Interoception and Brain Disorders

May 1-8, 2027 

Director: Sarah Garfinkel

University College London, UK

Co-Director: Sahib Khalsa

University of California, Los Angeles, USA

Faculty:

Kyle Simmons, Oklahoma State University Center for Health Sciences, Tulsa, USA

Justin Feinstein, Float Research Collective, Tulsa & University of Iowa, Iowa City, USA

Diego Bohórquez, Duke University School of Medicine, Durham, USA

Arno Villringer, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany

Ilse Van Diest, University of Leuven, Belgium

Sarah Garfinkel, University College London, UK

Sahib Khalsa, University of California, Los Angeles, USA

The study of interoception— the process by which the nervous system senses, interprets, and integrates signals arising from within the body—is revolutionizing our understanding of brain disorders. Interoception sits at the intersection of neuroscience, psychology, physiology, and medicine, providing a framework for understanding how signals arising from cardiovascular, respiratory, gastrointestinal, and other bodily systems interact with neural processes governing homeostasis, cognition, emotion, and behavior. This perspective challenges conventional brain-centric models by placing neural function within the ongoing physiological dynamics of the body.

This Advanced Course will immerse participants in the latest cutting-edge research on interoception, exploring how interoceptive signals are sensed and integrated across conscious and unconscious levels and how it reshapes our understanding of neurological and psychiatric conditions. Faculty will lead a deep examination of neurobiological and computational models of interoceptive sensing, prediction, and regulation, bridging mechanisms across species and levels of analysis while highlighting the role of interoception in shaping human cognition, emotion, memory, decision-making, and the embodied sense of self. Throughout this course, we will break new ground in exploring interoception’s role in the mechanisms and pathophysiology of complex brain disorders, including anxiety, depression, traumatic stress, schizophrenia, eating disorders, functional neurological disorders, and depersonalization/derealization syndromes.

Attendees and faculty will engage in rich discussions about whether altered body–brain signaling represents a shared mechanism linking mental and physical illness, and how these pathways provide tractable targets for intervention. Participants will 1) Explore and critique the most advanced contemporary models of interoception, examining neural, behavioral, computational, and cognitive perspectives, 2) Gain insights into the dynamic and temporally patterned interactions between peripheral bodily systems and central neural circuits, focusing on how they contribute to mood regulation, memory formation, and decision-making. 3) Discuss and debate interoception’s role in health and disease, emphasising how causal perturbations and mechanistic models across species can reveal disease mechanisms and identify new therapeutic targets. 4) Engage directly with each faculty expert for a full day of personalized, intense, and stimulating one-on-one or small-group mentoring. This transformative experience is designed for both emerging researchers and established investigators eager to enrich their understanding of interoception and its role in brain disorders. Dynamic, trans-disciplinary debates will challenge existing frameworks for understanding brain–body integration and identify new questions, experimental approaches, and therapeutic opportunities for brain disorders.

Diego Bohórquez

Deciphering visceral instincts

The body builds a sensory representation of the food we eat, translating the external world into an internal experience. The lectures will cover the basic biology underpinning that translation, providing participants with a gastrointestinal case study for the Advanced Course’s central questions: how the nervous system detects signals from within the body, how those signals are distinguished from those about the external world, and how a bodily stimulus becomes a behavioral response. We will cover studies on the cells and circuits that make this translation possible.

We will begin with a foundational discovery. Sensory cells of the gut epithelium – neuropod cells – form direct synaptic connections with the vagus nerve, the gut’s fastest route to the brain. This wiring allows the gut to signal the brain in milliseconds rather than minutes, providing a concrete, mechanistic example of how a peripheral sensory organ shapes central neural processing in real time. We will walk through how these cells use this fast synapse to inform the brain about food consumption. Using a fibre-optic tool to switch these gut cells on and off with light, we showed that the gut itself can distinguish real sugar from artificial sweetener. We will also introduce our most recent finding: that these same cells sense our gut bacteria, using a shared bacterial signature to quiet appetite. We call this a neurobiotic sense.

We will close the lectures by introducing two open questions we are pursuing now. Does the gut also sense reward, the pleasure of a good meal? And does it sense protein, the nutrient our bodies work hardest to find? Participants will leave with a working model of gut-to-brain sensory transduction and a clear sense of why this circuitry, which senses first and acts fast, is a tractable target for understanding and treating disorders of appetite, mood, and reward.

Sarah Garfinkel

Dissociating dimensions of interoception: body-brain interactions and mental health

Interoception can be delineated across different dimensions, from the nature of afferent signals and their central processing to the accuracy with which they are sensed. Interoceptive processing can also include higher-order measures involving interoceptive attribution and appraisal.

Disturbances in interoceptive processing can be observed across clinical and neurodevelopmental conditions; precisely delineating interoceptive dimensions, including the nature of the afferent signals themselves, can help elucidate mechanistic change. Differences in interoceptive processing associated with transdiagnostic symptoms (e.g. dissociation) and with different clinical and neurodevelopmental conditions (e.g. anxiety and autism) can be detailed across interoceptive dimensions. The responsivity and adaptability of afferent signals may also underpin clinical differences in the processing of emotion and self.

Interoceptive dimensions pertaining to interoceptive accuracy, interoceptive attention, interoceptive appraisal, and the neural architecture underlying interoceptive processing can be trained and modified. Interoceptive change can occur through techniques such as biofeedback, interoceptive accuracy training, behavioural activation, interoceptive appraisal, and peripherally acting drugs to directly target the interoceptive system. Interoceptive mechanisms, at different levels, have broad promise as accessible targets for therapeutic intervention.

Sahib Khalsa

Interoception and mental health: bridging the gap

The internal organs emit signals that rhythmically propagate throughout the human body before reaching the nervous system. These interoceptive signals do not usually dominate consciousness unless the body’s physiology is perturbed or aversive physical or mental threats are perceived. The hierarchical and feedforward processing of such signals across the neuraxis facilitates the brain’s generation of accurate internal models of the body and world that allow an individual to 1) formulate (i.e., anticipate or predict) potential future outcomes and 2) take corrective actions focused on controlling or preventing aversive outcomes. Interoception is thus crucial for human health as it represents the afferent component of the brain-body feedback loop essential for linking internal sensation with body regulation, thereby minimizing erroneous feedback and maintaining homeostasis. Abnormal interoception plays a role in the expression of many psychiatric disorders, which implies that identifying and ameliorating interoceptive dysfunctions may aid in improving the diagnosis, prognosis, or treatment of those conditions. During this session, we will discuss links between interoception and mental health, from states of optimal health and well-being to states of illness recognized or diagnosed as psychiatric disorders, including depression, anxiety, eating disorders, addiction, and functional disorders. Using previous and ongoing studies, I will illustrate current knowledge gaps and delineate key methodologies that can address many open questions mechanistically. This will equip attendees with a framework for further learning and developing basic and clinical studies that advance interoceptive neuroscience and potentially improve human mental health.