Gary G. Berntson
The wiki’s autonomic psychophysiologist — a tradition it had been drawing on without a representative. Craig supplies the afferent anatomy, Barrett and Seth the theory, Khalsa and Critchley the clinical programme; Berntson comes from the older lineage that measured what the autonomic nervous system does and asked how the brain controls it. His entry here is as first author of Berntson & Khalsa (2021).
The reciprocity thesis
His organizing commitment, and the reason his review is titled “circuits” rather than “pathways”:
Although our primary focus is on interoception, it is difficult to separate afferent interoceptive processes from their reciprocal efferent influences that can change the internal environment and reciprocally impact on interoceptive afference.
Interoceptive regulatory systems are “probably best conceived of as a set of reciprocal afferent/efferent circuits engaged in a continuous circular loop of interaction.” This is a mild-sounding claim with a sharp consequence: a sense whose object is continuously modified by the system doing the sensing is not well modelled as a channel with a signal on it. The wiki has met the same shape from three other directions — the urethral sphincter that bursts to defeat afferent accommodation (urinary-interoception), exhalation-gated vagal stimulation (bioelectronic-medicine), reflexes “enslaved” by descending policy (central-autonomic-network) — but Berntson states it as the general form.
Bottom-up meets top-down
The title of his 2019 chapter (in Tsakiris & De Preester’s The Interoceptive Mind, cited as reference 3 of the review; not in raw/) is the position. He does not take a side on feedforward-vs-predictive-interoception so much as insist the question is empirical and currently open: determining “the relative contributions of bottom-up versus top-down signals to interoception and body regulation is thus an important challenge facing the field.” He then lists the manipulations that could decide it, which is a more useful contribution to that page than another argument would be.
Two positions do show through. He is sceptical that reduction alone will get there, recommending a dynamic systems approach that models components and their interactions — the first serious methodological alternative in this wiki to both read-out and predictive-coding framings. And he treats Cannon’s “autonomic” — acting “automatically, without direction from the cerebral cortex” — as the historical error his field has spent decades disassembling. See walter-cannon.
What he is careful about
Worth recording, because it is unusual in this literature. The review states plainly that there are no animal models of interoceptive awareness; that the role of the NTS’s ascending targets in immune regulation is “unclear”; that the immune section is “a limited view”; and that the human/animal division of evidence (cortex known in humans, brainstem in rodents) leaves the middle of the hierarchy inferred rather than shown. He is describing a field with large holes and says so, which makes the inventory more useful than a more confident one would be.
Placement
Read with sahib-khalsa, his co-author, whose clinical-perturbation and taxonomy concerns account for the review’s awareness sections while the autonomic and cortical-visceral-control material is Berntson’s. He is the natural counterweight to ad-craig on the afferent side: not a dissenter, but someone for whom the lamina I pathway is one lane among vagal, cranial, sacral, humoral and direct-central-sensing routes rather than the substrate of interoception as such. See interoceptive-sensors.