Emerging theories emphasize the crucial role of allostasis (anticipatory and adaptive regulation of the body’s biological processes) and interoception (integration, anticipation, and regulation of internal bodily states) in adjusting physiological responses to environmental and bodily demands. In this review, we explore the disruptions in integrated allostatic interoceptive mechanisms in psychiatric and neurological disorders, including anxiety, depression, Alzheimer’s disease, and frontotemporal dementia. We assess the biological mechanisms associated with allostatic interoception, including whole-body cascades, brain structure and function of the allostatic interoceptive network, heart-brain interactions, respiratory-brain interactions, the gut-brain-microbiota axis, peripheral biological processes (inflammatory, immune), and epigenetic pathways. These processes span psychiatric and neurological conditions and call for developing dimensional and transnosological frameworks. We synthesize new pathways to understand how allostatic interoceptive processes modulate interactions between environmental demands and biological functions in brain disorders. We discuss current limitations of the framework and future transdisciplinary developments. This review opens a new research agenda for understanding how allostatic interoception involves brain predictive coding in psychiatry and neurology, allowing for better clinical application and the development of new therapeutic interventions.

中文翻译：

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精神病学和神经系统疾病的同种异体内感受超负荷


新兴理论强调失变（对身体生物过程的预期和适应性调节）和内感受（整合、预期和调节内部身体状态）在调整对环境和身体需求的生理反应中的关键作用。在这篇综述中，我们探讨了精神和神经系统疾病（包括焦虑、抑郁、阿尔茨海默病和额颞叶痴呆）中综合同种异体内感受机制的破坏。我们评估了与同种异体内感受相关的生物学机制，包括全身级联反应、同种异体内感受网络的大脑结构和功能、心脑相互作用、呼吸-脑相互作用、肠-脑-微生物群轴、外周生物过程（炎症、免疫）和表观遗传途径。这些过程跨越精神和神经系统疾病，需要开发维度和跨鼻学框架。我们综合了新的途径来了解同种异体内感受过程如何调节脑部疾病中环境需求和生物功能之间的相互作用。我们讨论了该框架的当前局限性和未来的跨学科发展。本综述为了解同种异体内感受如何涉及精神病学和神经学中的大脑预测编码开辟了新的研究议程，从而允许更好的临床应用和开发新的治疗干预措施。