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Insular cortex and neuropsychiatric disorders: A review of recent literature

Published online by Cambridge University Press:  09 April 2007

M. Nagai ,
K. Kishi  and
S. Kato
M. Nagai*
Affiliation:
Department of Internal Medicine, Shobara Red Cross Hospital, Hiroshima, Japan
K. Kishi
Affiliation:
Department of Medical Informatics, Jichi Medical School, Tochigi, Japan
S. Kato
Affiliation:
Department of Psychiatry, Jichi Medical School, Tochigi, Japan
*
∗Corresponding author. Department of Internal Medicine, Shobara Red Cross Hospital, 2710 Nishihonmachi, 727 0013 Shobara City, Hroshima Prefecture, Japan. Tel.: +81 824 72 3111; fax: +81 824 72 3576. E-mail address: [email protected] (M. Nagai).
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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.

Keywords

Insular cortexAffective disordersAnxiety disordersSchizophreniafMRIPET
Type
Review
Information
European Psychiatry , Volume 22 , Issue 6 , September 2007 , pp. 387 - 394
Copyright
Copyright © Elsevier Masson SAS 2007

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References

Augustine, J.R.The insular lobe in primates including humans. Neurol Res 1985;7:2–10.CrossRefGoogle ScholarPubMed
Augustine, J.R.Circuitry and functional aspects of the insular lobe in primates including humans. Brain Res Rev 1996;22:229–244.CrossRefGoogle ScholarPubMed
Banati, R.B., Goerres, G.W., Tjoa, C., Aggleton, J.P., Grasby, P.The functional anatomy of visual tactile integration in man: A study using positron emission tomography. Neuropsychologia 2000;38:115–124.CrossRefGoogle ScholarPubMed
Banzett, R.B., Mulnier, H.E., Murphy, K., Rosen, S.D., Wise, R.J.S., Adams, L.Breathlessness in humans activates insular cortex. Neuroreport 2000;11:2117–2120.CrossRefGoogle ScholarPubMed
Basbaum, A.I., Jessell, T.M.The perception of pain. In: Kandel, E.R., Schwartz, J., Jessell, T.M., editors. Principles of neural science 4th ed.San Francisco: McGraw-Hill; 2000. p. 472–491.Google Scholar
Beckmann, H., Jakob, H.Prenatal disturbances of nerve cell migration in the entorhinal region: a common vulnerability factor in functional psychosis?. J Neural Transmission 1991;84:155–164.CrossRefGoogle Scholar
Benarroch, E.E.The central autonomic network: functional organization dysfunction and perspective. Mayo Clin Proc 1993;68:988–1001.CrossRefGoogle ScholarPubMed
Benkelfat, C., Bradwejn, J., Meyer, E., Ellenbogen, M., Milot, S., Gjedde, A.et al.Functional neuroanatomy of CCK4-induced anxiety in normal healthy volunteers. Am J Psychiatry 1995;152:1180–1184.Google ScholarPubMed
Biver, F., Wikler, D., Lotstra, F., Damhaut, P., Goldman, S., Mendlewicz, J.Serotonin 5-HT2 receptor imaging in major depression; focal changes in orbito-insular cortex. Br J Psychiatry 1997;171:444–448.CrossRefGoogle ScholarPubMed
Brannan, S., Liotti, M., Egan, G., Shade, R., Madden, L., Robillard, R.et al.Neuroimaging of cerebral activations and deactivations associated with hypercapnea and hunger of air. Proc Natl Acad Sci U S A 2001;98:2029–2034.CrossRefGoogle Scholar
Bushara, K.O., Grafman, J., Hallet, M.Neural correlates of auditory visual stimulus onset asynchrony detection. J Neurosci 2001;21:300–304.CrossRefGoogle ScholarPubMed
