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Saliency, switching, attention and control: a network model of insula function
Open accessAbstract
The insula is a brain structure implicated in disparate cognitive, affective, and regulatory functions, including interoceptive awareness, emotional responses, and empathic processes. While classically considered a limbic region, recent evidence from network analysis suggests a critical role for the insula, particularly the anterior division, in high-level cognitive control and attentional processes. The crucial insight and view we present here is of the anterior insula as an integral hub in mediating dynamic interactions between other large-scale brain networks involved in externally oriented attention and internally oriented or self-related cognition. The model we present postulates that the insula is sensitive to salient events, and that its core function is to mark such events for additional processing and initiate appropriate control signals. The anterior insula and the anterior cingulate cortex form a “salience network” that functions to segregate the most relevant among internal and extrapersonal stimuli in order to guide behavior. Within the framework of our network model, the disparate functions ascribed to the insula can be conceptualized by a few basic mechanisms: (1) bottom–up detection of salient events, (2) switching between other large-scale networks to facilitate access to attention and working memory resources when a salient event is detected, (3) interaction of the anterior and posterior insula to modulate autonomic reactivity to salient stimuli, and (4) strong functional coupling with the anterior cingulate cortex that facilitates rapid access to the motor system. In this manner, with the insula as its integral hub, the salience network assists target brain regions in the generation of appropriate behavioral responses to salient stimuli. We suggest that this framework provides a parsimonious account of insula function in neurotypical adults, and may provide novel insights into the neural basis of disorders of affective and social cognition.
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“As part of the viscerosensory cortex, the anterior insula plays a pivotal role in appraising an interoceptive inference based on incoming raw interoceptive and exteroceptive input (Seeley et al., 2007; Menon and Uddin, 2010; Zaki et al., 2012; Wager et al., 2015).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Menon and Uddin, 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Here, the insula helps direct information to lateralized frontoparietal networks in the brain that involve the dorsolateral prefrontal cortex and the posterior parietal cortex in order to facilitate multisensory integration (Menon and Uddin, 2010; Figure 4).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Menon and Uddin, 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Developing an awareness of an emotional feeling underlying a sensory experience may aid in its translation to the central executive network, which plays a role in identifying the contextual meaning of an emotional feeling (Seeley et al., 2007; Menon and Uddin, 2010; Wager et al., 2015).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Menon and Uddin, 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, while both insula and dACC are components of the SN, they subserve different functions, with insula more related to internal somatic function and monitoring task performance (Eckert et al. 2009;Menon and Uddin 2010;Cai et al. 2014), while the dACC is”
From Brain Activity and Functional Connectivity Associated with Hypnosis (2016) · cites this paper as Menon and Uddin 2010
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“the insula is involved in the processing of body control and experience, emotion, empathy, and time through its extensive connections to cortical and subcortical limbic structures (Menon and Uddin 2010;Cai et al. 2014).”
From Brain Activity and Functional Connectivity Associated with Hypnosis (2016) · cites this paper as Menon and Uddin 2010
Experimental — accuracy not yet measured
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“Salience Network (SN): Crucial for detecting relevant internal and external stimuli and switching between the DMN and CCN/CEN, dysfunction in the SN (often involving the dorsal anterior cingulate cortex (dACC) and insula) has been linked to fatigue, aPective symptoms, and cognitive diPiculties post-concussion 12 13 .”
From Functional MRI Guided Accelerated Intermittent Theta Burst Stimulation for Chronic Post-Concussive Syndrome: A Feasibility and Efficacy Study (2025) · cites this paper as [12]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Here, the insula plays a putative role in engaging large-scale neural systems by translating incoming sensory information to intrinsic cortical connectivity networks that assist in modulating and contextualizing incoming salient sensory information to guide behavioral responses (Menon and Uddin, 2010; Seeley et al., 2007).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Menon and Uddin, 2010
The cited source says what the claim attributes to it.
In the citing paper
“The insular cortex has reciprocal connections to the ACC and can facilitate cognitive control by acting as the switch between the central-executive network and the default mode network DMN (Cole and Schneider, 2007; Sridharan et al., 2008; Menon and Uddin, 2010).”
From Mindfulness, Interoception, and the Body: A Contemporary Perspective (2019) · cites this paper as Menon and Uddin, 2010
The cited source says what the claim attributes to it.
In the citing paper
“The anterior insula node of the salience network, in particular, is crucial for bottom-up detection of salient events and switching between other large-scale networks to facilitate access to attention and working memory resources. 25”
From 20 years of the default mode network: A review and synthesis. (2023) · cites this paper as [25]
The cited source says what the claim attributes to it.
