terasawa Y., Hida A., Moriguchi Y., Mishima K.

Nature and Science of Sleep 17 1345 - 1359 2025年

ISSN 1179-1608

Purpose: This study examined the neural correlates in functional brain connectivity common to subjective and objective sleepiness. Because functional connectivity can be measured at rest and during tasks, it is well suited for exploring the commonalities between sleepiness during psychomotor vigilance task (PVT) and at rest with measurement of The Karolinska Sleepiness Scale (KSS). Serial resting and task-based fMRI measurements across various states of arousal may reveal a common neural substrate that does not vary with task demands. The neural basis shared by the PVT, an objective measure highly sensitive to sleep debt, and subjective reports of sleepiness may be robust markers for sleepiness and contribute to an improved understanding of the brain mechanisms underlying sleepiness. Participants and Methods: The participants were 16 healthy right-handed (self-reported) adult men who, after a 2-week home examination, participated in a 14-day/13-night experiment that included 9 days of extended sleep (12 h per night), followed by one night of total sleep deprivation (0 h), and recovery sleep. KSS and the PVT were used as subjective and objective measures of sleepiness, respectively. Functional connectivity in the brain during each condition were measured using fMRI. In particular, the association between the inverse of the reaction time to the PVT task and resting-state functional connectivity was analyzed using a general linear mixed model. Results: Functional connectivity in six pairs of regions commonly associated with the KSS and PVT were identified. These included the anterior cingulate cortex-posterior cingulate cortex (part of the default mode network) and thalamus-middle temporal cortex, indicating that connectivity in these brain regions were strongly associated with sleepiness. Conclusion: These results suggest a common neural substrate for subjective and objective sleepiness, which may be an important indicator of sleepiness. In addition, the functional connectivity between the thalamus and the middle temporal cortex may be a new network that deserves further attention in sleep research. The results of this study provide valuable insights into the effects of sleep deprivation and total sleep deprivation experienced in daily life on the brain and offer a new perspective on the expression of sleepiness in the brain.

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Interoceptive training impacts the neural circuit of the anterior insula cortex

Sugawara A., Katsunuma R., Terasawa Y., Sekiguchi A.

Translational Psychiatry 14 （ 1 ） 206 2024年12月

Interoception is the perception of afferent information that arises from anywhere and everywhere within the body. Recently, interoceptive accuracy could be enhanced by cognitive training. Given that the anterior insula cortex (AIC) is a key node of interoception, we hypothesized that resting functional connectivity (RSFC) from AIC was involved in an effect of interoceptive training. To address this issue, we conducted a longitudinal intervention study using interoceptive training and obtained RSFC using fMRI before and after the intervention. A heartbeat perception task evaluated interoceptive accuracy. Twenty-two healthy volunteers (15 females, age 19.9 ± 2.0 years) participated. After the intervention, interoceptive accuracy was enhanced, and anxiety levels and somatic symptoms were reduced. Also, RSFC from AIC to the dorsolateral prefrontal cortex (DLPFC), superior marginal gyrus (SMG), anterior cingulate cortex (ACC), and brain stem, including nucleus tractus solitarius (NTS) were enhanced, and those from AIC to the visual cortex (VC) were decreased according to enhanced interoceptive accuracy. The neural circuit of AIC, ACC, and NTS is involved in the bottom-up process of interoception. The neural circuit of AIC, DLPFC, and SMG is involved in the top-down process of interoception, which was thought to represent the cognitive control of emotion. The findings provided a better understanding of neural underpinnings of the effect of interoceptive training on somatic symptoms and anxiety levels by enhancing both bottom-up and top-down processes of interoception, which has a potential contribution to the structure of psychotherapies based on the neural mechanism of psychosomatics.

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The body mirroring thought: The relationship between thought transitions and fluctuations in autonomic nervous activity mediated by interoception.

Sakuragi M, Shinagawa K, Terasawa Y, Umeda S

Consciousness and cognition 125 103770 2024年10月

ISSN 1053-8100

Our thought states change without intention. This study verified that the transition of thought states varies with fluctuations in autonomic nervous activity, and that this effect is modulated by interoceptive accuracy. The participants completed the heartbeat counting task (HCT) and vigilance task. We assessed the participants’ interoceptive accuracy based on their performance on the HCT. The vigilance task is a simple attention task, and during this task, we asked the participants to report the content and contemplation of their thoughts. Consequently, participants with accurate interoception were more likely to remain in a highly contemplative thought state when parasympathetic activity was suppressed. In contrast, the dominance of parasympathetic activity facilitated transitions to different thought states or experiences of less contemplative thought states in them. The results suggest that even subtle changes in bodily responses at rest can affect thought transitions in people with accurate interoception.