Cameron, O.G., Zubieta, J.K., Grunhaus, L., Minoshima, S.Effects of yohimbine on cerebral blood flow, symptoms, and physiological functions in humans. Psychosom Med 2000;62:549–559.CrossRefGoogle ScholarPubMed
Clarke, E., O'Malley, C.D.The human brain and spinal cord: a historical study illustrated by writings from antiquity to the twentieth century. Norman Publishing; 1996.Google Scholar
Crespo-Facorro, B., Kim, J.J., Andreasen, N.C., O'Leary, D.S., Bockholt, H.J., Magnotta, V.Insular cortex abnormalities in schizophrenia: a structural magnetic resonance imaging study of first-episode patients. Schizophr Res 2000;46:35–43.CrossRefGoogle ScholarPubMed
Crespo-Facorro, B., Paradiso, S., Andreasen, N.C., O'Leary, D.S., Watkins, G.L., Ponto, L.L.B.et al.Neural mechanisms of anhedonia in schizophrenia: a PET study of response to unpleasant and pleasant odors. JAMA 2001;286:427–435.CrossRefGoogle ScholarPubMed
Crespo-Facorro, B., Wiser, A.K., Andreasen, N.C., O'Leary, D.S., Watkins, G.L., Boles Ponto, L.L.et al.Neural basis of novel and well-learned recognition memory in schizophrenia: a positron emission tomography study. Hum Brain Mapp 2001;12:219–231.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Curtis, V.A., Bollmore, E.T., Brammer, M.J., Wright, I.C., Chir, B., Williams, S.C.R.et al.Attenuated frontal activation during a verbal fluency task in patients with schizophrenia. Am J Psychiatry 1998;155:1056–1063.CrossRefGoogle ScholarPubMed
Damasio, A.R., Grabowski, T.J., Bechara, A., Damasio, H., Ponto, L.L.B., Parvizi, J.et al.Subcortical and cortical brain activity during the feeling of self-generated emotions. Nat Neurosci 2000;3:1049–1056.CrossRefGoogle ScholarPubMed
Daniels, S.K., Foundas, A.L., Iglesia, G.C., Sullivan, M.A.Lesion site in unilateral stroke patients with dysphagia. J Stroke Cerebrovasc Dis 1996;6:30–34.CrossRefGoogle ScholarPubMed
Daniels, S.K., Foundas, A.L.The role of the insular cortex in dysphagia. Dysphagia 1997;12:146–156.CrossRefGoogle ScholarPubMed
Duggal, H.S., Muddasani, S., Keshavan, M.S.Insular volumes in first-episode schizophrenia: gender effect. Schizophr Res 2005;73:113–120.CrossRefGoogle ScholarPubMed
Farrer, C., Franck, N., Frith, C.D., Decety, J., Georgieff, N., d'Amato, T.et al.Neural correlates of action attribution in schizophrenia. Psychiatry Res 2004;131:31–44.CrossRefGoogle Scholar
Freud, S.Zur Auffassung der Aphasien. Vienna: Deutike; 1891. in German.Google Scholar
George, M.S., Ketter, T.A., Parekh, P.I., Horwitz, B., Herscovitch, P., Post, R.M.Brain activity during transient sadness and happiness in healthy women. Am J Psychiatry 1995;152:341–351.Google ScholarPubMed
Goldstein, J.M., Goodman, J.M., Seidman, L.J., Kennedy, D.N., Makris, N., Lee, H.et al.Cortical abnormalities in schizophrenia identified by structural magnetic resonance imaging. Arch Gen Psychiatry 1999;56:537–547.CrossRefGoogle ScholarPubMed
Gordon, C.M., Dougherty, D.D., Rauch, S.L., Emans, S.J., Grace, E., Lamm, R.et al.Neuroanatomy of human appetitive function: a positron emission tomography investigation. Int J Eat Dis 2000;27:163–171.3.0.CO;2-Y>CrossRefGoogle ScholarPubMed
Gross-Isseroff, R., Israeli, M., Biegon, A.Autoradiographic analysis of tritiated imipramine binding in the human brain post mortem: effect of suicide. Arch Gen Psychiatry 1989;46:237–241.CrossRefGoogle ScholarPubMed
