I've been noticing something interesting in the von Economo neuron (VEN) literature. These cells stay stable during normal aging but actually increase in SuperAgers, while showing selective vulnerability in bvFTD and Alzheimer's. Since VENs process autonomic signals fundamental to interoception, I'm proposing that VEN density links interoceptive accuracy to systemic biological age—and that senotherapeutic drugs might preserve this connection.

The mechanism likely works like this: VENs in the anterior cingulate and frontoinsular cortex integrate visceral afferent signals through the vagus nerve, converting somatosensory autonomic information into salience detection and intuitive decision-making. I think of VENs as the neural "canary" for multi-organ aging for three reasons. First, their unusually large size and simple radial morphology make them heavily dependent on sustained metabolic support from the neurovascular unit. Second, their position in layer 5 of the frontoinsular cortex places them at the nexus of descending autonomic modulatory pathways. Third, age-related decline in gut microbiome diversity and vagal tone probably shows up first as reduced interoceptive precision, well before any detectable cognitive decline.

The SuperAger elevation in VEN density might reflect a feedback loop: preserved interoceptive signaling drives continuous VEN maintenance through activity-dependent trophic support, creating a protective cascade against frailty and systemic inflammation. In contrast, the 56% VEN loss seen in bvFTD could represent a tipping point where interoceptive disruption accelerates multi-organ dysfunction through loss of bottom-up homeostatic signaling.

This leads to several testable predictions. First, individuals with higher interoceptive accuracy on heartbeat discrimination tasks should show greater VEN density in the ACC and FI at postmortem, independent of chronological age. Second, the gap between biological age (epigenetic clocks) and functional age (interoceptive battery) should correlate positively with VEN density—SuperAgers would show narrower gaps. Third, senotherapeutic interventions like dasatinib plus quercetin or rapamycin, given to aged mice, should preserve VEN populations in the FIc and ACC while rescuing interoceptive behavior on visceral stimulation tasks. Fourth, vagotomy or chemogenetic silencing of vagal afferents in aged rodents should reduce VEN density and trigger accelerated biological aging markers across organ systems.

The hypothesis is falsifiable if VEN density shows no correlation with interoceptive accuracy in human postmortem cohorts, if senotherapeutics fail to preserve VENs despite rescuing other neuronal populations, or if SuperAgers don't demonstrate superior interoceptive performance relative to age-matched controls.

For the research approach, I'd combine UK Biobank-derived brain age gap metrics with standardized interoceptive assessment in living participants, then validate against postmortem VEN counts. Parallel preclinical work using the 453-intervention screening pipeline could rapidly identify candidate senotherapeutics for VEN-specific rescue.

This framework connects VEN preservation to body-brain communication and systemic health outcomes—an integration that's missing from current literature.