Bolus isoproterenol infusions provide a reliable method for assessing interoceptive awareness
Open accessAbstract
Interoception, defined as the perception of internal body states, plays a central role in classic and contemporary theories of emotion. In particular, deviations from baseline body states have been hypothesized to be integral to the experience of emotion and feeling. Consequently, reliable measurement of interoception is critical to the testing of emotion theories. Heartbeat perception tasks have been considered the standard method for assessing interoceptive awareness, primarily due to their non-invasive nature and technical feasibility. However, these tasks are limited by the fact that above chance group performance rates on heartbeat detection (or the frequency of 'good detectors') are rarely higher than 40%, meaning that such tasks (as they are typically utilized) do not obtain a measure of interoceptive awareness in the majority of individuals. Here we describe a novel protocol for inducing and assessing a range of deviations in body states via bolus infusions of isoproterenol, a non-selective beta adrenergic agonist. Using a randomized, double-blinded, and placebo-controlled experimental design, we found that bolus isoproterenol infusions elicited rapid and transient increases in heart rate and concomitant ratings of heartbeat and breathing sensations, in a dose-dependent manner. Our protocol revealed changes in interoceptive awareness in all 15 participants tested, thus overcoming a major limitation of heartbeat detection tasks. These findings indicate that bolus isoproterenol infusions provide a reliable method for assessing interoceptive awareness, which sets a foundation for further investigation of the role of interoceptive sensations in the experience of emotion.
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Cardiac perception accuracy increases following an increase in cardiac signal strength, such as that induced by isoproterenol infusions or exercise.
“Indeed, cardiac perception accuracy has been found to increase following an increase in cardiac signal strength, for example that induced by isoproterenol infusions or exercise (Jones and Hollandsworth, 1981; Khalsa, Rudrauf, Sandesara, et al., 2009).”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Khalsa, Rudrauf, Sandesara, et al., 2009
The Introduction (Measuring interoceptive awareness; page unavailable) reports that heartbeat-perception accuracy increases during exercise or stress. The Discussion (page unavailable) reports greater awareness of cardiac sensations with higher isoproterenol doses, but says comparison with standard heartbeat-perception tasks remains for future study; it does not establish increased perception accuracy after isoproterenol. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAccess to the full range of interoceptive signals often involves invasive approaches, which tend to elicit physiological perturbations and index more objectively measurable features.
“Access to the full range of interoceptive signals often involves invasive approaches, which tend to elicit physiological perturbations and index more objectively measurable features (28).”
From Interoception and Mental Health: A Roadmap. (2018) · cites this paper as [28]
The Introduction (‘The current study’) describes drug infusions that alter bodily state and compares subjective sensations with objectively measured heart-rate changes; the Results report increased heart rate after infusion (page numbers unavailable). This supports the example of an invasive approach that elicits a measurable physiological perturbation. The paper does not establish that accessing the full range of interoceptive signals often requires invasive approaches, or that such approaches generally focus on more objectively measurable features. (LLM, conf=0.85)
Experimental — accuracy not yet measured
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- Authors
- Khalsa, S. S., Rudrauf, D., Sandesara, C., Olshansky, B., & Tranel, D.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Khalsa, S.S.
- Venue
- International Journal of Psychophysiology
- Publisher
- Elsevier BV
- Published
- 2009-04
- Volume
- 72
- Issue
- 1
- Pages
- 34-45
- ISSN
- 0167-8760 (ISSN-L)
- PMC
- PMC3085829
- OpenAlex
- W1981509781
- Cited by
- 155
- References
- 15
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 17 · 2023: 11 · 2022: 12 · 2021: 19 · 2020: 20 · 2019: 16 · 2018: 8 · 2017: 9 · 2016: 7 · 2015: 6 · 2013: 5 · 2012: 2
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Psychophysiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Ministerstvo Školství, Mládeže a Tělovýchovy
- National Institute on Drug Abuse (R01DA022549)
- National Institute of General Medical Sciences (T32GM007337)
- National Center for Complementary and Integrative Health (F31AT003061)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
- Keywords
- interoception, interoceptive awareness, isoproterenol, beta-adrenergic agonists, bolus infusion, heart rate, heartbeat perception, emotion theory, dose-dependent effects
- MeSH terms
- Adult, Analysis of Variance, Awareness, Dose-Response Relationship, Drug, Double-Blind Method, Emotions, Female, Heart Rate, Humans, Infusions, Intravenous, Isoproterenol, Male, Middle Aged, Online Systems, Psychophysics, Sympathomimetics, Time Factors, Reproducibility of Results, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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