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Clinical considerations on a right operculo-insular cavernous angioma: an illustrative case

  • Case Report - Vascular Neurosurgery - Other
  • Published:
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Abstract

The insular cortex is considered one of the most complex regions of the brain, defined as the “hub” of somatosensory areas. Here, we examine the case of a surgically treated haemorrhagic cavernoma involving the middle and posterior insular cortex, presenting both sensory, gustative and speech symptoms. By reviewing the recent findings in humans’ and primates’ basic research, we illustrated clinical and radiological correlations of the reported case, confirming insular role in sensitive and gustatory functions.

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Abbreviations

EEG:

Electroencephalogram

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

fMRI:

Functional magnetic resonance imaging

References

  1. Afif A, Chabardes S, Minotti L, Kahane P, Hoffmann D (2008) Safety and usefulness of insular depth electrodes implanted via an oblique approach in patients with epilepsy. Neurosurgery 62(5 Suppl 2):ONS471-9 (discussion 479-80)

    PubMed  Google Scholar 

  2. Afif A, Minotti L, Kahane P, Hoffmann D (2010) Anatomofunctional organization of the insular cortex: a study using intracerebral electrical stimulation in epileptic patients: functional Organization of the Insula. Epilepsia 51(11):2305–2315. https://doi.org/10.1111/j.1528-1167.2010.02755

    Article  PubMed  Google Scholar 

  3. Afif A, Minotti L, Kahane P, Hoffmann D (2010) Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy. Epilepsia 51(2):206–213. https://doi.org/10.1111/j.1528-1167.2009.02271.x

    Article  PubMed  Google Scholar 

  4. Baier B, Eulenburg PZ, Glassl O, Dieterich M (2011) Lesions to the posterior insular cortex cause dysarthria. Eur J Neurol 18:1429–1431. https://doi.org/10.1111/j.1468-1331.2011.03473

    Article  PubMed  CAS  Google Scholar 

  5. Benarroch EE (2019) Insular cortex: functional complexity and clinical correlations. Neurology 93(21):932–938. https://doi.org/10.1212/WNL.0000000000008525

    Article  PubMed  Google Scholar 

  6. Bjornsdotter M, Loken L, Olausson H, Vallbo A, Wessberg J (2009) Somatotopic organization of gentle touch processing in the posterior insular cortex. J Neurosci 29(29):9314–9320. https://doi.org/10.1523/JNEUROSCI.0400-09.2009

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Cerliani L, Thomas RM, Jbabdi S, Siero JCW, Nanetti L, Crippa A, Gazzola V, D’Arceuil H, Keysers C (2012) Probabilistic tractography recovers a rostrocaudal trajectory of connectivity variability in the human insular cortex. Hum Brain Mapp 33(9):2005–2034. https://doi.org/10.1002/hbm.21338

    Article  PubMed  Google Scholar 

  8. Craig AD (2002) How do you feel? Interoception: the sense of the physiological condition of the body. Nat Rev Neurosci 3:655–666. https://doi.org/10.1038/nrn894

    Article  PubMed  CAS  Google Scholar 

  9. Evrard HC (2019) The organization of the primate insular cortex. Front Neuroanat 13:43. https://doi.org/10.3389/fnana.2019.00043

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Henderson LA, Rubin TK, Macefield VG (2011) Within-limb somatotopic representation of acute muscle pain in the human contralateral dorsal posterior insula: somatotopy of muscle pain in insula. Hum Brain Mapp 32(10):1592–1601. https://doi.org/10.1002/hbm.21131

    Article  PubMed  Google Scholar 

  11. Hua LH, Strigo IA, Baxter LC, Johnson SC, Craig AD, (Bud). (2005) Anteroposterior somatotopy of innocuous cooling activation focus in human dorsal posterior insular cortex. Am J Physiol Regul Integr Comp Physiol 289(2):R319–R325. https://doi.org/10.1152/ajpregu.00123.2005

    Article  CAS  Google Scholar 

  12. Isnard J, Guenot M, Sindou M, Mauguiere F (2004) Clinical manifestations of insular lobe seizures: a stereo-electroencephalographic study. Epilepsia 45(9):1079–1090. https://doi.org/10.1111/j.0013-9580.2004.68903.x

    Article  PubMed  Google Scholar 

  13. Kurth F, Zilles K, Fox PT, Laird AR, Eickhoff SB (2010) A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Funct 214(5–6):519–534. https://doi.org/10.1007/s00429-010-0255-z

