How the insula speaks to the heart: Cardiac responses to insular stimulation in humans
Open accessAbstract
Despite numerous studies suggesting the role of insular cortex in the control of autonomic activity, the exact location of cardiac motor regions remains controversial. We provide here a functional mapping of autonomic cardiac responses to intracortical stimulations of the human insula. The cardiac effects of 100 insular electrical stimulations into 47 epileptic patients were divided into tachycardia, bradycardia, and no cardiac response according to the magnitude of RR interval (RRI) reactivity. Sympathetic (low frequency, LF, and low to high frequency powers ratio, LF/HF ratio) and parasympathetic (high frequency power, HF) reactivity were studied using RRI analysis. Bradycardia was induced by 26 stimulations (26%) and tachycardia by 21 stimulations (21%). Right and left insular stimulations induced as often a bradycardia as a tachycardia. Tachycardia was accompanied by an increase in LF/HF ratio, suggesting an increase in sympathetic tone; while bradycardia seemed accompanied by an increase of parasympathetic tone reflected by an increase in HF. There was some left/right asymmetry in insular subregions where increased or decreased heart rates were produced after stimulation. However, spatial distribution of tachycardia responses predominated in the posterior insula, whereas bradycardia sites were more anterior in the median part of the insula. These findings seemed to indicate a posterior predominance of sympathetic control in the insula, whichever the side; whereas the parasympathetic control seemed more anterior. Dysfunction of these regions should be considered when modifications of cardiac activity occur during epileptic seizures and in cardiovascular diseases.
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Electrical stimulation of different parts of the insula induces different conscious visceral sensations and autonomic changes.
“Electrical stimulation of different parts of the insula induces different conscious visceral sensations and autonomic changes [53,54].”
From The Insular Cortex: An Interface Between Sensation, Emotion and Cognition (2024) · cites this paper as [53]
Section 3.6 reports that insular stimulation evoked visceral sensations and that stimulation sites producing tachycardia were more posterior than those producing bradycardia. It does not show that different insular regions produce different conscious visceral sensations; it also found no relationship between the type of cardiac response and the type of sensation evoked. Page numbers are unavailable in our copy. (LLM, conf=0.84)
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The Insular Cortex: An Interface Between Sensation, Emotion and Cognition
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- Authors
- Chouchou, F., Mauguière, F., Vallayer, O., Catenoix, H., Isnard, J., Montavont, A., Jung, J., Pichot, V., Rheims, S., & Mazzola, L.
- Affiliations
- University of Reunion Island (RE)
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon Université de Lyon Lyon France
- Centre Hospitalier Universitaire de Saint-Étienne (FR)
- Centre National de la Recherche Scientifique (FR)
- Université Jean Monnet (FR)
- ORCID
- Venue
- Human Brain Mapping
- Publisher
- Wiley
- Published
- 2019-02-28
- Volume
- 40
- Issue
- 9
- Pages
- 2611-2622
- ISSN
- 1065-9471 (ISSN-L)
- 1097-0193
- PMC
- PMC6865697
- OpenAlex
- W2920212835
- Cited by
- 148
- References
- 69
- Citations by year
- 2026: 22 · 2025: 21 · 2024: 22 · 2023: 17 · 2022: 20 · 2021: 26 · 2020: 14 · 2019: 5 · 2018: 1
- FWCI
- 11.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Human Brain Mapping (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- insula, cardiac autonomic control, tachycardia, bradycardia, heart rate variability, sympathetic tone, parasympathetic activity, epilepsy, RR interval
- MeSH terms
- Electrocorticography, Adult, Bradycardia, Brain Mapping, Cerebral Cortex, Electric Stimulation, Electrocardiography, Epilepsy, Female, Heart Rate, Humans, Male, Parasympathetic Nervous System, Sympathetic Nervous System, Tachycardia
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