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Neuropsychological Deficits Due to Insular Damage

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Island of Reil (Insula) in the Human Brain

Abstract

Although our comprehension on the functions of the human insula has greatly benefited from functional neuroimaging and cortical stimulation studies over the past two decades, lesion studies provide unique insights on the role(s) it exerts in neuropsychological functioning. However, cerebral damage confined to the insular cortex is extremely uncommon. The characterization of the neuropsychological deficits due to insular injury is further complicated by the possible specialization of insular functions in each cerebral hemisphere, by the variety of clinical presentations associated with lesions damaging different parts of the insula, and by the fact that almost all insular lesions are unilateral. This chapter reviews the literature on the neuropsychological consequences of insular lesions in humans. A selective review of the literature is performed, with more consideration given to isolated ischemic insular strokes. The effects of insular damage are very heterogeneous, with neuropsychological deficits being reported in the sensory (somatosensory, interoceptive, and vestibular processing, neglect, audition, olfaction, and taste), cognitive (speech, memory, attention, and executive functions), and affective (emotional experience, social cognitive, and risky decision-making) domains. In many cases, the neuropsychological consequences are transient or alleviated with time. The various clinical presentations of insular injury are congruent with the widespread connectivity of the insula with other brain regions.

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References

  1. Uddin LQ, Nomi JS, Hébert-Seropian B, Ghaziri J, Boucher O. Structure and function of the human insula. J Clin Neurophysiol. 2017;34:300–6.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kurth F, Zilles K, Fox PT, Laird AR, Eickhoff SB. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Fucnt. 2010;214:519–34.

    Article  Google Scholar 

  3. Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. J Clin Neurophysiol. 2017;34:307–14.

    Article  PubMed  Google Scholar 

  4. Ibañez A, Gleichgerrcht E, Manes F. Clinical effects of insular damage in humans. Brain Struct Funct. 2010;214:397–410.

    Article  PubMed  Google Scholar 

  5. Türe U, Yaşargil MG, Al-Mefty O, Yaşargil DC. Arteries of the insula. J Neurosurg. 2000;92:676–87.

    Article  PubMed  Google Scholar 

  6. Cereda C, Ghika J, Maeder P, Bogousslavsky J. Strokes restricted to the insular cortex. Neurology. 2002;59:1950–5.

    Article  PubMed  CAS  Google Scholar 

  7. Dronkers NF. A new brain region for coordinating speech articulation. Nature. 1996;384:159–61.

    Article  PubMed  CAS  Google Scholar 

  8. Karnath HO, Baier B, Nagele T. Awareness of the functioning of one’s own limbs mediated by the insular cortex? J Neurosci. 2005;25:7134–8.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  9. Bates E, Wilson SM, Saygin AP, Dick F, Sereno MI, Knight RT, et al. Voxel-based lesion-symptom mapping. Nat Neurosci. 2003;6:448–50.

    Article  PubMed  CAS  Google Scholar 

  10. Moon HI, Pyun SB, Tae WS, Kwon HK. Neural substrates of lower extremity motor, balance, and gait function after supratentorial stroke using voxel-based lesion symptom mapping. Neuroradiology. 2016;58:723–31.

    Article  PubMed  Google Scholar 

  11. Kodumuri N, Sebastian R, Davis C, Posner J, Kim EH, Tippett DC, et al. The association of insular stroke with lesion volume. Neuroimage Clin. 2016;11:41–5.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gras-Combe G, Minotti L, Hoffmann D, Krainik A, Kahane P, Chabardes S. Surgery for nontumoral insular epilepsy explored by stereoelectroencephalography. Neurosurgery. 2016;79:578–88.

    Article  PubMed  Google Scholar 

  13. Kalani MY, Kalani MA, Gwinn R, Keogh B, Tse VC. Embryological development of the human insula and its implications for the spread and resection of insular gliomas. Neurosurg Focus. 2009;27:E2.

    Article  PubMed  Google Scholar 

  14. Skrap M, Mondani M, Tomasino B, Weis L, Budai R, Pauletto G, et al. Surgery of insular nonenhancing gliomas: volumetric analysis of tumoral resection, clinical outcome, and survival in a consecutive series of 66 cases. Neurosurgery. 2012;70:1081–93.