Ha, T.H., Youn, T., Ha, K.S., Rho, K.S., Lee, J.M., Kim, I.Y.et al.Gray matter abnormalities in paranoid schizophrenia and their clinical correlations. Psychiatry Res 2004;132:251–260.Google ScholarPubMed
Hulshoff Pol, H.E., Schnack, H.G., Mandl, R.C., Van Haren, N.E., Koning, H., Collins, D.L.et al.Focal gray matter density changes in schizophrenia. Arch Gen Psychiatry 2001;58:1118–1125.CrossRefGoogle Scholar
Javanmard, M., Shlik, J., Kennedy, S.H., Vaccarino, F.J., Houle, S., Bradwejn, J.Neuroanatomic correlates of cck-4-induced panic attacks in healthy humans: a comparison of two time points. Biol Psychiatry 1999;45:872–882.CrossRefGoogle ScholarPubMed
Kasai, K., Shenton, M.E., Salisbury, D.F., Onitsuka, T., Toner, S.K., Yurgelun-Todd, D.et al.Differences and similarities in insular and temporal pole MRI gray matter volume abnormalities in first-episode schizophrenia and affective psychosis. Arch Gen Psychiatry 2003;60:1069–1077.CrossRefGoogle ScholarPubMed
Kennedy, S.H., Evans, K.R., Kruger, S., Mayberg, H.S., Meyer, J.H., McCann, S.et al.Changes in regional brain glucose metabolism measured with positron emission tomography after paroxetine treatment of major depression. Am J Psychiatry 2001;158:899–905.CrossRefGoogle ScholarPubMed
Kennedy, S.E., Koeppe, R.A., Young, E.A., Zubieta, J.K.Dysregulation of endogenous opioid emotion regulation circuitry in major depression in women. Arch Gen Psychiatry 2006;63:1199–1208.CrossRefGoogle ScholarPubMed
Ketter, T.A., Andreason, P.J., George, M.S., Lee, C., Gill, D.S., Parekh, P.I.et al.Anterior paralimbic medication of procaine-induced emotional and psychosensory experiences. Arch Gen Psychiatry 1996;53:59–69.CrossRefGoogle Scholar
Ketter, T.A., Kimbrell, T.A., George, M.S., Willis, M.W., Benson, B.E., Danielson, A.et al.Baseline cerebral hypermetabolism associated with carbamazepine response and hypometabolism with nimodipine response in mood disorders. Biol Psychiatry 1999;46:1364–1374.CrossRefGoogle ScholarPubMed
Kishi, K., Nagai, M.A neural network model for synesthesia. Neurosci Res 24Suppl2000 77 (abstract).CrossRefGoogle Scholar
Kosslyn, S.M., Shin, L.M., Thompson, W.L., McNally, R.J., Rauch, S.L., Pitman, R.K.et al.Neural effects of visualizing and perceiving aversive stimuli: a PET investigation. Neuroreport 1996;7:1569–1576.CrossRefGoogle ScholarPubMed
Lane, R.D., Reiman, E.M., Ahern, G.L., Schwartz, G.E., Davidson, R.J.Neuroanatomical correlates of happiness, sadness, and disgust. Am J Psychiatry 1997;154:926–933.Google ScholarPubMed
Liepmann, H., Pappenheim, M.Über einen Fall von sogenannter Leitungs Aphasie mit anatomischen Befund. Neurol Psychiatr 1914;27:1–41 (in German).Google Scholar
Livingstone, R.B.Some brain stem mechanisms relating to psychosomatic functions. Psychosom Med 1955;17:347–354.CrossRefGoogle Scholar
Makris, N., Goldstein, J.M., Kennedy, D., Hodge, S.M., Caviness, V.S., Faraone, S.V.et al.Decreased volume of left and total anterior insular lobule in schizophrenia. Schizophr Res 2006;83:155–171.CrossRefGoogle Scholar
Malizia, A.L., Cunningham, V.J., Bell, C.J., Liddle, P.F., Jones, T., Nutt, D.J.Decreased brain GABAA-benzodiazepine receptor binding in panic disorder. Arch Gen Psychiatry 1998;55:715–720.CrossRefGoogle Scholar
Manes, F., Paradiso, S., Robinson, R.G.Neuropsychiatric effects of insular stroke. J Nerv Ment Dis 1999;187:707–712.CrossRefGoogle ScholarPubMed
