A predictive coding framework of allostatic–interoceptive overload in frontotemporal dementia
Open accessAbstract
Recent allostatic-interoceptive explanations using predictive coding models propose that efficient regulation of the body's internal milieu is necessary to correctly anticipate environmental needs. We review this framework applied to understanding behavioral variant frontotemporal dementia (bvFTD) considering both allostatic overload and interoceptive deficits. First, we show how this framework could explain divergent deficits in bvFTD (cognitive impairments, behavioral maladjustment, brain atrophy, fronto-insular-temporal network atypicality, aberrant interoceptive electrophysiological activity, and autonomic disbalance). We develop a set of theory-driven predictions based on levels of allostatic interoception associated with bvFTD phenomenology and related physiopathological mechanisms. This approach may help further understand the disparate behavioral and physiopathological dysregulations of bvFTD, suggesting targeted interventions and strengthening clinical models of neurological and psychiatric disorders.
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Adverse conditions such as pollution, heatwaves, or social isolation contribute to maladaptive epigenetic changes, increased allostatic load, cognitive decline, and diminished resilience.
“Conversely, adverse conditions such as pollution, heatwaves or social isolation contribute to maladaptive epigenetic changes, increased allostatic load, cognitive decline and diminished resilience21,22,63–67.”
From Resilience and brain health in global populations (2025) · cites this paper as [67]
In “Measurements of allostasis” (page unavailable), the paper says cumulative chronic stress and life events can produce allostatic overload through repeated environmental demands. That supports the allostatic-load component, but the paper does not establish that pollution, heatwaves, or social isolation cause the claimed epigenetic changes, cognitive decline, and diminished resilience. (LLM, conf=0.82)
Experimental — accuracy not yet measuredAllostasis is linked to interoception, the brain's ability to sense and regulate internal bodily states.
“Allostasis33 is linked to interoception, which is the brain’s ability to sense and regulate internal bodily states63–67.”
From Resilience and brain health in global populations (2025) · cites this paper as [67]
Experimental — accuracy not yet measuredAllostatic interoception is the brain's ability to anticipate and regulate bodily responses to environmental demands, involving neural, neuroendocrine, and immune mechanisms that enable adaptation.
“Allostatic interoception (Fig. 2a) is the brain’s ability to anticipate and regulate bodily responses to environmental demands and involves neural, neuroendocrine and immune mechanisms that enable adaptation63–68.”
From Resilience and brain health in global populations (2025) · cites this paper as [67]
Both atrophy and functional connectivity alterations observed in people with bvFTD substantially overlap with the AIN.
“Moreover, both atrophy and functional connectivity alterations observed in people with bvFTD14,17,24 substantially overlap with the AIN.3”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
Behavioural-variant frontotemporal dementia (bvFTD) provides an opportunity to investigate the PAIO-INT framework via a lesion model approach.
“Behavioural-variant frontotemporal dementia (bvFTD) provides an opportunity to investigate the PAIO-INT framework via a lesion model approach.11,14,16”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
This disrupted intrinsic neural processing within the AIN may imbalance interoceptive and exteroceptive signals, potentially explaining the maladaptive responses to environmental demands observed in people with bvFTD.
“This disrupted intrinsic neural processing within the AIN may imbalance interoceptive and exteroceptive signals,11 potentially explaining the maladaptive responses to environmental demands observed in people with bvFTD.14”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
Allostatic-interoception is underpinned by the Allostatic-Interoceptive Network (AIN), a large-scale domain-general network including the anterior cingulate cortex, insula, orbitofrontal cortex, amygdala, thalamus, hippocampus, ventral striatum, and angular gyrus.
“Allostatic-interoception is underpinned by the Allostatic-Interoceptive Network (AIN), a large-scale domain-general network including the anterior cingulate cortex, insula, orbitofrontal cortex, amygdala, thalamus, hippocampus, ventral striatum, and angular gyrus.1,3,14”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
This evidence supports the idea that the maladaptive environmental responses in this disease are due to a core allostatic-interoceptive deficit, and may be due to failures of temporal segregation and integration of relevant internal and external signals.
“This evidence supports the idea that the maladaptive environmental responses in this disease are due to a core allostatic-interoceptive deficit,11,14 and may be due to failures of temporal segregation and integration of relevant internal and external signals.11”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
This different pattern of results in bvFTD and AD may reflect the preferential and widespread damage within the AIN in bvFTD whereas in AD, AIN damage appears to be more circumscribed.
“This different pattern of results in bvFTD and AD may reflect the preferential and widespread damage within the AIN in bvFTD11,14,16, 17, 18, 19, 20,24 whereas in AD, AIN damage appears to be more circumscribed.17,38,88”
From Altered spatiotemporal brain dynamics of interoception in behavioural-variant frontotemporal dementia (2025) · cites this paper as [14]
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Self-citation
- Authors
- Migeot, J. A., Duran-Aniotz, C. A., Signorelli, C. M., Piguet, O., & Ibáñez, A.
- Affiliations
- Adolfo Ibáñez University (CL)
- Inserm (FR)
- The University of Sydney (AU)
- Consejo Nacional de Investigaciones Científicas y Técnicas (AR)
- Corresponding author
- Ibáñez, Agustín
- Venue
- Trends in Neurosciences
- Publisher
- Elsevier BV
- Published
- 2022-11
- Volume
- 45
- Issue
- 11
- Pages
- 838-853
- ISSN
- 0166-2236 (ISSN-L)
- PMC
- PMC11286203
- OpenAlex
- W4294142652
- Cited by
- 76
- References
- 138
- Citations by year
- 2026: 11 · 2025: 24 · 2024: 18 · 2023: 20 · 2022: 3
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Trends in Neurosciences (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ORBi (University of Liège) (submittedVersion, other-oa)
- Funders
- Alzheimer's Association (20-725707, SG-20- 725707, ACT210096, AARG-591107, SG-20-, UK-20-639295, 2018-AARG-591107, R01 AG057234)
- Universidad de Santiago de Chile
- Global Brain Health Institute (20-639295, 1210176, ALZ UK-20-639295)
- Fonds De La Recherche Scientifique - FNRS
- Consejo Nacional de Investigaciones Científicas y Técnicas (ANID/FONDAP/15150012, 2017-1820, 15150012, PICT 2017-, 1210176, 1210195)
- Universidad del Valle (CI 5316)
- Agencia Nacional de Investigación y Desarrollo (ACT210096, 15150012, FONCYT-PICT 2017-1820, ID20I10152, ANID/FONDAP/15150012, 1210195, 1210622, 1210176)
- National Institutes of Health (UK-20-639295, 15150012)
- Medical Research Council
- National Health and Medical Research Council (2008020)
- National Institute on Aging (R01AG057234)
- Fondo para la Investigación Científica y Tecnológica (2017–1820, PICT-2017, 15150012, 1210195, 1210176)
- Fondo de Fomento al Desarrollo Científico y Tecnológico (15150012, ANID/FONDAP/15150012, CW2680521, ID20I10152)
- Fondo de Financiamiento de Centros de Investigación en Áreas Prioritarias (15150012, /FONDAP/15150012, 2017-1820, ANID/FONDAP/15150012)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Embodied and Extended Cognition
- Keywords
- behavioral variant frontotemporal dementia, predictive coding, allostatic overload, interoception, interoceptive deficits, autonomic dysfunction, brain atrophy
- MeSH terms
- Atrophy, Humans, Magnetic Resonance Imaging, Frontotemporal Dementia, Cognitive Dysfunction, Interoception
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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