    Article  PubMed  Google Scholar 

  15. Finet P, Nguyen DK, Bouthillier A. Vascular consequences of operculoinsular corticectomy for refractory epilepsy. J Neurosurg. 2015;122:1293–8.

    Article  PubMed  CAS  Google Scholar 

  16. Simon M, Neuloh G, von Lehe M, Meyer B, Schramm J. Insular gliomas: the case for surgical management. J Neurosurg. 2009;110:685–95.

    Article  PubMed  Google Scholar 

  17. Mesulam MM, Mufson EJ. Insula of the old world monkey. III: efferent cortical output and comments on function. J Comput Neurosci. 1982;212:38–52.

    Article  CAS  Google Scholar 

  18. Greenspan JD, Lee RR, Lenz FA. Pain Sensitivity alterations as a function of lesion location in the parasylvian cortex. Pain. 1999;81:273–82.

    Article  PubMed  CAS  Google Scholar 

  19. Starr CJ, Sawaki L, Wittenberg GF, Burdette JH, Oshiro Y, Quevedo AS, Coghill RC. Roles of the insular cortex in the modulation of pain: insights from brain lesions. J Neurosci. 2009;29:2684–94.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Berthier M, Starkstein S, Leiguarda R. Asymbolia for pain: a sensory-limbic disconnection syndrome. Ann Neurol. 1988;24:41–9.

    Article  PubMed  CAS  Google Scholar 

  21. Garcia-Larrea L, Perchet C, Creac'h C, Convers P, Peyron R, Laurent B, et al. Operculo-insular pain parasylvian pain: a distinct central pain syndrome. Brain. 2010;133:2528–39.

    Article  PubMed  Google Scholar 

  22. Denis DJ, Marouf R, Rainville P, Bouthillier A, Nguyen DK. Effects of insular stimulation on thermal nociception. Eur J Pain. 2016;20:800–10.

    Article  PubMed  CAS  Google Scholar 

  23. Birklein F, Rolke R, Müller-Forell W. Isolated insular infarction eliminates contralateral cold, cold pain, and pinprick perception. Neurology. 2005;65:1381.

    Article  PubMed  Google Scholar 

  24. Baier B, zu Eulenburg P, Geber C, Rohde F, Rolke R, Maihöfner C, et al. Insula and sensory insular cortex and somatosensory control in patients with insular stroke. Eur J Pain. 2014;18:1385–93.

    Article  PubMed  CAS  Google Scholar 

  25. Cattaneo L, Chierici E, Cucurachi L, Cobelli R, Pavesi G. Posterior insular stroke causing selective loss of contralateral nonpainful thermal sensation. Neurology. 2007;68:237.

    Article  PubMed  CAS  Google Scholar 

  26. Augustine JR. Circuitry and functional aspects of he insular lobe in primates including humans. Brain Res Brain Res Rev. 1996;22:229–44.

    Article  PubMed  CAS  Google Scholar 

  27. Fifer RC. Insular stroke causing unilateral auditory processing disorder: case report. J Am Acad Audiol. 1993;4:364–9.

    PubMed  CAS  Google Scholar 

  28. Habib M, Daguin G, Milandre L, Royere ML, Rey M, Lanteri A, et al. Mutism and auditory agnosia due to bilateral insular damage – role of the insula in human communication. Neuropsychologia. 1995;33:327–39.

    Article  PubMed  CAS  Google Scholar 

  29. Griffiths TD, Rees A, Witton C, Cross PM, Shakir RA, Green GG. Spatial and temporal auditory processing deficits following right hemisphere infarction. A psychophysical study. Brain. 1997;120:785–94.

    Article  PubMed  Google Scholar 

  30. Ayotte J, Peretz I, Rousseau I, Bard C, Bojanowski M. Patterns of music agnosia associated with middle cerebral artery infarcts. Brain. 2000;123:1926–38.

    Article  PubMed  Google Scholar 

  31. Griffiths TD, Warren JD, Dean JL, Howard D. “When the feeling’s gone”: a selective loss of musical emotion. J Neurol Neurosurg Psychiatry. 2004;75:344–5.

    PubMed  PubMed Central  CAS  Google Scholar 

  32. Bamiou DE, Musiek FE, Stow I, Stevens J, Cipolotti L, Brown MM, et al. Auditory temporal processing deficits in patients with insular stroke. Neurology. 2006;67:614–9.

