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An insula hierarchical network architecture for active interoceptive inference
Open accessAbstract
In the brain, the insular cortex receives a vast amount of interoceptive information, ascending through deep brain structures, from multiple visceral organs. The unique hierarchical and modular architecture of the insula suggests specialization for processing interoceptive afferents. Yet, the biological significance of the insula's neuroanatomical architecture, in relation to deep brain structures, remains obscure. In this opinion piece, we propose the Insula Hierarchical Modular Adaptive Interoception Control (IMAC) model to suggest that insula modules (granular, dysgranular and agranular), forming parallel networks with the prefrontal cortex and striatum, are specialized to form higher order interoceptive representations. These interoceptive representations are recruited in a context-dependent manner to support habitual, model-based and exploratory control of visceral organs and physiological processes. We discuss how insula interoceptive representations may give rise to conscious feelings that best explain lower order deep brain interoceptive representations, and how the insula may serve to defend the body and mind against pathological depression.
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“Recently, Fermin et al. attempted to expand upon this framework, proposing a three-tiered insula model [49]. The granular insula first receives interoceptive afferent signals and uses these to inform lower-order innate interoceptive representations. Resulting prediction errors are projected to the mid-dorsal insula, which facilitates preemptive adjustments to the visceral system through model-”
From Neural correlates of altered interoception in depressive and anxiety disorders: a systematic review and meta-analysis (2026) · cites this paper as [49]
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Flagged first, then by citations
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Cited by
Sorted by citations
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Metadata
- Authors
- Fermin, A. S. R., Friston, K., & Yamawaki, S.
- Affiliations
- Hiroshima University (JP)
- Wellcome Centre for Human Neuroimaging (GB)
- Corresponding author
- Fermin, Alan S. R.
- Venue
- Royal Society Open Science
- Publisher
- The Royal Society
- Published
- 2022-06
- Volume
- 9
- Issue
- 6
- Pages
- 220226-220226
- ISSN
- 2054-5703 (ISSN-L)
- PMC
- PMC9240682
- OpenAlex
- W4283707164
- Cited by
- 101
- References
- 329
- Citations by year
- 2026: 31 · 2025: 22 · 2024: 28 · 2023: 16 · 2022: 2
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Royal Society Open Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Centre for Human Neuroimaging (205103/Z/16/Z)
- Canada-UK Artificial Intelligence Initiative (ES/T01279X/1)
- Japan Agency for Medical Research and Development (JP19dm0107093)
- Center of Innovation Program (JPMJCA2208, JPMJCE1311)
- Japan Society for the Promotion of Science (20309202, 20K07723, JPMJMS2296)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Embodied and Extended Cognition
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- insula, interoception, prefrontal cortex, striatum, model-based control, depression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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