The insula: a critical neural substrate for craving and drug seeking under conflict and risk
Open accessAbstract
Drug addiction is characterized by the inability to control drug use when it results in negative consequences or conflicts with more adaptive goals. Our previous work showed that damage to the insula disrupted addiction to cigarette smoking—the first time that the insula was shown to be a critical neural substrate for addiction. Here, we review those findings, as well as more recent studies that corroborate and extend them, demonstrating the role of the insula in (1) incentive motivational processes that drive addictive behavior, (2) control processes that moderate or inhibit addictive behavior, and (3) interoceptive processes that represent bodily states associated with drug use. We then describe a theoretical framework that attempts to integrate these seemingly disparate findings. In this framework, the insula functions in the recall of interoceptive drug effects during craving and drug seeking under specific conditions where drug taking is perceived as risky and/or where there is conflict between drug taking and more adaptive goals. We describe this framework in an evolutionary context and discuss its implications for understanding the mechanisms of behavior change in addiction treatments.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The insula has long been implicated in drug cravings, the maintenance of drug-seeking behavior, and the regulation of distress during withdrawal.
“The insula has long been implicated in drug cravings, the maintenance of drug-seeking behavior, and the regulation of distress during withdrawal [1,6,71].”
From The Insular Cortex: An Interface Between Sensation, Emotion and Cognition (2024) · cites this paper as [71]
The sections on appetitive motivation and the integrative model link the insula to drug craving and drug seeking. The Alternative models section discusses insula signaling in a model involving withdrawal-related negative affect, but does not establish that the insula regulates distress during withdrawal. Our copy provides no page numbers for these passages. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAs a result of drug use and abuse, neuronal circuits involved in reward and fear processing are co-opted to each stage of the addictive cycle and continue to function to maintain addiction.
“As a result of drug use and abuse, different neuronal circuits, such as the circuits involved in reward and fear processing, are co-opted to each stage of the addictive cycle and continue to function to maintain addiction”
From The Insula: A Brain Stimulation Target for the Treatment of Addiction (2019) · cites this paper as Naqvi et al., 2014
Many of the insula's connectivity constitute areas known to be involved in addiction.
“Many of the insula’s connectivity constitute areas known to be involved in addiction”
From The Insula: A Brain Stimulation Target for the Treatment of Addiction (2019) · cites this paper as Naqvi et al., 2014
With addiction the insula may undergo both a loss and gain of function depending on the specific function investigated.
“Naqvi et al. (2014) described that with addiction the insula may undergo both a loss and gain of function depending on the specific function investigated.”
From The Insula: A Brain Stimulation Target for the Treatment of Addiction (2019) · cites this paper as Naqvi et al., 2014
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
An Integrative Theory of Prefrontal Cortex Function
Miller, E. K., & Cohen, J. D. (2001) · Annual Review of Neuroscience · doi:10.1146/annurev.neuro.24.1.167 · Cited by 12,803 · see citing works
(1994) · DigitalGeorgetown (Georgetown University Library) · Cited by 10,542 · see citing works
DESCARTES' ERROR: Emotion, Reason, and the Human Brain
Marg, E. (1995) · Optometry and Vision Science · doi:10.1002/j.1538-9235.1995.tb03988.x · Cited by 8,177 · see citing works
Dissociable intrinsic connectivity networks for salience processing and executive control
Seeley, W. W., Menon, V., Schatzberg, A. F., Keller, J., Glover, G. H., Kenna, H., Reiss, A. L., & Greicius, M. D. (2007) · The Journal of Neuroscience · doi:10.1523/jneurosci.5587-06.2007 · Cited by 7,426 · see citing works
Motivational interviewing: preparing people for change.
Miller, W. R., & Rollnick, S. (2002) · Cited by 7,002 · see citing works
How do you feel? Interoception: The sense of the physiological condition of the body
Craig, A. D. (2002) · Nature Reviews Neuroscience · doi:10.1038/nrn894 · Cited by 6,006 · see citing works
The feeling of what happens: body and emotion in the making of consciousness
(2000) · Choice Reviews Online · doi:10.5860/choice.37-6553 · Cited by 5,998 · see citing works
Saliency, switching, attention and control: a network model of insula function
Menon, V., & Uddin, L. Q. (2010) · Brain Structure and Function · doi:10.1007/s00429-010-0262-0 · Cited by 5,592 · see citing works
WARWICK, R., Williams, P. L., Dyson, M., & Bannister, L. (1985) · British Journal of Radiology · doi:10.1259/0007-1285-58-694-1029 · Cited by 4,532 · see citing works
Empathy for Pain Involves the Affective but not Sensory Components of Pain
Singer, T., Seymour, B., O'Doherty, J., Kaube, H., Dolan, R. J., & Frith, C. D. (2004) · Science · doi:10.1126/science.1093535 · Cited by 3,929 · see citing works
Neural systems of reinforcement for drug addiction: from actions to habits to compulsion
Everitt, B. J., & Robbins, T. W. (2005) · Nature Neuroscience · doi:10.1038/nn1579 · Cited by 3,785 · see citing works
Conflict monitoring and anterior cingulate cortex: an update
Botvinick, M. M., Cohen, J. D., & Carter, C. S. (2004) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2004.10.003 · Cited by 3,623 · see citing works
Drug Addiction, Dysregulation of Reward, and Allostasis
Koob, G. (2001) · Neuropsychopharmacology · doi:10.1016/s0893-133x(00)00195-0 · Cited by 2,953 · see citing works
Sridharan, D., Levitin, D. J., & Menon, V. (2008) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0800005105 · Cited by 2,892 · see citing works
Descartes’ Error. Emotion, Reason and the Human Brain. New York (Grosset/Putnam) 1994.