    Article  PubMed  Google Scholar 

  33. Boucher O, Turgeon C, Chapoux S, Ménard L, Rouleau I, Lassonde M, et al. Hyperacusis following unilateral damage to the insular cortex: a three-case report. Brain Res. 2015;1606:102–12.

    Article  PubMed  CAS  Google Scholar 

  34. Tomasino B, Marin D, Canderan C, Maieron M, Skrap M, Rumiati RI. Neuropsychological patterns following lesions of the anterior insula in a series of forty neurosurgical patients. AIMS Neurosci. 2014;1:225–44.

    Article  Google Scholar 

  35. Mak YE, Simmons KB, Gitelman DR, Small DM. Taste and olfactory intensity perception changes following left insular stroke. Behav Neurosci. 2005;119:1693–700.

    Article  PubMed  Google Scholar 

  36. Ribas ES, Duffau H. Permanent anosmia and ageusia after resection of a left temporoinsular low-grade glioma: anatomofunctional considerations. J Neurosurg. 2012;116:1007–13.

    Article  PubMed  Google Scholar 

  37. Metin B, Melda B, Birsen I. Unusual clinical manifestation of a cerebral infarction restricted to the insulate cortex. Neurocase. 2007;13:94–6.

    Article  PubMed  Google Scholar 

  38. Beume LA, Klingler A, Reinhard M, Niesen WD. Olfactory hallucinations as primary symptom for ischemia in the right posterior insula. J Neurol Sci. 2015;354:138–9.

    Article  PubMed  Google Scholar 

  39. Pritchard TC, Macaluso DA, Eslinger PJ. Taste perception in patients with insular cortex lesions. Behav Neurosci. 1999;113:663–71.

    Article  PubMed  CAS  Google Scholar 

  40. Stevenson RJ, Miller LA, McGrillen K. The lateralization of gustatory function and the flow of information from tongue to cortex. Neuropsychologia. 2013;51:1408–16.

    Article  PubMed  Google Scholar 

  41. Mazzola L, Lopez C, Faillenot I, Chouchou F, Mauguière F, Isnard J. Vestibular responses to direct stimulation of the human insular cortex. Ann Neurol. 2014;76:609–19.

    Article  PubMed  Google Scholar 

  42. Lopez C, Blanke O, Mast FW. The human vestibular cortex revealed by coordinate-based activation likelihood estimation meta-analysis. Neuroscience. 2012;212:159–79.

    Article  PubMed  CAS  Google Scholar 

  43. zu Eulenburg P, Caspers S, Roski C, Eickhoff SB. Meta-analytical definition and functional connectivity of the human vestibular cortex. NeuroImage. 2012;60:162–9.

    Article  PubMed  CAS  Google Scholar 

  44. Papathanasiou ES, Papacostas SS, Charalambous M, Eracleous E, Thodi C, Pantzaris M. Vertigo and imbalance caused by a small lesion in the anterior insula. Electromyogr Clin Neurophysiol. 2006;46:185–92.

    PubMed  CAS  Google Scholar 

  45. Baier B, Conrad J, Zu Eulenburg P, Best C, Müller-Forell W, Birklein F, et al. Insular strokes cause no vestibular deficits. Stroke. 2013;44:2604–6.

    Article  PubMed  Google Scholar 

  46. Khalsa SS, Rudrauf D, Feinstein JS, Tranel D. The pathways of interoceptive awareness. Nat Neurosci. 2009;12:1494–6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  47. Grossi D, De Vita A, Palermo L, Sabatini U, Trojano L, Guariglia C. The brain network for self-feeling: a symptom-lesion mapping study. Neuropsychologia. 2014;63:92–8.

    Article  PubMed  Google Scholar 

  48. Ronchi R, Bello-Ruiz J, Lukowska M, Herbelin B, Cabrilo I, Schaller K, Blanke O. Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness. Neuropsychologia. 2015;70:11–20.

