Insular cortex and neuropsychiatric disorders: A review of recent literature

Abstract

The insular cortex is located in the centre of the cerebral hemisphere, having connections with the primary and secondary somatosensory areas, anterior cingulate cortex, amygdaloid body, prefrontal cortex, superior temporal gyrus, temporal pole, orbitofrontal cortex, frontal and parietal opercula, primary and association auditory cortices, visual association cortex, olfactory bulb, hippocampus, entorhinal cortex, and motor cortex. Accordingly, dense connections exist among insular cortex neurons. The insular cortex is involved in the processing of visceral sensory, visceral motor, vestibular, attention, pain, emotion, verbal, motor information, inputs related to music and eating, in addition to gustatory, olfactory, visual, auditory, and tactile data. In this article, the literature on the relationship between the insular cortex and neuropsychiatric disorders was summarized following a computer search of the Pub-Med database. Recent neuroimaging data, including voxel based morphometry, PET and fMRI, revealed that the insular cortex was involved in various neuropsychiatric diseases such as mood disorders, panic disorders, PTSD, obsessive-compulsive disorders, eating disorders, and schizophrenia. Investigations of functions and connections of the insular cortex suggest that sensory information including gustatory, olfactory, visual, auditory, and tactile inputs converge on the insular cortex, and that these multimodal sensory information may be integrated there.

Brain activation predicts treatment improvement in patients with major depressive disorder

“…The insula is involved in gustatory, visceral sensation and visceral motor responses, but also in psychosomatic functions with autonomic regulation and emotion processing (see Damasio et al, 2000, Ketter et al,1996, Reiman et al, 1989Lane et al, 1997;Ottowitz et al, 2004; for an overview, see Nagai et al, 2007). Mayberg et al (1999) and Kennedy et al (2001) found post-treatment responsiveness associated with decreased metabolism in the insula.…”

Functional Connectivity Changes and Executive and Social Problems in Neurofibromatosis Type I

“…The insular cortex has been associated with a variety of different functions, such as cognitive control (Cole and Schneider, 2007), individual emotions (Nieuwenhuys, 2012;Phan et al, 2002), and social emotion, including empathy and compassion, as well as interpersonal phenomena such as fairness and cooperation (Lamm and Singer, 2010). Also, the importance of the insular cortex has already been shown in several diseases associated with social-cognitive dysfunction such as mood disorders, post-stroke depression, panic disorders, post-traumatic stress disorders, obsessive compulsive disorder, and schizophrenia (Nagai et al, 2007). Hence, a shift in functional connectivity of the …”

Abnormal Amygdala Resting-State Functional Connectivity in Irritable Bowel Syndrome

“…9 The insula is involved in emotional arousal and visceral sensory, autonomic visceral motor, and pain processing 33 and is consistently activated in healthy subjects exposed to visceral stimuli. 6 The insula is also an essential node in the homeostatic afferent network that is hyperactivated in IBS.…”