Microstructural Brain Correlates of Inter-individual Differences in Respiratory Interoception.

Interoception, the perception and integration of physiological signals, is a fundamental aspect of self-awareness and homeostasis. While previous work has explored interoceptive processing in the cardiac system, research in the respiratory domain, particularly in relation to brain structure and function, is limited. To address this gap, we utilized a Bayesian psychophysical model to quantify perceptual, metacognitive, and affective dimensions of respiratory interoception in a sample of over 200 healthy participants of both genders. Hierarchical modeling revealed that respiratory metacognition was associated with higher somatic and lower cognitive anxiety, respectively. Whole-brain microstructural indices of myelin content and cortical iron were measured using quantitative brain imaging. Whole-brain voxel-based quantification revealed distinct microstructural patterns in the insular, cingulate, and primary sensory cortices that underlie interoceptive sensitivity and precision. Myelination in the cingulate cortex and periaqueductal gray was associated with confidence bias, while metacognitive sensitivity correlated with myelination in the midline prefrontal cortex. Our findings highlight key brain pathways involved in respiratory interoception and its perceptual, metacognitive, and emotional dimensions.