Damasio, A. R. (1994) · Cited by 2,266 · see citing works
The human orbitofrontal cortex: linking reward to hedonic experience
Kringelbach, M. L. (2005) · Nature Reviews Neuroscience · doi:10.1038/nrn1747 · Cited by 2,180 · see citing works
Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective
Bechara, A. (2005) · Nature Neuroscience · doi:10.1038/nn1584 · Cited by 2,149 · cited 1× · see citing works
“103,104 In addition, goal-directed reward seeking, like all forms of goal-directed behavior, requires (4) working memory and attentional functions that hold goal representations online, mediated by the dorsolateral prefrontal cortex,105 as well as (5) monitoring conflict between reward seeking and competing goals that…”
Self-citationBerridge, K. C., & Robinson, T. E. (2003) · Trends in Neurosciences · doi:10.1016/s0166-2236(03)00233-9 · Cited by 1,869 · see citing works
Circuitry and functional aspects of the insular lobe in primates including humans
AUGUSTINE, J. (1996) · Brain Research Reviews · doi:10.1016/s0165-0173(96)00011-2 · Cited by 1,776 · see citing works
Balleine, B. W., & O'Doherty, J. P. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.131 · Cited by 1,775 · see citing works
The incentive sensitization theory of addiction: some current issues
Robinson, T. E., & Berridge, K. C. (2008) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2008.0093 · Cited by 1,717 · see citing works
Ikemoto, S., & Panksepp, J. (1999) · Brain Research Reviews · doi:10.1016/s0165-0173(99)00023-5 · Cited by 1,450 · see citing works
Damage to the insula disrupts addiction to cigarette smoking
Naqvi, N. H., Rudrauf, D., Damasio, H., & Bechara, A. (2007) · Science · doi:10.1126/science.1135926 · Cited by 1,245 · see citing works
Self-citationThe Neural Basis of Financial Risk Taking
Kuhnen, C. M., & Knutson, B. (2005) · Neuron · doi:10.1016/j.neuron.2005.08.008 · Cited by 1,182 · see citing works
Encoding Predictive Reward Value in Human Amygdala and Orbitofrontal Cortex
Gottfried, J. A., O'Doherty, J., & Dolan, R. J. (2003) · Science · doi:10.1126/science.1087919 · Cited by 1,165 · see citing works
Rogers, R. (1999) · Neuropsychopharmacology · doi:10.1016/s0893-133x(98)00091-8 · Cited by 1,101 · see citing works
Insula of the old world monkey. III: Efferent cortical output and comments on function
Mesulam, M. ‐., & Mufson, E. J. (1982) · Journal of Comparative Neurology · doi:10.1002/cne.902120104 · Cited by 1,013 · see citing works
Unmyelinated tactile afferents signal touch and project to insular cortex
Olausson, H., Lamarre, Y., Backlund, H., Morin, C., Wallin, B. G., Starck, G., EKHOLM, S. E., Strigo, I. A., Worsley, K. J., Vallbo, Å. B., et al. (2002) · Nature Neuroscience · doi:10.1038/nn896 · Cited by 993 · see citing works
The hidden island of addiction: the insula
Naqvi, N. H., & Bechara, A. (2009) · Trends in Neurosciences · doi:10.1016/j.tins.2008.09.009 · Cited by 833 · see citing works
Self-citationHuman insula activation reflects risk prediction errors as well as risk
Preuschoff, K., Quartz, S. R., & Bossaerts, P. (2008) · The Journal of Neuroscience · doi:10.1523/jneurosci.4286-07.2008 · Cited by 784 · see citing works
Associative processes in addiction and reward. The role of amygdala-ventral striatal subsystems
EVERITT, B. J., PARKINSON, J. A., OLMSTEAD, M. C., ARROYO, M., ROBLEDO, P., & ROBBINS, T. W. (1999) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1999.tb09280.x · Cited by 708 · see citing works
The neurocircuitry of impaired insight in drug addiction
Goldstein, R. Z., Craig, A. D. (., Bechara, A., Garavan, H., Childress, A. R., Paulus, M. P., & Volkow, N. D. (2009) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2009.06.004 · Cited by 641 · see citing works
Self-citationDifferential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making
Clark, L., Bechara, A., Damasio, H., Aitken, M. R. F., Sahakian, B. J., & Robbins, T. W. (2008) · Brain · doi:10.1093/brain/awn066 · Cited by 613 · see citing works
Self-citationCraig, A. D. (. (2010) · Brain Structure and Function · doi:10.1007/s00429-010-0248-y · Cited by 600 · see citing works
Franklin, T. R., Acton, P. D., Maldjian, J. A., Gray, J. D., Croft, J. R., Dackis, C. A., O’Brien, C. P., & Childress, A. R. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01269-0 · Cited by 599 · see citing works
The insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making
