Home › Research › Digital health tools
Allostatic-Interoceptive Overload in Frontotemporal Dementia
Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, Fittipaldi S, Duran-Aniotz C et al.. Biological psychiatry, 2022-02-24
Topic: Brain proteins, microglia and lab models
Background The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload. Methods We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks). Results Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group. Conclusions Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
Key findings
- Results Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex).
- In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN.
- Machine learning results confirmed AIN specificity in predicting the bvFTD group.
- Conclusions Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.
Why it matters
This study found that patients with behavioral variant frontotemporal dementia showed altered heartbeat evoked potential modulation and reduced brain volume and connectivity in the allostatic-interoceptive network compared with healthy controls and patients with Alzheimer's disease. It concerns understanding frontotemporal dementia, not treating, curing, or preventing Alzheimer's disease.
New to this subject? Start with our plain-English guide: Digital health →
Study details
- Participants94
- Evidence strengthLow
How this study scored 56/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Biological psychiatry) |
| Journal's citation record | 3 / 4 | Biological Psychiatry: journal h-index 428 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 1 / 4 | 94 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 70 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.7 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 4 / 6 | Cited 9.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 42 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Agustín M. Ibáñez: h-index 81 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 18 institution(s) in 6 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 35491275) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1016/j.biopsych.2022.02.955
- PubMed: 35491275
- Original source →
- Free full text: Biological Psychiatry →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Birba, A., Santamaría-García, H., Prado, P., Cruzat, J., Ballesteros, A. S., Legaz, A., et al. (2022). Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biological psychiatry. https://doi.org/10.1016/j.biopsych.2022.02.955
Vancouver
Birba A, Santamaría-García H, Prado P, Cruzat J, Ballesteros AS, Legaz A, et al. Allostatic-Interoceptive Overload in Frontotemporal Dementia. Biological psychiatry. 2022. doi:10.1016/j.biopsych.2022.02.955. PMID: 35491275.
BibTeX
@article{birba2022-35491275,
author = {Birba, A. and Santamaría-García, H. and Prado, P. and Cruzat, J. and Ballesteros, A. S. and Legaz, A. and Fittipaldi, S. and Duran-Aniotz, C. and others},
title = {{Allostatic-Interoceptive Overload in Frontotemporal Dementia}},
journal = {Biological psychiatry},
year = {2022},
doi = {10.1016/j.biopsych.2022.02.955},
pmid = {35491275},
url = {https://doi.org/10.1016/j.biopsych.2022.02.955}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
3 studies in the alzhub library list this one in their references.