Exploring multimodal interoception in women with Endometriosis

Endometriosis is a condition characterised by chronic pelvic pain and visceral hypersensitivity. Altered interoception leading to misperception of the physiological states of one’s body has been reported in chronic pain conditions mainly using questionnaires or cardiac interoception tasks. Here, we investigate multimodal interoception in healthy women (HC) and in patients with endometriosis (EP) with the aim of characterising potential interoceptive deficits as early markers of the disease. Following the multimodal interoceptive model, we measured interoceptive accuracy in 15 EP (age: 34±6.71) and 15 HC (age: 33.3±7.27) through three tasks: the Heartbeat Counting Task (HCT) to assess the cardiac domain, the Water Load Test-II (WLT-II) for the gastric domain, and a novel Urinary Interoceptive Task (UIT) for the bladder domain. We also assessed participants’ interoceptive sensibility via the MAIA-II questionnaire. Preliminary results showed a significant correlation between the WLT-II and the UIT in all participants (R=0.51; p<0.01), indicating a relationship between gastric and urinary interoception. Moreover, compared to HC, EPs show lower scores in two interoceptive accuracy tasks, namely the WLT (F= 4.988; p<0.05) and UIT (F=13.05; p<0.01), and showed lower interoceptive sensibility in the 'Not distracting' MAIA-II subscale (F=14.09; p<0.001), assessing the tendency to ignore pain and discomfort. Thus, probably due to their habituation to chronic pain, EPs tend to ignore discomfort sensations and are less accurate in detecting physiological signals, specifically those coming from the pelvic area. These results pave the way for the possibility to use interoceptive signals as a predictor of endometriosis, facilitating the diagnosis process.