Naqvi, N. H., & Bechara, A. (2010) · Brain Structure and Function · doi:10.1007/s00429-010-0268-7 · Cited by 598 · see citing works
Self-citationSchacht, J. P., Anton, R. F., & Myrick, H. (2013) · Addiction Biology · doi:10.1111/j.1369-1600.2012.00464.x · Cited by 583 · see citing works
Erratum to: “Parsing reward” [Trends Neurosci. 26 (2003) 507–513]
Berridge, K. C., & Robinson, T. E. (2003) · Trends in Neurosciences · doi:10.1016/j.tins.2003.09.001 · Cited by 559 · see citing works
Abnormal Brain Structure Implicated in Stimulant Drug Addiction
Ersche, K. D., Jones, P. S., Williams, G. B., Turton, A. J., Robbins, T. W., & Bullmore, E. T. (2012) · Science · doi:10.1126/science.1214463 · Cited by 546 · see citing works
Resting state functional connectivity in addiction: Lessons learned and a road ahead
Sutherland, M. T., McHugh, M. J., Pariyadath, V., & Stein, E. A. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.01.117 · Cited by 495 · see citing works
Transcranial magnetic stimulation of deep brain regions: evidence for efficacy of the H-Coil
Zangen, A., Roth, Y., Voller, B., & Hallett, M. (2004) · Clinical Neurophysiology · doi:10.1016/j.clinph.2004.11.008 · Cited by 477 · see citing works
Kühn, S., & Gallinat, J. (2011) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2010.07590.x · Cited by 474 · see citing works
The von Economo neurons in frontoinsular and anterior cingulate cortex in great apes and humans
Allman, J., Tetreault, N. A., Hakeem, A. Y., Manaye, K., Semendeferi, K., Erwin, J., Park, S. Q., Goubert, V., & Hof, P. (2010) · Brain Structure and Function · doi:10.1007/s00429-010-0254-0 · Cited by 429 · see citing works
Chanraud, S., Martelli, C., Delain, F., Kostogianni, N., Douaud, G., Aubin, H., Reynaud, M., & Martinot, J. (2006) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301219 · Cited by 419 · see citing works
Janes, A. C., Pizzagalli, D. A., Richardt, S., Frederick, B. D., Chuzi, S., Pachas, G., Culhane, M. A., Holmes, A. J., Fava, M., Evins, A. E., et al. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.12.034 · Cited by 416 · see citing works
Mohr, P. N. C., Biele, G., & Heekeren, H. R. (2010) · The Journal of Neuroscience · doi:10.1523/jneurosci.0003-10.2010 · Cited by 411 · see citing works
Neural substrates of smoking cue reactivity: A meta-analysis of fMRI studies
Engelmann, J. M., Versace, F., Robinson, J. D., Minnix, J. A., Lam, C. Y., Cui, Y., Brown, V. L., & Cinciripini, P. M. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2011.12.024 · Cited by 394 · see citing works
The pathways of interoceptive awareness
Khalsa, S. S., Rudrauf, D., Feinstein, J. S., & Tranel, D. (2009) · Nature Neuroscience · doi:10.1038/nn.2411 · Cited by 387 · see citing works
Self-citationDifferent Roles for Orbitofrontal Cortex and Basolateral Amygdala in a Reinforcer Devaluation Task
Pickens, C. L., Saddoris, M. P., Setlow, B., Gallagher, M., Holland, P. C., & Schoenbaum, G. M. (2003) · Journal of Neuroscience · doi:10.1523/jneurosci.23-35-11078.2003 · Cited by 379 · see citing works
Decreased Volume of the Brain Reward System in Alcoholism
Makris, N., Oscar-Berman, M., Jaffin, S. K., Hodge, S. M., Kennedy, D. N., Caviness, V. S., Marinkovic, K., Breiter, H. C., Gasic, G. P., & Harris, G. J. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.01.018 · Cited by 372 · see citing works
Paulus, M. P., Tapert, S. F., & Schuckit, M. A. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.7.761 · Cited by 369 · see citing works
A somatic marker theory of addiction
Verdejo‐García, A., & Bechara, A. (2008) · Neuropharmacology · doi:10.1016/j.neuropharm.2008.07.035 · Cited by 359 · see citing works
Self-citationA cognitive processing model of alcohol craving and compulsive alcohol use
Tiffany, S. T., & Conklin, C. A. (2000) · Addiction · doi:10.1046/j.1360-0443.95.8s2.3.x · Cited by 356 · see citing works
Nicotine and nonnicotine factors in cigarette addiction
Rose, J. E. (2005) · Psychopharmacology · doi:10.1007/s00213-005-0250-x · Cited by 348 · see citing works
Some observations on cortical inputs to the macaque monkey amygdala: An anterograde tracing study
Stefanacci, L., & Amaral, D. G. (2002) · Journal of Comparative Neurology · doi:10.1002/cne.10339 · Cited by 345 · see citing works
Chikama, M., McFarland, N. R., Amaral, D. G., & Haber, S. N. (1997) · Journal of Neuroscience · doi:10.1523/jneurosci.17-24-09686.1997 · Cited by 341 · see citing works