    Article  PubMed  Google Scholar 

  49. Schandry R. Heart beat perception and emotional experience. Psychophysiology. 1981;18:483–8.

    Article  PubMed  CAS  Google Scholar 

  50. Damasio A. Descartes’ error: emotion, reason and the human brain. Grosset/Putnam: New York, NY; 1994.

    Google Scholar 

  51. Craig AD. How do you feel—now? The anterior insula and human awareness. Nat Rev Neurosci. 2009;10:59–70.

    Article  PubMed  CAS  Google Scholar 

  52. Philippi CL, Feinstein JS, Khalsa SS, Damasio A, Tranel D, Landini G, et al. Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices. PLoS One. 2012;7:e38413.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  53. Karnath HO, Berger MF, Küker W, Rorden C. The anatomy of spatial neglect based on voxelwise statistical analysis: a study of 140 patients. Cereb Cortex. 2004;14:1164–72.

    Article  PubMed  Google Scholar 

  54. Berthier M, Starkstein S, Leiguarda R. Behavioral effects of damage to the right insula and surrounding regions. Cortex. 1987;23:673–8.

    Article  PubMed  CAS  Google Scholar 

  55. Manes F, Paradiso S, Springer JA, Lamberty G, Robinson RG. Neglect after right insular cortex infarction. Stroke. 1999;30:946–8.

    Article  PubMed  CAS  Google Scholar 

  56. Golay L, Schnider A, Ptak R. Cortical and subcortical anatomy of chronic spatial neglect following vascular damage. Behav Brain Funct. 2008;4:43.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Chechlacz M, Rotshtein P, Roberts KL, Bickerton WL, Lau JKL, Humphreys GW. The prognosis of allocentric and egocentric neglect: evidence from clinical scans. PLoS One. 2012;7:e47821.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  58. Kenzie JM, Girgulis K, Semrau JA, Findlater SE, Desai JA, Dukelow SP. Lesion sites associated with allocentric and egocentric visuospatial neglect in acute stroke. Brain Connect. 2015;5:413–22.

    Article  PubMed  Google Scholar 

  59. Pedrazzini E, Schnider A, Ptak R. A neuroanatomical model of space-based and object-centered processing in spatial neglect. Brain Struct Funct. 2017;222(8):3605–13. https://doi.org/10.1007/s00429-017-1420-4.

    Article  PubMed  Google Scholar 

  60. Smith DV, Clithero JA, Rorden C, Karnath HO. Decoding the anatomical network of spatial attention. Proc Natl Acad Sci U S A. 2013;110:1518–23.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Shuren J. Insula and aphasia. J Neurol. 1993;240:216–8.

    Article  PubMed  CAS  Google Scholar 

  62. Borovsky A, Saygin AP, Bates E, Dronkers N. Lesion correlates of conversational speech production deficits. Neuropsychologia. 2007;45:2525–33.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Marshall RS, Laza RM, Mohr JP, Van Heertum RL, Mast H. “Semantic” conduction aphasia from a posterior insular cortex infarction. J Neuroimaging. 1996;6:189–91.

    Article  PubMed  CAS  Google Scholar 

  64. Carota A, Annoni JM, Marangolo P. Repeating through the insula: evidence from two consecutive strokes. Neuroreport. 2007;18:1367–70.

    Article  PubMed  Google Scholar 

  65. Kreisler A, Godefroy O, Delmaire C, Debachy B, Leclercq M, Pruvo JP, et al. The anatomy of aphasia revisited. Neurology. 2000;54:1117–23.

    Article  PubMed  CAS  Google Scholar 

  66. Nagao M, Takeda K, Komori T, Isozaki E, Hirai S. Apraxia of speech associated with an infarct in the precentral gyrus of the insula. Neuroradiology. 1999;41:356–7.

    Article  PubMed  CAS  Google Scholar 

  67. Baldo JV, Wilkins DP, Ogar J, Willock S, Dronkers NF. Role of the precentral gyrus of the insula in complex articulation. Cortex. 2011;47:800–7.

    Article  PubMed  Google Scholar 

  68. Hiraga A, Tanaka S, Kamitsukasa I. Pure dysarthria due to an insular infarction. J Clin Neurosci. 2010;17:812–3.

    Article  PubMed  Google Scholar 

  69. Boucher O, Rouleau I, Escudier F, Malenfant A, Denault C, Charbonneau S, et al. Neuropsychological performance before and after partial or complete insulectomy in patients with epilepsy. Epilepsy Behav. 2015;43:53–60.

    Article  PubMed  Google Scholar 

  70. Lang FF, Olansen NE, DeMonte F, Gokaslan ZL, Holland EC, Kalhorn C, et al. Surgical resection of intrinsic insular tumors: complication avoidance. J Neurosurg. 2001;95:638–50.