In the citing paper
“The SN governs our attention to the external and internal world (Menon and Uddin, 2010), and as such, integrates sensory, emotional and cognitive information to facilitate optimal communication, social behavior and self-awareness (Menon, 2015).”
From Distinct functional connectivities predict clinical response with emotion regulation therapy (2017) · cites this paper as Menon and Uddin, 2010
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In the citing paper
“The anterior insula is associated with the integration of interoception and cognition (Menon and Uddin, 2010), and the right anterior VLPFC with reflexive reorienting and response inhibition (Levy and Wagner, 2011).”
From Neural correlates of emotion acceptance vs worry or suppression in generalized anxiety disorder (2017) · cites this paper as Menon and Uddin, 2010
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In the citing paper
“Notably, suppression of the DMN and engagement of cognitive control networks during task performance are thought to be controlled by a common mechanism, with the salience network playing a crucial role.”
From 20 years of the default mode network: A review and synthesis. (2023) · cites this paper as [25]
The cited source says what the claim attributes to it.
In the citing paper
“as well as empathic perception of pain in others, (Menon and Uddin 2010;Gu et al. 2012)”
From Brain Activity and Functional Connectivity Associated with Hypnosis (2016) · cites this paper as Menon and Uddin 2010
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“While decreases have been for MPFC and ACC in depression [74], but also social anxiety [75] or Alzheimer disease [76], a recent study in bipolar depression rather indicated an increase in MPFC ReHo [74].”
From State and training effects of mindfulness meditation on brain networks reflect neuronal mechanisms of its antidepressant effect (2016) · cites this paper as [74]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The rationale for applying TMS, and specifically iTBS, to PCS stems from converging evidence suggesting that persistent post-concussive symptoms are associated with disruptions in largescale functional brain networks.”
From Functional MRI Guided Accelerated Intermittent Theta Burst Stimulation for Chronic Post-Concussive Syndrome: A Feasibility and Efficacy Study (2025) · cites this paper as [12]
Experimental — accuracy not yet measuredIn the citing paper
“The right aINS has previously been identified as a critical node for suppressing DN activity and reallocating attentional resources to salient events.244,245”
From The default network and self-generated thought: component processes, dynamic control, and clinical relevance (2014) · cites this paper as [244]
In the citing paper
“Detected hub nodes were located within the CON (i.e., the left dACC), the salience network (53) (i.e., the right anterior insula, right intraparietal sulcus, and bilateral dACC), and the motor network (i.e., bilateral pre- and post-central gyri).”
From Impact of Childhood Trauma on Executive Function in Adolescence—Mediating Functional Brain Networks and Prediction of High-Risk Drinking (2020) · cites this paper as [53]
In the citing paper
“Together these distributed brain networks integrate bottom-up attention with top-down control and generate appropriate behavioral responses to salient stimuli, thereby contributing to behavioral regulation and sound executive function (51–57).”
From Impact of Childhood Trauma on Executive Function in Adolescence—Mediating Functional Brain Networks and Prediction of High-Risk Drinking (2020) · cites this paper as [53]
In the citing paper
“As such, the SN has been proposed to play a key role in cognitive control (Ham et al., 2013), i.e., switching brain activity between introspective, ruminative functions of the default-mode network and externally focused, task-based functions of the central executive network (Menon and Uddin, 2010).”
From Cortico-striatal-thalamic loop circuits of the salience network: A central pathway in psychiatric disease and treatment (2016) · cites this paper as Menon and Uddin, 2010
In the citing paper
“It is activated in a wide variety of cognitive and emotional tasks (Dosenbach et al., 2006) and forms the important salience network in resting state literature (Menon and Uddin, 2010).”
From Cognitive flexibility in adolescence: Neural and behavioral mechanisms of reward prediction error processing in adaptive decision making during development (2015) · cites this paper as Menon and Uddin, 2010
In the citing paper
“Indeed, activity in the AIC is a common feature in studies of cognitive control and inhibitory processing [7, 46–50] and reward sensitivity [8, 9].”