Goldstein, R. Z., Leskovjan, A. C., Hoff, A. L., HITZEMANN, R. J., Bashan, F., Khalsa, S. S., Wang, G., Fowler, J. S., & Volkow, N. D. (2004) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2004.04.002 · Cited by 338 · see citing works
Chase, H. W., Eickhoff, S. B., Laird, A. R., & Hogarth, L. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.05.025 · Cited by 316 · see citing works
Seif, T., Chang, S., Simms, J. A., Gibb, S. L., Dadgar, J., Chen, B. T., Harvey, B. K., Dorit Ron, A., Messing, R. O., Bonci, A., et al. (2013) · Nature Neuroscience · doi:10.1038/nn.3445 · Cited by 310 · see citing works
Taste representation in the human insula
Small, D. M. (2010) · Brain Structure and Function · doi:10.1007/s00429-010-0266-9 · Cited by 300 · see citing works
Inactivation of the Interoceptive Insula Disrupts Drug Craving and Malaise Induced by Lithium
Contreras, M., Ceric, F., & Torrealba, F. (2007) · Science · doi:10.1126/science.1145590 · Cited by 297 · see citing works
Insular hypocretin transmission regulates nicotine reward
Hollander, J. A., Lu, Q., Cameron, M. D., Kamenecka, T. M., & Kenny, P. J. (2008) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0808023105 · Cited by 296 · see citing works
Morrison, I., Björnsdotter, M., & Olausson, H. (2011) · Journal of Neuroscience · doi:10.1523/jneurosci.0397-11.2011 · Cited by 290 · see citing works
Persistence of feelings and sentience after bilateral damage of the insula
Damasio, A., Damasio, H., & Tranel, D. (2013) · Cerebral Cortex · doi:10.1093/cercor/bhs077 · Cited by 282 · see citing works
Self-citationConditioning factors in opiate addiction and relapse
Wikler, A. (1984) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(84)90008-4 · Cited by 279 · see citing works
Exposure to the Taste of Alcohol Elicits Activation of the Mesocorticolimbic Neurocircuitry
Filbey, F. M., Claus, E., Audette, A. R., Niculescu, M., Banich, M. T., Tanabe, J., Du, Y. P., & Hutchison, K. E. (2008) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301513 · Cited by 270 · see citing works
A cognitive processing model of alcohol craving and compulsive alcohol use
Tiffany, S. T., & Conklin, C. A. (2000) · Addiction · doi:10.1080/09652140050111717 · Cited by 261 · see citing works
The impact of prior risk experiences on subsequent risky decision-making: The role of the insula
Xue, G., Lu, Z., Levin, I. P., & Bechara, A. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2009.12.097 · Cited by 249 · see citing works
Self-citationIdentifying Neurobiological Phenotypes Associated with Alcohol Use Disorder Severity
Claus, E. D., Ewing, S. W. F., Filbey, F. M., Sabbineni, A., & Hutchison, K. E. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2011.99 · Cited by 249 · see citing works
Reynolds, S. M., & Zahm, D. S. (2005) · The Journal of Neuroscience · doi:10.1523/jneurosci.3432-05.2005 · Cited by 239 · see citing works
Amygdaloid projections to ventromedial striatal subterritories in the primate
Fudge, J. L., Kunishio, K., Walsh, P., Richard, C., & Haber, S. N. (2002) · Neuroscience · doi:10.1016/s0306-4522(01)00546-2 · Cited by 226 · see citing works
Deep brain stimulation in addiction: a review of potential brain targets
Luigjes, J., van den Brink, W., Feenstra, M. G. P., van den Munckhof, P., Schuurman, P. R., Schippers, R., Mazaheri, A., Vries, T. J. D., & Denys, D. A. J. P. (2011) · Molecular Psychiatry · doi:10.1038/mp.2011.114 · Cited by 222 · see citing works
Balleine, B. W., & Dickinson, A. (2000) · The Journal of Neuroscience · doi:10.1523/jneurosci.20-23-08954.2000 · Cited by 218 · see citing works
Neuroscience of Behavioral and Pharmacological Treatments for Addictions
Potenza, M. N., Sofuoglu, M., Carroll, K. M., & Rounsaville, B. J. (2011) · Neuron · doi:10.1016/j.neuron.2011.02.009 · Cited by 214 · see citing works
Error awareness and the insula: links to neurological and psychiatric diseases
Klein, T. A., Ullsperger, M., & Danielmeier, C. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00014 · Cited by 210 · see citing works
Li, X., Hartwell, K. J., Owens, M., LeMatty, T., Borckardt, J. J., Hanlon, C. A., Brady, K. T., & George, M. S. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.003 · Cited by 206 · see citing works
Trait impulsivity and prefrontal gray matter reductions in cocaine dependent individuals
