Neural Correlates of Cardiac Interoceptive Focus Across Development: Implications for Social Symptoms in Autism Spectrum Disorder.

The sample was cross-sectional, so age-related brain response changes cannot be treated as within-person development. Heartbeat accuracy was analyzed in a smaller subset than the fMRI sample (ASD: n=28, TC: n=41), and SRS analyses used different subsets (children: ASD=17, TC=15; adults: ASD=19, TD=16). Self-report SRS was only collected in adults, while caregiver reports were mostly from children and young adults, so the self-report interaction may not apply across ages. Many psychotropic medications were excluded, which limits generalizability because such medications are common in ASD. ASD participants showed higher max translation in x and z and rotation around x, despite motion being included in the models. The study likely was not powered to detect relationships among interoceptive accuracy, age, IQ, and diagnostic group. Alexithymia was not measured, although it may relate to interoception and ASD traits. Heartbeat counting may be influenced by IQ and prior knowledge of heart rate, not pure interoception. Only one interoceptive modality was tested, so findings may not extend to other body signals.

The supplied metadata lists Research Support, N.I.H., Extramural. No funding or conflict-of-interest declaration appears in the article text.

Do not conclude that people with ASD have reduced heartbeat-counting accuracy or reduced insula response during interoception; the study found no significant group differences in either. Do not read the self-report social symptom interaction as evidence that insula response caused social symptoms, because the study was cross-sectional and measured brain response and symptom reports at the same time.