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内受容感覚と神経心理学

寺澤悠理

神経心理学（日本神経心理学会） 40 （ 1 ） 12 - 19 2024年03月

ISSN 09111085

内受容感覚は，主に身体内部の状態についての感覚である．内臓の活動やそれに関連する感覚や痛みなど，身体内部状態の変化がこの感覚の対象である．この20年ほどの間に急激に認知され，様々な心の機能の根底に存在する要素の一つとして注目を集めるようになってきた．本稿では，内受容感覚の定義，顕在化や動的調整のシステム，神経基盤，評価方法について概説する．

A case with prosopagnosia and difficulties in recognizing facial expressions caused by fresh cerebral infarction of the right occipital face area

澤木優治, 寺澤悠理, 梅田聡, 本村和也, 山本裕泰, 山本正彦, 山内崇弘

Japanese Journal of Stroke （一般社団法人日本脳卒中学会） 46 （ 6 ） 443 - 452 2024年

ISSN 09120726

広範な陳旧性の左後頭葉梗塞に加え，右後頭葉外側の新規脳梗塞にて熟知相貌に対する相貌失認を呈した症例を報告した．症例は70歳代の右利き男性であった．熟知相貌および表情の認知に困難さを認め，全般性注意機能，処理速度の低下がみられた．全般性認知機能および相貌認知以外の視覚認知機能は保たれていた．相貌失認は左右半球の後頭顔領域，紡錘状回顔領域，前部側頭葉の脳内ネットワークに機能不全が生じたことで発現したと考えられた．老若および性別の判断に関する相貌認知は保たれていた．拡散テンソルトラクトグラフィにより，右半球の下前頭後頭束や下縦束の白質線維が温存されたことが要因であると考えられた．さらに，全般性注意機能および処理速度の向上を図る認知リハビリテーション介入によって，表情認知の改善が得られる可能性が示唆された．

Altered sense of agency in schizophrenia: the aberrant effect of cardiac interoceptive signals.

Koreki A, Terasawa Y, Nuruki A, Oi H, Critchley H, Yogarajah M, Onaya M

Frontiers in psychiatry 15 1441585 2024年

ISSN 1664-0640

Background: Schizophrenia (SZ) is characterized by abnormalities in self-representation, including a disturbed sense of agency (SoA). The continuous processing of sensory information concerning the internal state of the body (interoception) is argued to be fundamental to neural representations of the self. We, therefore, tested if aberrant interoception underpins disturbances in SoA in SZ, focusing on cardiac interoceptive signaling. Methods: Forty-two SZ and 29 non-clinical participants (healthy controls; HC) performed an intentional binding task to measure SoA during concurrent heartbeat recording. The effect of cardiac interoceptive signals on SoA was measured by the difference in intentional binding effect during systole and diastole. This measure was standardized based on the overall intentional binding effect to control for non-cardiac factors, and then compared between SZ and HC. Results: Our study revealed a significant difference between SZ and HC groups, with opposite effects of cardiac systole on SoA. Specifically, cardiac systole disrupted SoA in SZ, contrasting with the enhanced SoA in HC. Across the SZ group, the extent to which SoA was disrupted by cardiac systole correlated significantly with a clinical proxy for symptom instability, namely the number of hospital admissions for hallucinations and delusions. Furthermore, the disruption was particularly observed in patients with severe hallucinations. Conclusions: This study revealed a disturbance in the impact of cardiac interoceptive signals on an implicit index of SoA in schizophrenia. This supports the notion that pathophysiological disruption of the central integration of interoceptive information increases vulnerability to disturbances in self-representation and the associated expression of schizophrenic symptoms.

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Biofeedback Training for Balance Ability Improvement: An Analysis of Short-term Effects and Sensory Information Utilization

Kaminishi K., Debun K., Okimura T., Terasawa Y., Maeda T., Ota J.

Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society EMBS 2024年

ISSN 1557170X

This study investigates the short-term effects of biofeedback rehabilitation on postural balance performance, addressing a significant gap in existing research that has focused primarily on long-term outcomes. The present study aims to test the following hypothesis: Changes in the way sensory information is used through biofeedback training will lead to changes in postural balance performance in the short term. Experiments were conducted with five young, healthy individuals. Participants underwent biofeedback training sessions involving tasks such as maintaining the center of pressure of the feet within specific targets, and performed quiet standing tasks and standing tasks with both open and closed eyes before and after the training sessions.The results showed suggestive correlations between changes in sway during quiet standing and changes in sway with eyes open and closed before and after the training session, which differed between the training and control groups. This supports the hypothesis and suggests that biofeedback training may indirectly affect postural balance ability by altering the way sensory information is used and the existence of diverse strategies.Clinical Relevance - This leads to more effective biofeedback training designs based on reweighting in the use of sensory information

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Effect of subconscious changes in bodily response on thought shifting in people with accurate interoception

Sakuragi M., Shinagawa K., Terasawa Y., Umeda S.

Scientific Reports （Scientific Reports） 13 （ 1 ） 16651 2023年12月

Our thought states shift from one state to another from moment to moment. The relationship between the thought shifting and bodily responses is yet to be directly examined. This exploratory study examined the influence of cardiovascular reactivity and interoception—sensing an internal bodily state—on the shifting of thought states. Participants (N = 100, 70 women) completed two tasks: the heartbeat counting task (HCT) and the vigilance task (VT). We assessed their interoceptive accuracy through their performance on the HCT. The VT was a simple sustained attention task in which participants pressed a key when the target stimulus appeared and were asked to report their thoughts. We presented subliminal vibration stimuli to induce alterations in heart rate (i.e., vibration block). Results showed that participants with higher interoceptive accuracy reported more continuation of self-referential thought (about past episodes and future plans regarding themselves) during the vibration block than did those with lower interoceptive accuracy. These results suggest that individuals with higher interoceptive accuracy are more likely to be influenced by their subliminal bodily response, resulting in divergent attention from the task and intermittent self-referential thought.

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特集アロスタシス-ホメオスタシスを超えて内受容感覚とアロスタシスからみた精神疾患

是木明宏, 寺澤悠理

BRAIN and NERVE （株式会社医学書院） 75 （ 11 ） 1251 - 1257 2023年11月

ISSN 18816096

特集アロスタシス-ホメオスタシスを超えて内受容感覚を媒介とするアロスタシスと感情

寺澤悠理, 是木明宏

BRAIN and NERVE （株式会社医学書院） 75 （ 11 ） 1245 - 1250 2023年11月

ISSN 18816096

Modulation of heartbeat-evoked potential and cardiac cycle effect by auditory stimuli

Tanaka Y., Ito Y., Terasawa Y., Umeda S.

Biological Psychology （Biological Psychology） 182 108637 2023年09月

ISSN 03010511

Interoception has been proposed as a factor that influences various psychological processes (Khalsa et al., 2018). Afferent signals from the cardiovascular system vary across cardiac cycle phases. Heartbeat-evoked potentials (HEP) and event-related potentials (ERP) were measured to examine whether interoceptive signals differed between cardiac cycle phases. Simultaneously, participants performed an auditory oddball task in which the timing of the presenting stimulus was synchronized with the heartbeat. Pure tones were presented at 10 ms (late diastole condition), 200 ms (systole condition), or 500 ms after the R wave (diastole condition). Greater HEP amplitudes were observed when the tone was presented during diastole than during systole or late diastole. ERP showed the same tendency: a greater amplitude was observed during diastole than systole or late diastole. These results suggest that the processing of interoception reflected by HEP and exteroception reflected by ERP share attentional resources when both stimuli coincide. When the tone was presented during systole, attention to the internal state decreased compared with when the tone was presented during diastole, and attention was distributed to both exteroception and interoception. Our study suggests that HEP may be considered an indication of a relative amount of resources to process the interoception.

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Functional connectivity changes between frontopolar cortex and nucleus accumbens following cognitive behavioral therapy in major depression: A randomized clinical trial

Katayama N., Nakagawa A., Umeda S., Terasawa Y., Shinagawa K., Kikuchi T., Tabuchi H., Abe T., Mimura M.