Moreno-López, L., Catena, A., Fernández-Serrano, M. J., Delgado-Rico, E., Stamatakis, E. A., Pérez-García, M., & Verdejo-García, A. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.02.012 · Cited by 203 · see citing works
Neural integrative activities of nucleus accumbens subregions in relation to learning and motivation
Kelley, A. E. (1999) · Psychobiology · doi:10.3758/bf03332114 · Cited by 195 · see citing works
Filbey, F. M., Ray, L. A., Smolen, A., Claus, E. D., Audette, A., & Hutchison, K. E. (2008) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2008.00692.x · Cited by 192 · see citing works
Factors underlying prefrontal and insula structural alterations in smokers
Zhang, X., Salmeron, B. J., Ross, T. J., Geng, X., Yang, Y., & Stein, E. A. (2011) · NeuroImage · doi:10.1016/j.neuroimage.2010.08.008 · Cited by 188 · see citing works
Smaller Volume of Prefrontal Lobe in Polysubstance Abusers: A Magnetic Resonance Imaging Study
Liu, X., Matochik, J., Cadet, J., & London, E. (1998) · Neuropsychopharmacology · doi:10.1016/s0893-133x(97)00143-7 · Cited by 185 · see citing works
Villafuerte, S., Heitzeg, M. M., Foley, S., Yau, W.-Y. W., Majczenko, K., Zubieta, J., Zucker, R. A., & Burmeister, M. (2011) · Molecular Psychiatry · doi:10.1038/mp.2011.33 · Cited by 182 · see citing works
The role of interoception and alliesthesia in addiction
Paulus, M. P., Tapert, S. F., & Schulteis, G. (2009) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2009.08.005 · Cited by 168 · see citing works
Anterior insular cortex anticipates impending stimulus significance
Lovero, K. L., Simmons, A. N., Aron, J. L., & Paulus, M. P. (2009) · NeuroImage · doi:10.1016/j.neuroimage.2008.12.070 · Cited by 158 · see citing works
Granular insular cortex inactivation as a novel therapeutic strategy for nicotine addiction
Forget, B., Pushparaj, A., & Le Foll, B. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.01.029 · Cited by 153 · see citing works
Philippi, C. L., Feinstein, J. S., Khalsa, S. S., Damasio, A., Tranel, D., Landini, G., Williford, K., & Rudrauf, D. (2012) · PLoS ONE · doi:10.1371/journal.pone.0038413 · Cited by 144 · see citing works
Self-citationMorales, A. M., Lee, B., Hellemann, G., O’Neill, J., & London, E. D. (2012) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2012.02.017 · Cited by 142 · see citing works
Rose, J. E., McClernon, F. J., Froeliger, B., Behm, F. M., Preudʼhomme, X., & Krystal, A. D. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.05.031 · Cited by 140 · see citing works
Reward, interrupted: Inhibitory control and its relevance to addictions
Jentsch, J. D., & Pennington, Z. T. (2013) · Neuropharmacology · doi:10.1016/j.neuropharm.2013.05.022 · Cited by 134 · see citing works
Sutherland, M. T., Carroll, A. J., Salmeron, B. J., Ross, T. J., Hong, L. E., & Stein, E. A. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.01.035 · Cited by 131 · see citing works
Neural and Behavioral Mechanisms of Impulsive Choice in Alcohol Use Disorder
Claus, E. D., Kiehl, K. A., & Hutchison, K. E. (2011) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2011.01455.x · Cited by 130 · see citing works
Pathology of the Insular Cortex in Alzheimer Disease Depends on Cortical Architecture
Bonthius, D. J., Solodkin, A., & Hoesen, G. W. V. (2005) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/01.jnen.0000182983.87106.d1 · Cited by 128 · see citing works
Claus, E. D., Blaine, S. K., Filbey, F. M., Mayer, A. R., & Hutchison, K. E. (2013) · Neuropsychopharmacology · doi:10.1038/npp.2013.134 · Cited by 124 · see citing works
Anhedonia After a Selective Bilateral Lesion of the Globus Pallidus
Miller, J. M., Vorel, S. R., Tranguch, A. J., Kenny, E. T., Mazzoni, P., van Gorp, W. G., & Kleber, H. D. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.5.786 · Cited by 120 · see citing works
Human brain activation during sexual stimulation of the penis
Georgiadis, J. R., & Holstege, G. (2005) · The Journal of Comparative Neurology · doi:10.1002/cne.20735 · Cited by 110 · see citing works
The role of sensory perception in the development and targeting of tobacco products
Carpenter, C. M., Wayne, G. F., & Connolly, G. N. (2006) · Addiction · doi:10.1111/j.1360-0443.2006.01649.x · Cited by 108 · see citing works
Cisler, J. M., Elton, A., Kennedy, A. P., Young, J., Smitherman, S., Andrew James, G., & Kilts, C. D. (2013) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2013.02.007 · Cited by 99 · see citing works
