Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes
BackgroundMigraine is one of the most common neurological disorders. Despite advances in understanding of episodic migraine, little is understood about the mechanisms underlying the chronification of migraine. Recently, increasing attention has been given to the potential roles of interoceptive abno...
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Frontiers Media S.A.
2025-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1643260/full |
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| author | Akihiro Koreki Akihiro Koreki Vilomi Bhatia Anne-Marie Logan Usman Khan Mitsumoto Onaya Sarah Garfinkel Hugo Critchley Mark Edwards Niranjanan Nirmalananthan Mahinda Yogarajah Mahinda Yogarajah |
| author_facet | Akihiro Koreki Akihiro Koreki Vilomi Bhatia Anne-Marie Logan Usman Khan Mitsumoto Onaya Sarah Garfinkel Hugo Critchley Mark Edwards Niranjanan Nirmalananthan Mahinda Yogarajah Mahinda Yogarajah |
| author_sort | Akihiro Koreki |
| collection | DOAJ |
| description | BackgroundMigraine is one of the most common neurological disorders. Despite advances in understanding of episodic migraine, little is understood about the mechanisms underlying the chronification of migraine. Recently, increasing attention has been given to the potential roles of interoceptive abnormalities and dissociation. Therefore, we sought to explore differences in interoception and dissociation in individuals with episodic and chronic migraine versus individuals without migraine.MethodsA total of 49 participants were analysed of which 26 had migraine (15 chronic and 11 episodic) and 23 were control subjects without a headache disorder. Their objective interoceptive accuracy was assessed using the heartbeat tracking and discrimination tasks. Interoceptive sensibility was assessed using the Porges body perception questionnaire. Interoceptive trait prediction error (ITPE) was calculated based on the discrepancy between their task performance and sensibility. Interoceptive state prediction error (ISPE) was calculated based on the trial-by-trial correspondence between task performance and confidence. The level of their dissociation was assessed via self-report questionnaires.ResultsPatients with migraine had lower interoceptive accuracy for the tracking task (median (interquartile range) 0.50 (0.43) in migraine vs. 0.78 (0.26) in control, Mann–Whitney U test, effect size r = 0.35, p = 0.014), higher interoceptive sensibility (110 (52) vs. 39 (14), r = 0.74, p < 0.001), and greater ITPE than controls (for the tracking task: 1.08 (1.78) vs. − 1.16 (0.88), r = 0.72, p < 0.001 / for the discrimination task: 0.87 (1.44) vs. − 0.62 (0.97), r = 0.69, p < 0.001). Greater ISPE was also found in patients with chronic migraine than episodic migraine (2.30 (0.35) in chronic vs. 1.75 (0.19) in episodic, r = 0.39, p = 0.046). A greater level of somatoform dissociation was found in individuals with chronic, compared to episodic, migraine (27 (11) vs. 22 (2), r = 0.43, p = 0.029).ConclusionThis is the first study to demonstrate interoceptive abnormalities in migraine, specifically of greater interoceptive prediction errors. Interoceptive abnormalities may represent a transdiagnostic mechanisms relevant to the chronification of migraine, and to frequent co-morbidities such as dissociation. |
| format | Article |
| id | doaj-art-6ae43ef350ed47c691c8abbfda7e4c28 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-08-01 |
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| series | Frontiers in Neurology |
| spelling | doaj-art-6ae43ef350ed47c691c8abbfda7e4c282025-08-20T04:14:15ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16432601643260Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypesAkihiro Koreki0Akihiro Koreki1Vilomi Bhatia2Anne-Marie Logan3Usman Khan4Mitsumoto Onaya5Sarah Garfinkel6Hugo Critchley7Mark Edwards8Niranjanan Nirmalananthan9Mahinda Yogarajah10Mahinda Yogarajah11Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, United KingdomDepartment of Psychiatry, NHO Shimofusa Psychiatric Medical Center, Chiba, JapanInstitute of Cognitive Neuroscience, University College London, London, United KingdomAtkinson Morley Regional Neuroscience Centre, St George’s Hospital, London, United