How Do You Feel—Now? The Anterior Insula and Human Awareness

Atkinson Research Laboratory, Barrow Neurological Institute, Phoenix, Arizona 85013, USA.
Nature Reviews Neuroscience (Impact Factor: 31.43). 02/2009; 10(1):59-70. DOI: 10.1038/nrn2555
Source: PubMed


The anterior insular cortex (AIC) is implicated in a wide range of conditions and behaviours, from bowel distension and orgasm, to cigarette craving and maternal love, to decision making and sudden insight. Its function in the re-representation of interoception offers one possible basis for its involvement in all subjective feelings. New findings suggest a fundamental role for the AIC (and the von Economo neurons it contains) in awareness, and thus it needs to be considered as a potential neural correlate of consciousness.

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    • "Whether this specific depression-related bias in interpreting sad and happy facial expressions is due to dysfunctions in sensory regions, regions involved in interpretation of facial expressions and/or cognitive control remains unclear. As previously mentioned the insular cortex is a brain area involved in the interpretation of facial information and it ahs been highlighted as an integrative hub between the sensory, interpretive and cognitive regions involved in emotional processing (Avery et al., 2013; Manoliu et al., 2013; Sprengelmeyer et al., 2011), Craig and others (Craig, 2009, 2011) (Chang et al., 2013; Menon and Uddin, 2010) have suggested that the insular cortex utilizes sensory information from ascending homeostatic afferents together with contextual input from other cortical brain areas to form a conscious " feeling " or an emotional moment in time (Craig, 2011). The posterior part receives information about the physiological state of the body, which is the integrated with information from higher order sensory cortices, as well as from the amygdala and the anterior cingulate cortex (ACC) in the middle and anterior part of the insular cortex where emotional awareness, self-recognition and other functions are represented (Craig, 2010; Nieuwenhuys, 2012). "
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    ABSTRACT: Background: Major depressive disorder (MDD) is a leading cause of disability worldwide and occurs commonly first during adolescence. The insular cortex (IC) plays an important role in integrating emotion processing with interoception and has been implicated recently in the pathophysiology of adult and adolescent MDD. However, no studies have yet specifically examined the IC in adolescent MDD during processing of faces in the sad- happy continuum. Thus, the aim of the present study is to investigate the IC during sad and happy face processing in adolescents with MDD compared to healthy controls (HCL). Methods: Thirty-one adolescents (22 female) with MDD and 36 (23 female) HCL underwent a well- validated emotional processing fMRI paradigm that included sad and happy face stimuli. Results: The MDD group showed significantly less differential activation of the anterior/middle insular cortex (AMIC) in response to sad versus happy faces compared to the HCL group. AMIC also showed greater functional connectivity with right fusiform gyrus, left middle frontal gyrus, and right amygdala/parahippocampal gyrus in the MDD compared to HCL group. Moreover, differential activation to sad and happy faces in AMIC correlated negatively with depression severity within the MDD group. Limitations: Small age-range and cross-sectional nature precluded assessment of development of the AMIC in adolescent depression. Conclusions: Given the role of the IC in integrating bodily stimuli with conscious cognitive and emotional processes, our findings of aberrant AMIC function in adolescent MDD provide a neuroscientific rationale for targeting the AMIC in the development of new treatment modalities.
    Journal of Affective Disorders 01/2016; 178. DOI:10.1016/j.jad.2015.03.012 · 3.38 Impact Factor
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    • "From the perspective of sensory input channels, the insula contains primary gustatory, primary auditory, as well as associative somato-and viscerosensory cortices. On a functional scale, along the caudo-rostral insula, primary interoceptive representation gradually shifts over environmental input representation into highly abstract cognitive representations of self and time (Craig, 2009). These observations exemplify that an identical ROI may be segmented along diverging features and notions of brain organization. "
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    ABSTRACT: Regional specialization and functional integration are often viewed as two fundamental principles of human brain organization. They are closely intertwined because each functionally specialized brain region is probably characterized by a distinct set of long-range connections. This notion has prompted the quickly developing family of connectivity-based parcellation (CBP) methods in neuroimaging research. CBP assumes that there is a latent structure of parcels in a region of interest (ROI). First, connectivity strengths are computed to other parts of the brain for each voxel/vertex within the ROI. These features are then used to identify functionally distinct groups of ROI voxels/vertices. CBP enjoys increasing popularity for the in-vivo mapping of regional specialization in the human brain. Due to the requirements of different applications and datasets, CBP has diverged into a heterogeneous family of methods. This broad overview critically discusses the current state as well as the commonalities and idiosyncrasies of the main CBP methods. We target frequent concerns faced by novices and veterans to provide a reference for the investigation and review of CBP studies.
    Human Brain Mapping 01/2016; DOI:10.1002/hbm.22933 · 5.97 Impact Factor
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    • "From a homeostasis point of view, all relevant information concerning the state of the body is interoceptive (Craig, 2002, 2003) and this point of view opens a wider window on the conceptualization of ''interoception " . When speaking ''interoception " , we do not refer solely to visceral sensations, but to the perception of the physiological condition of the body, a process associated with the autonomic nervous system and with the generation of subjective feelings and states (Craig, 2009; Critchley, Wiens, Rotshein, Ohman, & Dolan, 2004; Herbert & Pollatos, 2012). Moreover, all of the aforementioned studies estimated that an attentional bias underlies the hypervigilance in FM. "
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    ABSTRACT: Objectives: The hypervigilance model of pain perception states that patients with fibromyalgia (FM) have an enhanced sensitivity to aversive and non-aversive stimuli. Few studies have focused on enhanced interoceptive sensitivity in FM. Therefore, the aim of the present study was to investigate spontaneous sensations (SPS) in FM. Design: SPS are those tingling, tickly and other kind of sensations usually perceived on the skin during periods of rest and without any external trigger. Therefore, we have investigated SPS by requiring participants to focus attention on each hand. Methods: Eighteen patients with a diagnosis of FM and 18 matched healthy participants had to direct their gaze toward the hand tested for a period of 10s. Subsequently, they had to map and report the intensity, the number and the qualitative properties of sensations arising spontaneously. Finally, participants had to fill out questionnaires assessing cognitive and affective status that may influence the interoceptive sensations feedback. Results: Patients with FM perceived SPS as significantly more intense than controls did. Additionally, SPS were perceived by the FM group as occupying an overall larger area on the hand than those reported by controls. Importantly, entering scores of pain and catastrophism as covariates produced a relative effect on the feeling of SPS. Conclusions: The outcome of this study supports the generalized hypervigilance model, suggesting that patients with FM have a perceptual style of amplification of non-aversive interoceptive stimulation, modulated by pain and catastrophizing. This is discussed in relationship to interoceptive awareness.
    Brain and Cognition 12/2015; 101. DOI:10.1016/j.bandc.2015.10.002 · 2.48 Impact Factor
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