Emotions and bodily sensations evoked by cardiac adenosine stress
Peripheral physiological processes contribute to emotions; however, the extent of the influence of internal signals on subjective emotional experiences remains a subject of debate. MethodsHere we investigated the bodily sensations induced by pharmacological stimulation with adenosine, a potent vasodilator that does not cross the blood-brain barrier, and how these sensations are translated into emotional experiences in 193 patients (94 males, 99 females; mean age 62.6 {+/-} 9.2 years) undergoing pharmacological cardiac stress testing as a part of their clinical assessment for suspected obstructive coronary artery disease. We characterized the subjective experiences induced by adenosine using topographical bodily maps and Likert-rating scales of 16 somatic sensations and 16 emotions. ResultsAdenosine induced strong and consistent bodily sensations related to dyspnea, chest pain, tachycardia, feelings of warmth, and tension in the body. The induced sensations were topographically distinct, with pain and pressure concentrated in the chest, warmth distributed across the upper body, and weakness localized to the torso. These sensations were accompanied by a significant increase in negative emotions, such as anxiety, fear, restlessness, panic, and a decrease in positive emotions of happiness, joy, and calmness. Peak heart rate response predicted the intensity of most bodily and emotional responses. Patients diagnosed with myocardial ischemia did not show heightened sensitivity to adenosine-induced bodily sensations compared to non-ischemic patients, despite exhibiting a blunted tachycardiac reflex. ConclusionThese findings show that peripheral physiological activation alone is sufficient to drive subjective emotional experiences, providing causal evidence for the embodied nature of emotions.