Risk-Taking Behavior: Dopamine D2/D3 Receptors, Feedback, and Frontolimbic Activity
Kohno, M., Ghahremani, D. G., Morales, A. M., Robertson, C. L., Ishibashi, K., Morgan, A., Mandelkern, M. A., & London, E. D. (2013) · Cerebral Cortex · doi:10.1093/cercor/bht218 · Cited by 97 · see citing works
Wise, R. A., Wang, B., & You, Z. (2008) · PLoS ONE · doi:10.1371/journal.pone.0002846 · Cited by 92 · see citing works
Sullivan, E. V., Müller‐Oehring, E. M., Pitel, A., Chanraud, S., Shankaranarayanan, A., Alsop, D. C., Torsten Rohlfing, B., & Pfefferbaum, A. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.02.026 · Cited by 88 · see citing works
A Role for the Insular Cortex in Long-Term Memory for Context-Evoked Drug Craving in Rats
Contreras, M., Billeke, P. B., Vicencio, S., Madrid, C., Perdomo, G., González, M., & Torrealba, F. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2012.59 · Cited by 81 · see citing works
Naqvi, N. H., & Bechara, A. (2005) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2005.06.005 · Cited by 81 · see citing works
Self-citationReduced grey matter in the posterior insula as a structural vulnerability or diathesis to addiction
Gardini, S., & Venneri, A. (2011) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2011.11.021 · Cited by 77 · see citing works
Neural Correlates of Impulsivity in Healthy Males and Females with Family Histories of Alcoholism
DeVito, E. E., Meda, S. A., Jiantonio‐Kelly, R. E., Potenza, M. N., Krystal, J. H., & Pearlson, G. D. (2013) · Neuropsychopharmacology · doi:10.1038/npp.2013.92 · Cited by 77 · see citing works
Pushparaj, A. P., Hamani, C., Yu, W., Shin, D. S.-H., Kang, B., Nóbrega, J. N., & Foll, B. L. (2012) · Neuropsychopharmacology · doi:10.1038/npp.2012.235 · Cited by 73 · see citing works
Gaznick, N., Tranel, D., McNutt, A., & Bechara, A. (2014) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntt172 · Cited by 72 · see citing works
Self-citationSmoking cessation 1 year poststroke and damage to the insular cortex
Suñer-Soler, R., Grau, A., Gras, M. E., Font-Mayolas, S., Silva, Y., Dávalos, A., Cruz, V., Rodrigo, J., & Serena, J. (2012) · Stroke · doi:10.1161/strokeaha.111.630004 · Cited by 71 · see citing works
Inactivating anterior insular cortex reduces risk taking
Ishii, H., Ohara, S., Tobler, P. N., Tsutsui, K.-I., & Iijima, T. (2012) · The Journal of Neuroscience · doi:10.1523/jneurosci.2278-12.2012 · Cited by 64 · see citing works
Deconstructing Craving: Dissociable Cortical Control of Cue Reactivity in Nicotine Addiction
Scott, D., & Hiroi, N. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.01.023 · Cited by 63 · see citing works
The anti-smoking climate in EU countries and Poland
Fagerström, K. O., Boyle, P., Kunze, M., et al. (2001) · Lung Cancer · doi:10.1016/s0169-5002(00)00203-8 · Cited by 62 · see citing works
Patterns of motivations and ways of quitting smoking among Polish smokers: A questionnaire study
Siemińska, A., Buczkowski, K., Jassem, E., Lewandowska, K., Ucińska, R., & Chełmińska, M. (2008) · BMC Public Health · doi:10.1186/1471-2458-8-274 · Cited by 60 · see citing works
Janes, A. C., Smoller, J. W., David, S. P., Frederick, B. B., Haddad, S. A., Basu, A., D, M. F. M., Evins, A. E., & Kaufman, M. J. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.06.009 · Cited by 54 · see citing works
Franklin, T. R., Wang, Z., Sciortino, N., Harper, D., Li, Y., Hakun, J. G., Kildea, S., Kampman, K. M., Ehrman, R., Detre, J. A., et al. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.01.015 · Cited by 43 · see citing works
Paulus, M. P., Lovero, K. L., Wittmann, M., & Leland, D. S. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.09.007 · Cited by 42 · see citing works
Encoding of reward expectation by monkey anterior insular neurons
Mizuhiki, T., Richmond, B. J., & Shidara, M. (2012) · Journal of Neurophysiology · doi:10.1152/jn.00282.2011 · Cited by 41 · see citing works
Conditioning of narcotic abstinence symptoms in human subjects
O’Brien, C. P., O'Brien, T. J., Mintz, J., & Brady, J. P. (1975) · Drug and Alcohol Dependence · doi:10.1016/0376-8716(75)90013-7 · Cited by 38 · see citing works
Albrecht, J., Kopietz, R., Linn, J., et al. (2008) · Human Brain Mapping · doi:10.1002/hbm.20535 · Cited by 34 · see citing works
