Use of gut-brain electrophysiology to study interoception in eating disorders

Eating disorders are complex psychiatric illnesses tied to continual disturbances in eating behaviors that lead to adverse health conditions, such as medical instability in the context of weight loss. Interoception, the brain’s perception of, and response to, the body’s internal physiological state, has recently been shown to be altered in eating disorders. Anorexia nervosa (AN) and avoidant restrictive food intake disorder (ARFID) two restrictive eating disorders with distinct pathogenesis, and aberrant interoception. In both illnesses, individuals report gastric discomfort, early satiety, and lower hunger relative to healthy controls. AN symptoms are driven by shape and weight concerns, whereas ARFID is due to sensory sensitivity, or fear of choking/ vomiting. Commonly used measures of interoception, however, are either fully behavioral or do not measure gastric/brain physiology. In this study, we aim to (i) perform a feasibility study to determine the acceptance and feasibility of performing such recordings in the AN and ARFID eating disorders population and (ii) test the hypothesis that the electrophysiologic monitoring of the brain and stomach is associated with a clinically validated behavioral measure of interoception involving water distention of the stomach. Successful demonstration of tracking gastric interoception has potential to galvanize significant expansion of research into this emerging area involving the electrophysiologic underpinnings of the gut-brain axis in humans.