Psychiatry Research - Neuroimaging （Psychiatry Research - Neuroimaging） 332 111643 2023年07月

ISSN 09254927

Cognitive behavioral therapy (CBT) is a psychotherapy that challenges distorted cognitions; however, the neural mechanisms that underpin CBT remain unclear. Hence, we aimed to assess the treatment-related resting-state functional connectivity (rsFC) changes in the brain regions associated with future thinking and the associations between rsFC changes and clinical improvements. Thirty-eight adult patients with MDD were randomly assigned with equal likelihood to receive 16-week individual CBT or talking control with a 12-month follow-up period. We evaluated the rsFC changes in the frontal regions, nucleus accumbens, amygdala, and limbic structures key to the depression pathophysiology and future thinking with 2 × 2 mixed ANOVA interaction analysis. Pearson's correlation analysis with Bonferroni's correction was also performed to examine the associations with clinical symptoms, such as depression severity and automatic thoughts in follow-up evaluations. Treatment-specific changes include enhancement in frontopolar connectivity with the nucleus accumbens. An increased rsFC was associated with lower negative automatic thoughts postoperatively, together with lower depressive symptoms and higher positive automatic thoughts at follow-up. Conclusively, rsFC changes in the fronto-limbic neural control circuit after CBT, particularly between the frontal pole and nucleus accumbens, may be clinically meaningful functional changes related to the depression recovery process.

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The effect of cognitive behavioral therapy on future thinking in patients with major depressive disorder: A randomized controlled trial

Amano M., Katayama N., Umeda S., Terasawa Y., Tabuchi H., Kikuchi T., Abe T., Mimura M., Nakagawa A.

Frontiers in Psychiatry （Frontiers in Psychiatry） 14 997154 2023年01月

ISSN 1664-0640

Background: Pessimistic thinking about the future is one of the cardinal symptoms of major depression. Few studies have assessed changes in pessimistic thinking after undergoing cognitive behavioral therapy (CBT). A randomized clinical trial (RCT) was conducted with patients diagnosed with major depressive disorder (MDD) to determine whether receiving a course of CBT affects pessimistic future thinking using a future thinking task. Methods: Thirty-one patients with MDD were randomly assigned to either CBT (n = 16) or a talking control (TC) (n = 15) for a 16-week intervention. The main outcomes were the change in response time (RT) and the ratio of the responses for positive valence, measured by the future thinking task. Secondary outcomes included the GRID-Hamilton Depression Rating Scale, the Beck Depression Inventory-Second Edition (BDI-II), the Dysfunctional Attitude Scale (DAS), and the word fluency test (WFT). Results: Regarding the main outcomes, the CBT group showed reduced RT for the positive valence (within-group Cohen’s d = 0.7, p = 0.012) and negative valence (within-group Cohen’s d = 0.6, p = 0.03) in the distant future condition. The ratio of positive valence responses in both groups for all temporal conditions except for the distant past condition increased within group (distant future: CBT: Cohen’s d = 0.5, p = 0.04; TC: Cohen’s d = 0.8, p = 0.008; near future: CBT: Cohen’s d = 1.0, p < 0.001; TC: Cohen’s d = 1.1, p = 0.001; near past: CBT: Cohen’s d = 0.8, p = 0.005; TC: Cohen’s d = 1.0, p = 0.002). As for secondary outcomes, the CBT group showed greater improvement than the TC group regarding the need for social approval as measured by the DAS (p = 0.012). Conclusion: Patients with MDD who received CBT showed a reduced RT for the positive and negative valence in the distant future condition. RT in the future thinking task for depressed patients may be a potential objective measure for the CBT treatment process. Because the present RCT is positioned as a pilot RCT, a confirmatory trial with a larger number of patients is warranted to elucidate the CBT treatment process that influences future thinking. Clinical trial registration: https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000021028, identifier UMIN000018155.

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心拍誘発電位から見る内受容感覚と認知機能の関係性

田仲祐登, 寺澤悠理, 梅田聡

自律神経（日本自律神経学会） 60 （ 2 ） 92 - 96 2023年

ISSN 02889250

拍動や呼吸の速さ，胃の痛みなど，自律神経系を含む身体内部の状態は内受容感覚を通して知覚されている．近年，内受容感覚を測定する指標として，脳波における心拍誘発電位（Heartbeat-evoked potentials：HEP）が注目されている．HEPは心電図のR波を基準とした誘発電位であり，主観報告の必要のない，心臓からの求心性信号を反映している時間解像度の高い指標として，注意，感情，自己認識といった心的機能や，精神疾患と関係があることが報告されている．本研究ではHEPが有効な指標であることについて，さまざまな認知機能との関係性に焦点を当てながら概観する．

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