TACR 1 Genotypes Predict f MRI Response to Alcohol Cues and Level of Alcohol Dependence
Blaine, S. K., Claus, E. D., Harlaar, N., & Hutchison, K. E. (2012) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2012.01923.x · Cited by 32 · see citing works
Insular lesions and smoking cessation after first-ever ischemic stroke: A 3-month follow-up
Bienkowski, P., Zatorski, P., Baranowska, A., Ryglewicz, D., & Sienkiewicz-Jarosz, H. (2010) · Neuroscience Letters · doi:10.1016/j.neulet.2010.05.008 · Cited by 29 · see citing works
Insula Damage and Quitting Smoking
Vorel, S. R., Bisaga, A. M., McKhann, G. M., & Kleber, H. D. (2007) · Science · doi:10.1126/science.317.5836.318c · Cited by 16 · see citing works
Skin conductance responses are elicited by the airway sensory effects of puffs from cigarettes
Naqvi, N. H., & Bechara, A. (2006) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2005.10.018 · Cited by 15 · see citing works
Self-citation(1984) · PubMed · Cited by 10 · see citing works
The role of the insular cortex in chemosensory responses to ethanol
Castro, N. (2012) · CSUN ScholarWorks (California State University, Northridge) · Cited by 4 · see citing works
Abraham Wikler: Conditioning factors in opiate addiction
Shaffer, H. J. (1984) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(84)90007-2 · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [13]Vorel SR Bisaga A McKhann G Kleber HD Insula damage and quitting smoking Science 2007 317 318 319 17641181
- [120]Marlatt GA Gordon JR Relapse Prevention 1985 New York The Guilford Press
- [122]Craig AD How do you feel? Interoception: the sense of the physiological condition of the body Nat. Rev. Neurosci 2002 3 655 666 12154366
Cited by
Sorted by citations
Potenza, M. N., Balodis, I. M., Derevensky, J., Grant, J. E., Petry, N. M., Verdejo-Garcia, A., & Yip, S. W. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0099-7 · Cited by 437 · see citing works
Revisiting the role of the insula in addiction
Droutman, V., Read, S. J., & Bechara, A. (2015) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2015.05.005 · Cited by 317 · see citing works
Self-citationHomeostatic circuits selectively gate food cue responses in insular cortex
Livneh, Y., Ramesh, R. N., Burgess, C. R., Levandowski, K. M., Madara, J. C., Fenselau, H., Goldey, G. J., Diaz, V. E., Jikomes, N., Resch, J. M., et al. (2017) · Nature · doi:10.1038/nature22375 · Cited by 316 · see citing works
Time to connect: bringing social context into addiction neuroscience
Heilig, M., Epstein, D. H., Nader, M. A., & Shaham, Y. (2016) · Nature Reviews Neuroscience · doi:10.1038/nrn.2016.67 · Cited by 298 · see citing works
Circuitry of self-control and its role in reducing addiction
Tang, Y.-Y., Posner, M. I., Rothbart, M. K., & Volkow, N. D. (2015) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2015.06.007 · Cited by 236 · see citing works
Estimation of Current and Future Physiological States in Insular Cortex
Livneh, Y., Sugden, A. U., Madara, J. C., Essner, R. A., Flores, V. I., Sugden, L. A., Resch, J. M., Lowell, B. B., & Andermann, M. L. (2020) · Neuron · doi:10.1016/j.neuron.2019.12.027 · Cited by 209 · see citing works
Zhang, J.-T., Yao, Y.-W., Potenza, M. N., Xia, C.-C., Lan, J., Liu, L., Wang, L.-J., Liu, B., Ma, S.-S., & Fang, X.-Y. (2016) · NeuroImage: Clinical · doi:10.1016/j.nicl.2016.09.004 · Cited by 177 · see citing works
The Insular Cortex: An Interface Between Sensation, Emotion and Cognition
Zhang, R., Deng, H., & Xiao, X. (2024) · Neuroscience Bulletin · doi:10.1007/s12264-024-01211-4 · Cited by 158 · see citing works
The Insula: A “Hub of Activity” in Migraine
Borsook, D., Veggeberg, R., Erpelding, N., Borra, R., Linnman, C., Burstein, R., & Becerra, L. (2016) · The Neuroscientist · doi:10.1177/1073858415601369 · Cited by 146 · see citing works
The Insula: A Brain Stimulation Target for the Treatment of Addiction
Ibrahim, C., Rubin-Kahana, D. S., Pushparaj, A., Musiol, M., Blumberger, D. M., Daskalakis, Z. J., Zangen, A., & Le Foll, B. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.00720 · Cited by 133 · see citing works
Droutman, V., Bechara, A., & Read, S. J. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00309 · Cited by 131 · see citing works
Self-citationXiao, P., Dai, Z., Zhong, J., Zhu, Y., Shi, H., & Pan, P. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.05.030 · Cited by 120 · see citing works