KingdomAtkinson Morley Regional Neuroscience Centre, St George’s Hospital, London, United KingdomDepartment of Psychiatry, NHO Shimofusa Psychiatric Medical Center, Chiba, JapanInstitute of Cognitive Neuroscience, University College London, London, United KingdomDepartment of Clinical Neuroscience, Brighton and Sussex Medical School, Sussex University, Sussex, United KingdomNeurology and Interface Disorders at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, London, United KingdomAtkinson Morley Regional Neuroscience Centre, St George’s Hospital, London, United KingdomDepartment of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, United KingdomChalfont Centre for Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, London, United KingdomBackgroundMigraine is one of the most common neurological disorders. Despite advances in understanding of episodic migraine, little is understood about the mechanisms underlying the chronification of migraine. Recently, increasing attention has been given to the potential roles of interoceptive abnormalities and dissociation. Therefore, we sought to explore differences in interoception and dissociation in individuals with episodic and chronic migraine versus individuals without migraine.MethodsA total of 49 participants were analysed of which 26 had migraine (15 chronic and 11 episodic) and 23 were control subjects without a headache disorder. Their objective interoceptive accuracy was assessed using the heartbeat tracking and discrimination tasks. Interoceptive sensibility was assessed using the Porges body perception questionnaire. Interoceptive trait prediction error (ITPE) was calculated based on the discrepancy between their task performance and sensibility. Interoceptive state prediction error (ISPE) was calculated based on the trial-by-trial correspondence between task performance and confidence. The level of their dissociation was assessed via self-report questionnaires.ResultsPatients with migraine had lower interoceptive accuracy for the tracking task (median (interquartile range) 0.50 (0.43) in migraine vs. 0.78 (0.26) in control, Mann–Whitney U test, effect size r = 0.35, p = 0.014), higher interoceptive sensibility (110 (52) vs. 39 (14), r = 0.74, p < 0.001), and greater ITPE than controls (for the tracking task: 1.08 (1.78) vs. − 1.16 (0.88), r = 0.72, p < 0.001 / for the discrimination task: 0.87 (1.44) vs. − 0.62 (0.97), r = 0.69, p < 0.001). Greater ISPE was also found in patients with chronic migraine than episodic migraine (2.30 (0.35) in chronic vs. 1.75 (0.19) in episodic, r = 0.39, p = 0.046). A greater level of somatoform dissociation was found in individuals with chronic, compared to episodic, migraine (27 (11) vs. 22 (2), r = 0.43, p = 0.029).ConclusionThis is the first study to demonstrate interoceptive abnormalities in migraine, specifically of greater interoceptive prediction errors. Interoceptive abnormalities may represent a transdiagnostic mechanisms relevant to the chronification of migraine, and to frequent co-morbidities such as dissociation.https://www.frontiersin.org/articles/10.3389/fneur.2025.1643260/fullchronicdissociationinteroceptionmigrainepredictive coding |
| spellingShingle | Akihiro Koreki Akihiro Koreki Vilomi Bhatia Anne-Marie Logan Usman Khan Mitsumoto Onaya Sarah Garfinkel Hugo Critchley Mark Edwards Niranjanan Nirmalananthan Mahinda Yogarajah Mahinda Yogarajah Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes Frontiers in Neurology chronic dissociation interoception migraine predictive coding |
| title | Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes |
| title_full | Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes |
| title_fullStr | Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes |
| title_full_unstemmed | Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes |
| title_short | Interoception and dissociation in migraine: a case–control study of chronic and episodic subtypes |
| title_sort | interoception and dissociation in migraine a case control study of chronic and episodic subtypes |
| topic | chronic dissociation interoception migraine predictive coding |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1643260/full |
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