From The role of the anterior insula in adolescent decision making (2014) · cites this paper as [8]
In the citing paper
“The SN dynamically switches between the ECN and DMN, which are generally anticorrelated, following detection of relevant stimulation or condition”
From The Insula: A Brain Stimulation Target for the Treatment of Addiction (2019) · cites this paper as Menon and Uddin, 2010
In the citing paper
“These include automatic salience evaluation, [ 4 9 8 _ T D $ D I F F ] inhibition/interruption of ongoing activity[ 4 9 9 _ T D $ D I F F ] , alerting, salience-driven switching, and reflexive orienting [40,43,47,48].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [48]
In the citing paper
“In addition, over-reactive threat salience-driven switching may cause excessive threat-prioritisation in cognitive system functioning (attention, working memory), and resultant anxiety [48].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [48]
In the citing paper
“The adaptive value of this inhibitory mechanism in salient, emotional situations may be to prepare for immediate action in the external world [39].”
From On the interaction of social affect and cognition: empathy, compassion and theory of mind (2018) · cites this paper as [39]
In the citing paper
“These regions are interconnected with the ventral striatum and form core components of the brain's incentive salience system (Menon and Uddin, 2010).”
From Neural networks involved in adolescent reward processing: an activation likelihood estimation meta-analysis of functional neuroimaging studies (2015) · cites this paper as Menon and Uddin, 2010
In the citing paper
“The insula is a critical component of the brain's salience network (Craig, 2009; Menon and Uddin, 2010) and participates in interoceptive awareness, the representation of physiological states associated with risk (Xue et al., 2010), and integration of such states with behavior during risky contexts that are characterized by uncertainty (Singer et al., 2009).”
From Neural networks involved in adolescent reward processing: an activation likelihood estimation meta-analysis of functional neuroimaging studies (2015) · cites this paper as Menon and Uddin, 2010
In the citing paper
“The anterior cingulate, frequently co-activated with the anterior insula (Menon and Uddin, 2010) may play a role in integrating emotion and motivational signals pertaining to contextual salience with executive control systems (Pessoa, 2009) so that adaptive behavioral responses can be formulated and executed.”
From Neural networks involved in adolescent reward processing: an activation likelihood estimation meta-analysis of functional neuroimaging studies (2015) · cites this paper as Menon and Uddin, 2010
In the citing paper
“The SORT not only activates brain regions involved in semantic memory recall, which include bilateral inferior frontal gyrus (including Broca's area), left DLPFC, left middle temporal gyrus, bilateral angular gyrus, and PCC [Assaf et al., 2006;Binder et al., 2009], but also activates salience-related regions, including dorsal anterior cingulate cortex (dACC), pre-SMA [Assaf et al., 2006] and”
From Specific default mode subnetworks support mentalizing as revealed through opposing network recruitment by social and semantic FMRI tasks: Mentalizing and Default-Mode Subnetworks (2015) · cites this paper as Menon and Uddin, 2010
In the citing paper
“SN also plays a role in adaptive switching between the central executive network (CEN), involved in focused attentional states, and the default mode network (DMN), active during introspective self-referential thought and social emotional processes ( Amodio and Frith, 2006 ; Sridharan et al., 2008 ; Menon and Uddin, 2010 ; Spreng and Grady, 2010 ; Menon, 2015 ).”
From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Menon and Uddin, 2010
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Metadata
- Authors
- Menon, V., & Uddin, L. Q.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Menon, Vinod
- Uddin, Lucina Q.
- Venue
- Brain Structure and Function
- Published
- 2010-05-29
- Volume
- 214
- Issue
- 5-6
- Pages
- 655-667
- ISSN
- 1863-2653 (ISSN-L)
- 1863-2661
- PMC
- PMC2899886
- OpenAlex
- W2129624700
- Semantic Scholar
- 7fd8bee2d3a38b29ae2228466d3431a34c7ae240
- Cited by
- 5,592
- References
- 93
- Citations by year
- 2026: 429 · 2025: 445 · 2024: 429 · 2023: 398 · 2022: 428 · 2021: 568 · 2020: 437 · 2019: 397 · 2018: 389 · 2017: 368 · 2016: 356 · 2015: 334 · 2014: 225 · 2013: 200 · 2012: 118
- FWCI
- 8.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Brain Structure and Function (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (K01MH092288)
- National Institute of Neurological Disorders and Stroke (NS058899, R21NS058899)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD057610, HD047520, HD057610, R01HD047520, R01HD059205)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural dynamics and brain function
- Keywords
- anterior insula, salience network, cognitive control, attention, network switching, anterior cingulate cortex, saliency detection, bottom-up processing, interoception, autonomic reactivity, working memory, large-scale brain networks
- MeSH terms
- Animals, Cerebral Cortex, Humans, Nerve Net, Neural Networks, Computer, Executive Function
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