    Article  PubMed  PubMed Central  Google Scholar 

  14. Limanowski J, Lopes P, Keck J, Baudisch P, Friston K, Blankenburg F (2020) Action-dependent processing of touch in the human parietal operculum and posterior insula. Cereb Cortex 30(2):607–617. https://doi.org/10.1093/cercor/bhz111

  15. Mazzola L, Isnard J, Peyron R, Guénot M, Mauguière F (2009) Somatotopic organization of pain responses to direct electrical stimulation of the human insular cortex. Pain 146(1):99–104. https://doi.org/10.1016/j.pain.2009.07.014

    Article  PubMed  CAS  Google Scholar 

  16. Mazzola L, Royet J-P, Catenoix H, Montavont A, Isnard J, Mauguière F (2017) Gustatory and olfactory responses to stimulation of the human insula: taste-odor and insula. Ann Neurol 82(3):360–370. https://doi.org/10.1002/ana.25010

    Article  PubMed  CAS  Google Scholar 

  17. Nieuwenhuys R (2012) The insular cortex: a review. Prog Brain Res 195:123–163. https://doi.org/10.1016/B978-0-444-53860-4.00007-6

  18. Ostrowsky K (2002) Representation of pain and somatic sensation in the human insula: a study of responses to direct electrical cortical stimulation. Cereb Cortex 12(4):376–385. https://doi.org/10.1093/cercor/12.4.376

    Article  PubMed  Google Scholar 

  19. Ronchi R, Bello-Ruiz J, Lukowska M, Herbelin B, Cabrilo I, Schaller K, Blanke O (2015) Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness. Neuropsychologia 70:11–20. https://doi.org/10.1016/j.neuropsychologia.02.010

    Article  PubMed  Google Scholar 

  20. Schaller K, Iannotti GR, Orepic P, Betka S, Haemmerli J, Boex C, Alcoba-Banqueri S, Garin DFA, Herbelin B, Park HD, Michel CM, Blanke O (2021) The perspectives of mapping and monitoring of the sense of self in neurosurgical patients. Acta Neurochir (Wien) 163(5):1213–1226. https://doi.org/10.1007/s00701-021-04778-3

    Article  Google Scholar 

  21. Seeley WW (2019) The salience network: a neural system for perceiving and responding to homeostatic demands. J Neurosci 39(50):9878–9882. https://doi.org/10.1523/JNEUROSCI.1138-17.2019

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Small DM (2010) Taste representation in the human insula. Brain Struct Funct 214(5–6):551–561. https://doi.org/10.1007/s00429-010-0266-9

    Article  PubMed  Google Scholar 

  23. Staszko SM, Boughter JD, Fletcher ML (2020) Taste coding strategies in insular cortex. Exp Biol Med 245(5):448–455. https://doi.org/10.1177/1535370220909096

    Article  CAS  Google Scholar 

  24. Stephani C, Fernandez-Baca Vaca G, Maciunas R, Koubeissi M, Lüders HO (2011) Functional neuroanatomy of the insular lobe. Brain Struct Funct 216(2):137–149. https://doi.org/10.1007/s00429-010-0296-3

    Article  PubMed  CAS  Google Scholar 

  25. Woolnough O, Forseth KJ, Rollo PS, Tandon NE (2019) Uncovering the functional anatomy of the human insula during speech. eLIFE 8:e53086. https://doi.org/10.7554/eLife.53086

    Article  PubMed  PubMed Central  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, ASST Niguarda Metropolitan Hospital, P.Le Ospedale Maggiore, 3, 20162, Milano, Italy

    Eleonora Marcati, Erika Ferrari, Enrica Fava, Giuseppe Talamonti & Giuseppe A. D’Aliberti

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  1. Eleonora Marcati
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  2. Erika Ferrari
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  3. Enrica Fava
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  4. Giuseppe Talamonti
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  5. Giuseppe A. D’Aliberti
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Correspondence to Eleonora Marcati.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Vascular Neurosurgery—Other

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Marcati, E., Ferrari, E., Fava, E. et al. Clinical considerations on a right operculo-insular cavernous angioma: an illustrative case. Acta Neurochir 163, 2755–2759 (2021). https://doi.org/10.1007/s00701-021-04947-4

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  • DOI: https://doi.org/10.1007/s00701-021-04947-4

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