The insula has been implicated in playing important roles in various brain functions including consciousness, homeostasis, perception, self-awareness, language processing, and interpersonal experience. Abnormalities of the insula have been observed in patients suffering from addiction, deteriorating language function, anorexia, and emotional dysregulation. We analyzed typical development of insular connections in a large-scale pediatric population using 642 magnetic resonance imaging examinations. Interpreting large quantities of acquired data is one of the major challenges in connectomics. This article focuses its analysis on the connectivity observed between the insula and many other regions throughout the brain and performs a hemispheric asymmetry analysis comparing localized connectome measurements. Results demonstrate asymmetries in the pathways connecting the insula to the superior temporal region, pars opercularis, etc. that may be representative of language lateralization in the brain. Results also demonstrate multiple fiber pathways that exhibit hemispheric dominance in tract length and an inverted hemispheric dominance in tract counts, implying the presence of asymmetric lateralization of some of the brain's insular pathways. This study illustrates the investigative potential of performing connectomics-style analyses in a clinical context across a large population of children as part of routine imaging, demonstrating the feasibility of using current technologies to perform regionally focused clinical connectivity studies.
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