Heartbeat-evoked potentials reveal interoceptive dysfunction in clinical disorders: Experimental frameworks and promising applications.

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.