The neuropsychological impact of insular cortex lesions
Open accessAbstract
Influential models based on an increasing body of neuroimaging evidence propose that insular cortex integrates cognitive, affective, sensory and autonomic information to create a consciously perceived, 'feeling state.' To appraise these models and evaluate interpretations of neuroimaging findings, the authors review evidence pertaining to the psychological and behavioural consequences of insula lesions. The authors focus on the emotional, perceptual, sensorimotor symptoms and disorders of body awareness associated with insula damage. This comprehensive review is intended to inform existing neuropsychological models of insula function in order to guide future research.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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 insular cortex is a critical neural substrate for interoceptive and emotional awareness.
“the insular cortex has been singled out as a critical neural substrate for interoceptive and emotional awareness”
From Anterior insular cortex and emotional awareness (2013) · cites this paper as Jones et al., 2010
AIC and ACC are usually considered as one system with AIC as input sensory region and ACC as output control region.
“Although AIC and ACC are usually considered as one system with AIC as the input sensory region and ACC as the output control region (Seeley et al., 2007; Craig, 2009; Jones et al., 2010), the finding that ACC is usually activated by but not necessary for empathetic pain perception suggests the existence of multiple control regions other than ACC and that AIC is the only critical input region.”
From Anterior insular cortex and emotional awareness (2013) · cites this paper as Jones et al., 2010
Lesions to insular cortex do not always give rise to dissociative symptoms, raising the possibility that the predictive processes underlying presence play out across multiple brain regions with key nodes potentially extending down into brainstem areas.
“lesions to insular cortex do not always give rise to dissociative symptoms (Jones et al., 2010), raising the possibility that the predictive processes underlying presence play out across multiple brain regions with key nodes potentially extending down into brainstem areas (Damasio, 2010).”
From An Interoceptive Predictive Coding Model of Conscious Presence (2012) · cites this paper as Jones et al., 2010
Cites
How do you feel — now? The anterior insula and human awareness
(Bud) Craig, A. D. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2555 · Cited by 6,657 · cited 1× · see citing works
“Thus, one challenge in developing a satisfactory neuropsychological model of insula function is to account for its involvement across these different domains which require access across multiple functional circuits. It is thus unclear if a unitary account of insula functioning is feasible or realistic. In the most gen…”
BackgroundCognitive, social, and physiological determinants of emotional state.
Schachter, S., & Singer, J. (1962) · Psychological Review · doi:10.1037/h0046234 · Cited by 6,223 · see citing works
Insensitivity to future consequences following damage to human prefrontal cortex
Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994) · Cognition · doi:10.1016/0010-0277(94)90018-3 · Cited by 6,128 · see citing works
Neural systems supporting interoceptive awareness
Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004) · Nature Neuroscience · doi:10.1038/nn1176 · Cited by 3,406 · cited 2× · see citing works
“and underpin certain subjective states such as those implicated in anxiety [18, 81].”