    Article  PubMed  CAS  Google Scholar 

  71. Duffau H, Taillandier L, Gatignol P, Capelle L. The insular lobe and brain plasticity: lessons from tumor surgery. Clin Neurol Neurosurg. 2006;108:543–8.

    Article  PubMed  Google Scholar 

  72. Sanai N, Polley MY, Berger MS. Insular gioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg. 2010;112:1–9.

    Article  PubMed  Google Scholar 

  73. Manes F, Springer J, Jorge R, Robinson RG. Verbal memory impairment after left insular cortex infarction. J Neurol Neurosurg Psychiatry. 1999;67(4):532.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  74. Wu AS, Witgert ME, Lang FF, Xiao L, Bekele BN, Meyers CA, et al. Neurocognitive function before and after surgery for insular gliomas. J Neurosurg. 2011;115:1115–25.

    Article  PubMed  Google Scholar 

  75. Menon V, Uddin LQ. Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 2010;214:655–67.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Markostamou I, Rudolf J, Tsiptsious I, Kosmidis MH. Impaired executive functioning after left anterior insular stroke: a case report. Neurocase. 2014;21:148–53.

    Article  PubMed  Google Scholar 

  77. Borg C, Bedoin N, Peyron R, Bogey S, Laurent B, Thomas-Antérion C. Impaired emotional processing in a patient with a left posterior insula-SII lesion. Neurocase. 2013;19:592–603.

    Article  PubMed  Google Scholar 

  78. Calder AJ, Keane J, Manes F, Antoun N, Young AW. Impaired recognition and experience of disgust following brain injury. Nat Neurosci. 2000;3:1077–8.

    Article  PubMed  CAS  Google Scholar 

  79. Brown S, Gao X, Tisdelle L, Eickhoff SB, Liotti M. Naturalizing aesthetics: brain areas for aesthetic appraisal across sensory modalities. NeuroImage. 2011;58:250–8.

    Article  PubMed  Google Scholar 

  80. Phillips ML, Young AW, Senior C, Brammer M, Andrew C, Calder AJ, et al. A specific neural substrate for perceiving facial expressions of disgust. Nature. 1997;389:495–8.

    Article  PubMed  CAS  Google Scholar 

  81. Stark R, Zimmermann M, Kagerer S, Schienle A, Walter B, Weygandt M, et al. Hemodynamic brain correlates of disgust and fear ratings. NeuroImage. 2007;37:663–73.

    Article  PubMed  Google Scholar 

  82. Straube T, Weisbrod A, Schmidt S, Raschdorf C, Preul C, Mentzel HJ, et al. No impairment of recognition and experience of disgust in a patient with a right-hemispheric lesion of the insula and basal ganglia. Neuropsychologia. 2010;48:1735–41.

    Article  PubMed  Google Scholar 

  83. Wicker B, Keysers C, Plailly J, Royet JP, Gallese V, Rizzolatti G. Both of us disgusted in my insula: the common neural basis of seeing and feeling disgust. Neuron. 2003;40:655–64.

    Article  PubMed  CAS  Google Scholar 

  84. Manes F, Paradiso S, Robinson RG. Neuropsychiatric effects of insular stroke. J Nerv Ment Dis. 1999;187(12):707.

    Article  PubMed  CAS  Google Scholar 

  85. Thomas-Antérion C, Creac’h C, Dionet E, Borg C, Extier C, Faillenot I, et al. De novo artistic activity following insular-SII ischemia. Pain. 2010;150:121–7.

    Article  PubMed  Google Scholar 

  86. Hébert-Seropian B, Boucher O, Sénéchal C, Rouleau I, Bouthillier A, Lepore F, et al. Does unilateral insular resection disturb personality? A study with epileptic patients. J Clin Neurosci. 2017;43:121–5. https://doi.org/10.1016/j.jocn.2017.04.001.

    Article  PubMed  Google Scholar 

  87. Cho HJ, Kim SJ, Hwang SJ, Jo MK, Kim HJ, Seeley WW, et al. Social-emotional dysfunction after isolated right anterior insular infarction. J Neurol. 2012;259:764–7.

