{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:14:43Z","timestamp":1793218483923,"version":"4.5.0"},"reference-count":100,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"unspecified","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100013076","name":"National Major Science and Technology Projects of China","doi-asserted-by":"publisher","award":["No.2022ZD0208500"],"award-info":[{"award-number":["No.2022ZD0208500"]}],"id":[{"id":"10.13039\/501100013076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014718","name":"Innovative Research Group Project of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No.62276181, No.82020108013"],"award-info":[{"award-number":["No.62276181, No.82020108013"]}],"id":[{"id":"10.13039\/100014718","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Interoception refers to the ability to perceive and integrate physiological signals originating from within the body, such as heartbeat and respiration. This process involves both bottom-up and top-down. As a key neurophysiological marker of interoception, the heartbeat-evoked potential (HEP) reflects the cortical processing of cardiac signals in the brain. In this review, we first outline the neural mechanisms underlying interoception and HEP, followed by a comprehensive overview of the methodologies commonly employed in HEP research. Based on the directionality of interoceptive information flow, we categorize HEP-related experimental designs into three types: bottom-up bodily sensory input, top-down predictive perception, and top-down regulation. Additionally, we explore the clinical relevance of HEP in areas such as psychiatric disorders and cardiac-related conditions. Finally, we recommend expanding research on top-down predictive perception and top-down regulation in clinical contexts.<\/jats:p>","DOI":"10.1017\/s003329172610453x","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:48:58Z","timestamp":1783928938000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Heartbeat-evoked potentials reveal interoceptive dysfunction in clinical disorders: Experimental frameworks and promising applications"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7927-2167","authenticated-orcid":false,"given":"Jie","family":"Wang","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"},{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1226-2584","authenticated-orcid":false,"given":"Enshuo","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"},{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingwei","family":"An","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"},{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Ming","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"},{"id":[{"id":"https:\/\/ror.org\/012tb2g32","id-type":"ROR","asserted-by":"publisher"}],"name":"Tianjin University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"S003329172610453X_r14","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2022.0415"},{"key":"S003329172610453X_r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2021.108165"},{"key":"S003329172610453X_r85","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2024.09.006"},{"key":"S003329172610453X_r21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-330167"},{"key":"S003329172610453X_r88","doi-asserted-by":"publisher","DOI":"10.1007\/s12671-024-02482-8"},{"key":"S003329172610453X_r35","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2023.137466"},{"key":"S003329172610453X_r93","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2025.121265"},{"key":"S003329172610453X_r98","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.874859"},{"key":"S003329172610453X_r49","first-page":"123","article-title":"Complexity analysis of heartbeat-related signals in brain MRI time series as a potential biomarker for ageing and cognitive performance","volume":"232","author":"L\u00f3pez P\u00e9rez","year":"2023","journal-title":"European Physical Journal: Special Topics"},{"key":"S003329172610453X_r75","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2016.03.051"},{"key":"S003329172610453X_r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2020.12.012"},{"key":"S003329172610453X_r37","first-page":"793","article-title":"Interoception underlies therapeutic effects of mindfulness meditation for posttraumatic stress disorder: A randomized clinical trial","volume":"7","author":"Kang","year":"2022","journal-title":"Biological Psychiatry: Cognitive Neuroscience and Neuroimaging"},{"key":"S003329172610453X_r15","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.75352"},{"key":"S003329172610453X_r48","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.16394"},{"key":"S003329172610453X_r80","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2011.02.014"},{"key":"S003329172610453X_r33","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2025.1567574"},{"key":"S003329172610453X_r39","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2024.110969"},{"key":"S003329172610453X_r54","doi-asserted-by":"publisher","DOI":"10.1007\/s10943-021-01431-2"},{"key":"S003329172610453X_r44","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(01)00480-1"},{"key":"S003329172610453X_r67","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24319"},{"key":"S003329172610453X_r82","doi-asserted-by":"publisher","DOI":"10.1113\/JP287802"},{"key":"S003329172610453X_r30","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24352"},{"key":"S003329172610453X_r72","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12388"},{"key":"S003329172610453X_r87","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-024-01806-5"},{"key":"S003329172610453X_r22","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.622428"},{"key":"S003329172610453X_r1","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2024.3439341"},{"key":"S003329172610453X_r59","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.04.081"},{"key":"S003329172610453X_r90","doi-asserted-by":"publisher","DOI":"10.5665\/sleep.6308"},{"key":"S003329172610453X_r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2022.02.955"},{"key":"S003329172610453X_r95","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717000368"},{"key":"S003329172610453X_r97","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.119548"},{"key":"S003329172610453X_r23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2024-000665"},{"key":"S003329172610453X_r42","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.12508"},{"key":"S003329172610453X_r45","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273864"},{"key":"S003329172610453X_r74","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000195"},{"key":"S003329172610453X_r83","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.116902"},{"key":"S003329172610453X_r24","doi-asserted-by":"publisher","DOI":"10.1186\/s40479-020-00139-1"},{"key":"S003329172610453X_r46","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13247756"},{"key":"S003329172610453X_r69","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.4262-15.2016"},{"key":"S003329172610453X_r99","first-page":"1019","article-title":"Intranasal oxytocin improves interoceptive accuracy and heartbeat-evoked potentials during a cardiac interoceptive task","volume":"9","author":"Zhou","year":"2024","journal-title":"Biological Psychiatry: Cognitive Neuroscience