Aberrant heartbeat-evoked potential in schizophrenia

Akihiro Koreki, Kamiyu Ogyu, Takahiro Miyazaki, Kazumasa Takenouchi, Karin Matsushita, Shiori Honda, Teruki Koizumi, Mitsumoto Onaya, Hiroyuki Uchida, Masaru Mimura, Shinichiro Nakajima, Yoshihiro Noda

Research output: Contribution to journalArticlepeer-review


Self-disturbance is considered a core feature underlying the psychopathology of schizophrenia. Interoception has an important role in the development of a sense of self, leading to increased interest in the potential contribution of abnormal interoception to self-disturbances in schizophrenia. Several neuropsychological studies have demonstrated aberrant interoception in schizophrenia. However, cortical interoceptive processing has not yet been thoroughly investigated. Thus, we sought to examine resting-state heartbeat-evoked potential (HEP) in this population. We hypothesized that patients with schizophrenia would exhibit significant alterations in HEP compared to healthy controls (HCs). In this cross-sectional electroencephalogram (EEG) study, we compared the HEPs between age- and sex-matched groups of patients with schizophrenia and HCs. A 10-min resting-state EEG with eyes closed and an electrocardiogram (ECG) were recorded and analyzed for the time window of 450 ms to 500 ms after an ECG R peak. A positive HEP shift was observed in the frontal-central regions (F [1, 82] = 7.402, p = 0.008, partial η2 = 0.009) in patients with schizophrenia (n = 61) when compared with HCs (n = 31) after adjusting for confounders such as age, sex, and heart rate. A cluster-based correction analysis revealed that the HEP around the right frontal area (Fp2, F4, and F8) showed the most significant group differences (F [1, 82] = 10.079, p = 0.002, partial η2 = 0.021), with a peak at the F4 electrode site (F [1, 82] = 12.646, p < 0.001, partial η2 = 0.069). We observed no correlation between HEP and symptoms in patients with schizophrenia. A positive shift of HEP during the late component could reflect a trait abnormality in schizophrenia. Further research is required to determine the association between the altered cortical interoceptive processing indexed with HEP and self-disturbances in schizophrenia.

Original languageEnglish
Article number110969
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Publication statusPublished - 2024 Jun 8


  • Electroencephalogram
  • HEP
  • Interoception
  • Schizophrenia
  • Self-disturbances

ASJC Scopus subject areas

  • Pharmacology
  • Biological Psychiatry


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