BackgroundSelf-citationThe somatic marker hypothesis and the possible functions of the prefrontal cortex
Damasio, A. R. (1996) · Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences · doi:10.1098/rstb.1996.0125 · Cited by 2,847 · see citing works
Paulus, M. P., & Stein, M. B. (2006) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.03.042 · Cited by 1,325 · see citing works
Cardiovascular effects of human insular cortex stimulation
Oppenheimer, S. M., Gelb, A., Girvin, J. P., & Hachinski, V. C. (1992) · Neurology · doi:10.1212/wnl.42.9.1727 · Cited by 1,272 · see citing works
A common role of insula in feelings, empathy and uncertainty
Singer, T., Critchley, H. D., & Preuschoff, K. (2009) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2009.05.001 · Cited by 1,270 · see citing works
Self-citationThe 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 · cited 1× · see citing works
“This finding is also in line with a Somatic Marker model of addictive behaviour in which exposure to or recollection of an experience associated with a drug can reactivate this ‘interoceptive memory ’ state.(7) Future patient studies will establish how general the effects of insula lesions are on other forms of addict…”
ResultHuman cortical gustatory areas: A review of functional neuroimaging data
Small, D. M., Zald, D. H., Jones-Gotman, M., Zatorre, R. J., Pardo, J. V., Frey, S., & Petrides, M. (1999) · NeuroReport · doi:10.1097/00001756-199901180-00002 · Cited by 431 · see citing works
Neural Correlates of Auditory–Visual Stimulus Onset Asynchrony Detection
Bushara, K. O., Grafman, J., & Hallett, M. (2001) · The Journal of Neuroscience · doi:10.1523/jneurosci.21-01-00300.2001 · Cited by 361 · see citing works
Neural Origins of Human Sickness in Interoceptive Responses to Inflammation
Harrison, N. A., Brydon, L., Walker, C., Gray, M. A., Steptoe, A., Dolan, R. J., & Critchley, H. D. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.03.007 · Cited by 345 · see citing works
Self-citationStrokes restricted to the insular cortex
Cereda, C., Ghika, J., Maeder, P., & Bogousslavsky, J. (2002) · Neurology · doi:10.1212/01.wnl.0000038905.75660.bd · Cited by 302 · see citing works
Pain sensitivity alterations as a function of lesion location in the parasylvian cortex
Greenspan, J. D., Lee, R. R., & Lenz, F. A. (1999) · Pain · doi:10.1016/s0304-3959(99)00021-4 · Cited by 297 · see citing works
Taste perception in patients with insular cortex lesions
Pritchard, T. C., Macaluso, D. A., & Eslinger, P. J. (1999) · Behavioral Neuroscience · doi:10.1037/0735-7044.113.4.663 · Cited by 225 · cited 2× · see citing works
“, 1999 [48] 6 >1year Right (n=1) Left (n=5) Rostrodors al versus nonrostrodorsal Impaired taste recognition and magnitude estimate (taste intensity) in patients with rostrodorsal lesions.”
BackgroundPeyron, R., Frot, M., Schneider, F., Garcia-Larrea, L., Mertens, P., Barral, F. G., Sindou, M., Laurent, B., & Mauguière, F. (2002) · NeuroImage · doi:10.1006/nimg.2002.1315 · Cited by 209 · see citing works
Interoceptive basis to craving
Gray, M. A., & Critchley, H. D. (2007) · Neuron · doi:10.1016/j.neuron.2007.03.024 · Cited by 189 · see citing works
Self-citationModulation of Emotional Appraisal by False Physiological Feedback during fMRI
Gray, M. A., Harrison, N. A., Wiens, S., & Critchley, H. D. (2007) · PLoS ONE · doi:10.1371/journal.pone.0000546 · Cited by 170 · see citing works
Self-citationThe effects of insula damage on decision-making for risky gains and losses
Weller, J. A., Levin, I. P., Shiv, B., & Bechara, A. (2009) · Social Neuroscience · doi:10.1080/17470910902934400 · Cited by 119 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
An Interoceptive Predictive Coding Model of Conscious Presence
Seth, A. K., Suzuki, K., & Critchley, H. D. (2012) · Frontiers in Psychology · doi:10.3389/fpsyg.2011.00395 · Cited by 950 · see citing works
“Further, lesions to insular cortex do not always give rise to dissociative symptoms (Jones et al., 2010), raising the possibility that the predictive processes underlying presence play out across multiple brain regions with key nodes potentially extending down into brainstem areas (Damasio, 2010).”
BackgroundSelf-citationAnterior insular cortex and emotional awareness
Gu, X., Hof, P. R., Friston, K. J., & Fan, J. (2013) · Journal of Comparative Neurology · doi:10.1002/cne.23368 · Cited by 712 · see citing works
“…2007; Lieberman, 2007), the insular cortex has been singled out as a critical neural substrate for interoceptive and emotional awareness (Craig, 2009, 2010, 2011; Singer et al., 3372 The Journal of Comparative Neurology |Research in Systems Neuroscience 2009; Jones et al., 2010; Seth et al., 2011).”