Mayberg, H.S., Liotti, M., Brannan, S.K., McGinnis, S., Mahurin, R.K., Jerabek, P.A.et al.Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999;156:675–682.Google ScholarPubMed
Mesulam, M.M., Mufson, E.J.The Insula of Reil in man and monkey: architectonics, connectivity, and function. In: Peters, A., Jones, E.G., editors.Cerebral cortex 4 New York: Plenum Press; 1985. p. 179–226.Google Scholar
Morris, J.S., Scott, S.K., Dolan, R.J.Saying it with feeling: neural responses to emotional vocalizations. Neuropsychologia 1999;37:1155–1163.CrossRefGoogle ScholarPubMed
Mullan, S., Penfield, W.Illusions of comparative interpretation and emotion. Arch Neurol Psychiatry 1959;81:269–284.CrossRefGoogle ScholarPubMed
Oppenheimer, S.M., Cechetto, D.F.The cardiac chronotropic organization of the rat insular cortex. Brain Res 1990;533:66–72.CrossRefGoogle ScholarPubMed
Oppenheimer, S.M., Wilson, J.X., Guiraudon, C., Cechetto, D.F.Insular cortex stimulation produces lethal cardiac arrhythmias: a mechanism of sudden death?. Brain Res 1991;550:1–12.CrossRefGoogle ScholarPubMed
Oppenheimer, S.M., Gelb, A., Girvin, J.P., Hachinski, V.C.Cardiovascular effects of human insular cortex stimulation. Neurology 1992;42:1727–1732.CrossRefGoogle ScholarPubMed
Pazzaglia, P.J., Post, R.M., Ketter, T.A., George, M.S., Marangell, L.B.Preliminary controlled trial of nimodipine in ultrarapid cycling affective dysregulation. Psychiatry Res 1993;49:257–272.CrossRefGoogle Scholar
Penfield, W., Faulk, M.E.The insula: further observations on its function. Brain 1955;78:445–470.CrossRefGoogle ScholarPubMed
Phelps, E.A., O'Connor, K.J., Gatenby, J.C., Gore, J.C., Grillon, C., Davis, M.et al.Activation of the left amygdala to a cognitive representation of fear. Nat Neurosci 2001;4:437–441.CrossRefGoogle Scholar
Phillips, M.L., Young, A.W., Senior, C., Brammer, M., Andrew, C., Calder, A.J.et al.A specific neural substrate for perceiving facial expressions of disgust. Nature 1997;389:495–498.CrossRefGoogle ScholarPubMed
Post, R.M., Uhde, T.W., Roy-Byrne, P.P., Joffe, R.T.Correlates of antimanic response to carbamazepine. Psychiatry Res 1987;21:71–83.CrossRefGoogle ScholarPubMed
Pressler, M., Nopoulos, P., Ho, B.C., Andreasen, N.C.Insular cortex abnormalities in schizophrenia: Relationship to symptoms and typical neuroleptic exposure. Biol Psychiatry 2005;57:394–398.CrossRefGoogle ScholarPubMed
Rauch, S.L., Savage, C.R., Alpert, N.M., Miguel, E.C., Baer, L., Breiter, H.C.et al.A positron emission tomography study of simple phobic symptoms provocation. Arch Gen Psychiatry 1995;52:20–28.CrossRefGoogle ScholarPubMed
Rauch, S.L., Van der Kolk, B.A., Fisler, R.E., Alpert, N.M., Orr, S.P., Savage, C.R.et al.A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Arch Gen Psychiatry 1996;53:380–387.CrossRefGoogle ScholarPubMed
Rauch, S.L., Savage, C.R., Alpert, N.M., Fischman, A.J., Jenike, M.A.The functional neuroanatomy of anxiety: a study of three disorders using positron emission tomography and symptom provocation. Biol Psychiatry 1997;42:446–452.CrossRefGoogle ScholarPubMed
Reil, J.C.Die sylvische Grube. Arch Physiol (Halle) 1809;9:195–208 (in German).Google Scholar
Reiman, E.M., Raichle, M.E., Robins, E., Mintun, M.A., Fusselman, M.J., Fox, P.T.et al.Neuroanatomical correlates of a lactate-induced anxiety attack. Arch Gen Psychiatry 1989;46:493–500.CrossRefGoogle ScholarPubMed