and Neuroimaging"},{"key":"S003329172610453X_r6","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11081089"},{"key":"S003329172610453X_r100","doi-asserted-by":"publisher","DOI":"10.1159\/000529308"},{"key":"S003329172610453X_r19","doi-asserted-by":"publisher","DOI":"10.1093\/scan\/nst108"},{"key":"S003329172610453X_r4","doi-asserted-by":"publisher","DOI":"10.1093\/texcom\/tgaa060"},{"key":"S003329172610453X_r13","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.16079"},{"key":"S003329172610453X_r41","first-page":"1219","article-title":"Attenuation of the heartbeat-evoked potential in patients with atrial fibrillation","volume":"8","author":"Kumral","year":"2022","journal-title":"JACC: Clinical Electrophysiology"},{"key":"S003329172610453X_r86","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2012.02.086"},{"key":"S003329172610453X_r12","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1740-20.2021"},{"key":"S003329172610453X_r26","doi-asserted-by":"publisher","DOI":"10.1093\/pnasnexus\/pgae531"},{"key":"S003329172610453X_r65","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2023.108698"},{"key":"S003329172610453X_r94","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23933"},{"key":"S003329172610453X_r3","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2016.0004"},{"key":"S003329172610453X_r31","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.14535"},{"key":"S003329172610453X_r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2020.10.007"},{"key":"S003329172610453X_r53","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.25318"},{"key":"S003329172610453X_r73","doi-asserted-by":"publisher","DOI":"10.1016\/j.psycom.2022.100052"},{"key":"S003329172610453X_r20","doi-asserted-by":"publisher","DOI":"10.1177\/17456916231191537"},{"key":"S003329172610453X_r62","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-13861-8"},{"key":"S003329172610453X_r76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2020.110223"},{"key":"S003329172610453X_r58","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2019.00616"},{"key":"S003329172610453X_r66","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.25288"},{"key":"S003329172610453X_r77","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2018.02.009"},{"key":"S003329172610453X_r8","first-page":"103196","article-title":"The heartbeat evoked potential is a questionable biomarker in nightmare disorder: A replication study","volume":"33","author":"Bogd\u00e1ny","year":"2022","journal-title":"NeuroImage: Clinical"},{"key":"S003329172610453X_r52","doi-asserted-by":"publisher","DOI":"10.1027\/2512-8442\/a000061"},{"key":"S003329172610453X_r11","doi-asserted-by":"publisher","DOI":"10.1016\/j.crneur.2022.100050"},{"key":"S003329172610453X_r63","first-page":"1708","article-title":"Changes in interoceptive processes following brain stimulation","volume":"371","author":"Pollatos","year":"2016","journal-title":"Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences"},{"key":"S003329172610453X_r57","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2025.107948"},{"key":"S003329172610453X_r91","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.14386"},{"key":"S003329172610453X_r17","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1125-16.2016"},{"key":"S003329172610453X_r36","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2020.147238"},{"key":"S003329172610453X_r79","first-page":"302","article-title":"Investigation of heartbeat evoked potential (HEP) response during different stages of sleep in sleep disorders","volume":"11","author":"Seddighi","year":"2024","journal-title":"Frontiers in Biomedical Technologies"},{"key":"S003329172610453X_r89","first-page":"107237","article-title":"Mapping human brain topography to heart rhythms: An SEEG study","volume":"8","author":"Wang","year":"2025","journal-title":"Cardiovascular Research"},{"key":"S003329172610453X_r71","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2021.1987686"},{"key":"S003329172610453X_r68","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaa095"},{"key":"S003329172610453X_r2","doi-asserted-by":"publisher","DOI":"10.1111\/psyp.70057"},{"key":"S003329172610453X_r55","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.904052"},{"key":"S003329172610453X_r64","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25045"},{"key":"S003329172610453X_r78","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2013.06.027"},{"key":"S003329172610453X_r38","first-page":"501","article-title":"Interoception and mental health: A roadmap","volume":"3","author":"Khalsa","year":"2018","journal-title":"Biological Psychiatry: Cognitive Neuroscience and Neuroimaging"},{"key":"S003329172610453X_r56","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.1252"},{"key":"S003329172610453X_r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2018.09.013"},{"key":"S003329172610453X_r60","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-024-05895-2"},{"key":"S003329172610453X_r51","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsycho.2018.06.007"},{"key":"S003329172610453X_r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpsycho.2016.09.019"},{"key":"S003329172610453X_r32","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0609509104"},{"key":"S003329172610453X_r47","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.952329"},{"key":"S003329172610453X_r61","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2019.101701"},{"key":"S003329172610453X_r10","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3049"},{"key":"S003329172610453X_r70","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.11.139"},{"key":"S003329172610453X_r40","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.119133"},{"key":"S003329172610453X_r84","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2024.1391437"},{"key":"S003329172610453X_r28","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2023.1008490"},{"key":"S003329172610453X_r92","first-page":"495","article-title":"Neural interoceptive processing is modulated by deep brain stimulation to subcallosal cingulate cortex for treatment-resistant depression","volume":"10","author":"Xu","year":"2025","journal-title":"Biological Psychiatry: Cognitive Neuroscience and Neuroimaging"},{"key":"S003329172610453X_r50","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2019.06.009"},{"key":"S003329172610453X_r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2025.121257"},{"key":"S003329172610453X_r96","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2024.108867"},{"key":"S003329172610453X_r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.02.528"},{"key":"S003329172610453X_r81","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsab100"},{"key":"S003329172610453X_r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2015.10.005"},{"key":"S003329172610453X_r43","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.14979"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S003329172610453X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:49:01Z","timestamp":1783928941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S003329172610453X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":100,"alternative-id":["S003329172610453X"],"URL":"https:\/\/doi.org\/10.1017\/s003329172610453x","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e216"}}