InfluentialNieuwenhuys, R. (2012) · Progress in Brain Research · doi:10.1016/b978-0-444-53860-4.00007-6 · Cited by 580 · see citing works
Flowers, H. L., Silver, F. L., Fang, J., Rochon, E., & Martino, R. (2013) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2013.04.001 · Cited by 249 · see citing works
The Embodiment of Emotional Feelings in the Brain
Harrison, N. A., Gray, M. A., Gianaros, P. J., & Critchley, H. D. (2010) · The Journal of Neuroscience · doi:10.1523/jneurosci.1725-10.2010 · Cited by 250 · see citing works
Self-citationNeural systems underlying approach and avoidance in anxiety disorders
Robin L., A., & Martin, P. P. (2010) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2010.12.4/raupperle · Cited by 227 · see citing works
Atypical interoception as a common risk factor for psychopathology: A review
Brewer, R., Murphy, J., & Bird, G. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.036 · Cited by 180 · see citing works
Klumpp, H., Fitzgerald, D. A., & Phan, K. L. (2013) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2013.05.004 · Cited by 126 · see citing works
Amygdala hyperreactivity in restrictive anorexia nervosa
Joos, A. A. B., Saum, B., van Elst, L. T., Perlov, E., Glauche, V., Hartmann, A., Freyer, T., Tüscher, O., & Zeeck, A. (2011) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2010.11.008 · Cited by 124 · see citing works
Xiao, 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
Acquired alexithymia following damage to the anterior insula
Hogeveen, J., Bird, G., Chau, A., Krueger, F., & Grafman, J. (2016) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2016.01.021 · Cited by 116 · see citing works
Glucose Metabolism in the Insula and Cingulate Is Affected by Systemic Inflammation in Humans
Hannestad, J., Subramanyam, K., DellaGioia, N., Planeta-Wilson, B., Weinzimmer, D., Pittman, B., & Carson, R. E. (2012) · Journal of Nuclear Medicine · doi:10.2967/jnumed.111.097014 · Cited by 113 · see citing works
The bodily self and its disorders: neurological, psychological and social aspects
Brugger, P., & Lenggenhager, B. (2014) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000151 · Cited by 82 · see citing works
Anterior insula reflects surprise in value-based decision-making and perception
Loued-Khenissi, L., Pfeuffer, A., Einhäuser, W., & Preuschoff, K. (2020) · NeuroImage · doi:10.1016/j.neuroimage.2020.116549 · Cited by 66 · see citing works
Klumpp, H., Fitzgerald, D. A., Angstadt, M., Post, D., & Phan, K. L. (2014) · Psychological Medicine · doi:10.1017/s0033291714000567 · Cited by 75 · see citing works
Moon, Y., Moon, W.-J., Kim, H., & Han, S.-H. (2014) · European Neurology · doi:10.1159/000356343 · Cited by 56 · 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
Interoception and Psychopathology
Medford, N., Quadt, L., & Critchley, H. (2024) · Phenomenological Neuropsychiatry · doi:10.1007/978-3-031-38391-5_13 · Cited by 2 · see citing works
Self-citation
- Authors
- Jones, C. L., Ward, J., & Critchley, H. D.
- Affiliations
- University of Sussex (GB)
- Brighton and Sussex Medical School (GB)
- Corresponding author
- Jones, C. L.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2010-06-01
- Volume
- 81
- Issue
- 6
- Pages
- 611-618
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2100985172
- Cited by
- 158
- References
- 19
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 12 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 13 · 2015: 11 · 2014: 17 · 2013: 9 · 2012: 17
- FWCI
- 9.16
- Type
- journal article
- Language
- en
- Open access
- green
- hal.science
- Licence
- other-oa
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Figshare (submittedVersion, cc-by)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
- Keywords
- insula, neuropsychological outcomes, emotional symptoms, autonomic integration
- MeSH terms
- Arousal, Cerebral Cortex, Cognition Disorders, Decision Making, Frontal Lobe, Humans, Motivation, Neuropsychological Tests, Severity of Illness Index, Mood Disorders
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