    Article  PubMed  Google Scholar 

  88. Berntson GG, Norman GJ, Bechara A, Bruss J, Tranel D, Cacioppo JT. The insula and evaluative processes. Psychol Sci. 2011;22:80–6.

    Article  PubMed  Google Scholar 

  89. Knutson KM, Rakowsky ST, Solomon J, Krueger F, Raymont V, Tierney MC, et al. Injured brain regions associated with anxiety in Vietnam veterans. Neuropsychologia. 2013;51:686–94.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Knutson KM, Monte OD, Raymont V, Wassermann EM, Krueger F, Grafman J. Neural correlates of apathy revealed by lesion mapping in participants with traumatic brain injuries. Hum Brain Mapp. 2014;35:943–53.

    Article  PubMed  Google Scholar 

  91. Hogeveen J, Bird G, Chau A, Krueger F, Grafman J. Acquired alexithymia following damage to the anterior insula. Neuropsychologia. 2016;82:142–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  92. Bernhardt BC, Singer T. The neural basis of empathy. Ann Rev Neurosci. 2012;35:1–23.

    Article  PubMed  CAS  Google Scholar 

  93. Terasawa Y, Kurosaki Y, Ibata Y, Moriguchi Y, Umeda S. Attenuated sensitivity to the emotions of others by insular lesion. Front Psychol. 2015;6:1314.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Adolphs R, Tranel D, Damasio A. Dissociable neural systems for recognizing emotions. Brain Cogn. 2003;52:61–9.

    Article  PubMed  Google Scholar 

  95. Dal Monte O, Krueger F, Solomon JM, Schintu S, Knutson KM, Strenziok M, et al. A voxel-based lesion study on facial emotion recognition after penetrating brain injury. Soc Cogn Affect Neurosci. 2013;8:632–9.

    Article  PubMed  Google Scholar 

  96. Driscoll DM, Dal Monte O, Solomon J, Krueger F, Grafman J. Empathic deficits in combat veterans with traumatic brain injury: a voxel-based lesion-symptom mapping study. Cogn Behav Neurol. 2012;25:160–6.

    Article  PubMed  Google Scholar 

  97. Boucher O, Rouleau I, Lassonde M, Lepore F, Bouthillier A, Nguyen DK. Social information processing following resection of the insular cortex. Neuropsychologia. 2015;71:1–10.

    Article  PubMed  Google Scholar 

  98. Gu X, Gao Z, Wang X, Liu X, Knight RT, Hof PR, Fan J. Anterior insular cortex is necessary for empathetic pain perception. Brain. 2012;135:2726–35.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Chen P, Wang G, Ma R, Jing F, Zhang Y, Wang Y, et al. Multidimensional assessment of empathic abilities in patients with insular glioma. Cogn Affect Behav Neurosci. 2016;16:962–75.

    Article  PubMed  Google Scholar 

  100. Clark L, Bechara A, Damasio H, Aitken MR, Sahakian BJ, Robbins TW. Differential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making. Brain. 2008;131:1311–22.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  101. Weller JA, Levin IP, Shiv B, Bechara A. The effects of insula damage on decision-making for risky gains and losses. Soc Neurosci. 2009;4:347–58.

    Article  PubMed  Google Scholar 

  102. Von Siebenthal Z, Boucher O, Rouleau I, Lassonde M, Lepore F, Nguyen DK. Decision-making impairments following insular and medial temporal lobe resection for drug-resistant epilepsy. Soc Cogn Affect Neurosci. 2017;12:128–37.

    Google Scholar 

  103. Clark L, Studer B, Bruss J, Tranel D, Bechara A. Damage to insula abolishes cognitive distortions during simulated gambling. Proc Natl Acad Sci U S A. 2014;111:6098–103.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  104. Sellitto M, Ciaramelli E, Mattioli F, di Pellegrino G. Reduced sensitivity to sooner reward during intertemporal decision-making following insula damage in humans. Front Behav Neurosci. 2016;9:367.

    Article  PubMed  PubMed Central  Google Scholar 

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Boucher, O., Citherlet, D., Hébert-Seropian, B., Nguyen, D.K. (2018). Neuropsychological Deficits Due to Insular Damage. In: Turgut, M., Yurttaş , C., Tubbs, R. (eds) Island of Reil (Insula) in the Human Brain. Springer, Cham. https://doi.org/10.1007/978-3-319-75468-0_26

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