Stewart, J. L., May, A. C., Poppa, T., Davenport, P. W., Tapert, S. F., & Paulus, M. P. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.06.003 · Cited by 86 · see citing works
Oquendo, M. A., Galfalvy, H., Sullivan, G. M., Miller, J. M., Milak, M. M., Sublette, M. E., Cisneros-Trujillo, S., Burke, A. K., Parsey, R. V., & Mann, J. J. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.1478 · Cited by 93 · see citing works
Addicott, M. A., Sweitzer, M. M., Froeliger, B., Rose, J. E., & McClernon, F. J. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.114 · Cited by 85 · see citing works
Turel, O., He, Q., Brevers, D., & Bechara, A. (2018) · Cognitive, Affective, & Behavioral Neuroscience · doi:10.3758/s13415-018-0597-1 · Cited by 84 · see citing works
A genetically defined insula-brainstem circuit selectively controls motivational vigor
Deng, H., Xiao, X., Yang, T., Ritola, K., Hantman, A., Li, Y., Huang, Z. J., & Li, B. (2021) · Cell · doi:10.1016/j.cell.2021.11.019 · Cited by 75 · see citing works
Repeated Binge Drinking Increases Perineuronal Nets in the Insular Cortex
Chen, H., He, D., & Lasek, A. W. (2015) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.12847 · Cited by 77 · see citing works
D-Serine and D-Cycloserine Reduce Compulsive Alcohol Intake in Rats
Seif, T., Simms, J. A., Lei, K., Wegner, S., Bonci, A., Messing, R. O., & Hopf, F. W. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.84 · Cited by 75 · see citing works
Immordino-Yang, M. H., Yang, X.-F., & Damasio, H. (2014) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2014.00728 · Cited by 67 · see citing works
Garrison, K. A., Yip, S. W., Balodis, I. M., Carroll, K. M., Potenza, M. N., & Krishnan-Sarin, S. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.03.035 · Cited by 65 · see citing works
Malik, S., Jacobs, M., Cho, S.-S., Boileau, I., Blumberger, D., Heilig, M., Wilson, A., Daskalakis, Z. J., Strafella, A. P., Zangen, A., et al. (2018) · Brain Imaging and Behavior · doi:10.1007/s11682-017-9800-1 · Cited by 58 · see citing works
Berk, L., Stewart, J. L., May, A. C., Wiers, R. W., Davenport, P. W., Paulus, M. P., & Tapert, S. F. (2015) · Addiction · doi:10.1111/add.13090 · Cited by 42 · see citing works
Fedota, J. R., Matous, A. L., Salmeron, B. J., Gu, H., Ross, T. J., & Stein, E. A. (2016) · Neuropsychopharmacology · doi:10.1038/npp.2016.62 · Cited by 45 · see citing works
Neurostimulation techniques in the treatment of nicotine dependence: a review
Rachid, F. (2016) · The American Journal on Addictions · doi:10.1111/ajad.12405 · Cited by 24 · see citing works
Priddy, S. E., Hanley, A. W., Riquino, M. R., Platt, K. A., Baker, A. K., & Garland, E. L. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.03.040 · Cited by 19 · see citing works
Wang, C., Huang, P., Shen, Z., Qian, W., Li, K., Luo, X., Zeng, Q., Guo, T., Yu, H., Yang, Y., et al. (2019) · Neuroscience Letters · doi:10.1016/j.neulet.2018.12.013 · Cited by 16 · see citing works
Ethanol modulation of cortico-basolateral amygdala circuits: Neurophysiology and behavior
McCool, B. A. (2021) · Neuropharmacology · doi:10.1016/j.neuropharm.2021.108750 · Cited by 7 · see citing works
- Authors
- Naqvi, N. H., Gaznick, N., Tranel, D., & Bechara, A.
- Affiliations
- New York State Psychiatric Institute (US)
- University of Iowa (US)
- University of Southern California (US)
- Corresponding author
- Bechara, Antoine
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 2014-04
- Volume
- 1316
- Issue
- 1
- Pages
- 53-70
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- PMC
- PMC4114146
- OpenAlex
- W2166830183
- Cited by
- 336
- References
- 124
- Citations by year
- 2026: 15 · 2025: 16 · 2024: 29 · 2023: 36 · 2022: 31 · 2021: 34 · 2020: 29 · 2019: 30 · 2018: 26 · 2017: 26 · 2016: 27 · 2015: 30 · 2014: 7
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- NIDA (R01 DA16708, T32 DA007294)
- Leon Levy Foundation
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- insula, drug craving, drug-seeking behavior, addiction, interoception, incentive motivation, inhibitory control, conflict, risk, neural correlates, evolutionary perspective
- MeSH terms
- Animals, Brain Mapping, Cerebral Cortex, Conflict, Psychological, Humans, Models, Theoretical, Smoking, Tobacco Use Disorder, Behavior, Addictive, Substance-Related Disorders, Drug-Seeking Behavior
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