Reiman, E.M., Lane, R.D., Ahern, G.L., Schwartz, G.E., Davidson, R.J., Friston, K.J.et al.Neuroanatomical correlates of externally and internally generated human emotion. Am J Psychiatry 1997;154:918–925.Google ScholarPubMed
Rolls, E.T.Information processing in the taste system of primates. J Exp Biol 1989;146:141–164.Google ScholarPubMed
Servan-Schreiber, D., Perlstein, W.M., Cohen, J.D., Mintun, M.Selective pharmacological activation of limbic structures in human volunteers: a positron emission tomography study. J Neuropsychiatry Clin Neurosci 1998;10:148–159.CrossRefGoogle ScholarPubMed
Shergill, S.S., Brammer, M.J., Williams, S.C.R., Murray, R.M., McGuire, P.K.Mapping auditory hallucinations in schizophrenia using functional magnetic resonance imaging. Arch Gen Psychiatry 2000;57:1033–1038.CrossRefGoogle ScholarPubMed
Shin, L.M., McNally, R.J., Kosslyn, S.M., Thompson, W.L., Rauch, S.L., Alpert, N.M.et al.Regionl cerebral blood flow during script-driven imagery in childhood sexual abuse-related posttraumatic stress disorder: a positron emission tomographic investigation. Am J Psychiatry 1999;156:575–584.Google Scholar
Shin, L.M., Dougherty, D.D., Orr, S.P., Pitman, R.K., Lasko, M., Macklin, M.L.et al.Activation of anterior paralimbic structures during guilt-related script-driven imagery. Biol Psychiatry 2000;48:43–50.CrossRefGoogle ScholarPubMed
Sigmundsson, T., Suckling, J., Maier, M., Williams, S.C.R., Bullmore, E.T., Greenwood, K.E.et al.Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. Am J Psychiatry 2001;158:234–243.CrossRefGoogle ScholarPubMed
Surguladze, S.A., Calvert, G.A., Brammer, M.J., Campbell, R., Bullmore, E.T., Giampietro, V.et al.Audio-visual speech perception in schizophrenia: an fMRI study. Psychiatry Res Neuroimaging 2001;106:1–14.CrossRefGoogle Scholar
Takahashi, T., Suzuki, M., Zhou, S.Y., Hagino, H., Tanino, R., Kawasaki, Y.et al.Volumetric MRI study of the short and long insular cortices in schizophrenia spectrum disorders. Psychiatry Res 2005;138:209–220.CrossRefGoogle Scholar
Tataranni, P.A., Gautier, J.F., Chen, K., Uecker, A., Bandy, D., Salbe, A.D.et al.Neuroanatomical correlates of hunger and satiation in humans using positron emission tomography. Proc Natl Acad Sci U S A 1999;96:4569–4574.CrossRefGoogle ScholarPubMed
Tillfors, M., Furmark, T., Marteinsdottir, I., Fischer, H., Pissiota, A., Langstrom, B.et al.Cerebral blood flow in subjects with social phobia during stressful speaking tasks: a PET study. Am J Psychiatry 2001;158:1220–1226.CrossRefGoogle ScholarPubMed
Wernicke, C.Der aphasische Symptomencomplex. Breslau: Cohn and Weigert 1874 in German.Google Scholar
Wilke, M., Kaufmann, C., Grabner, A., Putz, B., Wetter, T.C., Auer, D.P.Gray matter-changes and correlates of disease severity in schizophrenia: a statistical parametric mapping study. Neuroimage 2001;13:814–824.CrossRefGoogle ScholarPubMed
Wright, I.C., Ellison, Z.R., Sharma, T., Friston, K.J., Murray, R.M., McGuire, P.K.Mapping of grey matter changes in schizophrenia. Schizophr Res 1999;35:1–14.CrossRefGoogle Scholar
Wright, C.I., Martis, B., McMullin, K., Shin, L.M., Rauch, S.L.Amygdala and insular responses to emotionally valenced human faces in small animal specific phobia. Biol Psychiatry 2003;54:1067–1076.CrossRefGoogle ScholarPubMed
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