Cited by 146Migraine and Headache StudiesPain Mechanisms and TreatmentsPsychosomatic Disorders and Their Treatments

The Insula: A “Hub of Activity” in Migraine

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Borsook, David, Veggeberg, Rosanna, Erpelding, Nathalie, Borra, Ronald, Linnman, Clas, Burstein, Rami, Becerra, Lino·2016·The Neuroscientist

Abstract

The insula, a “cortical hub” buried within the lateral sulcus, is involved in a number of processes including goal-directed cognition, conscious awareness, autonomic regulation, interoception, and somatosensation. While some of these processes are well known in the clinical presentation of migraine (i.e., autonomic and somatosensory alterations), other more complex behaviors in migraine, such as conscious awareness and error detection, are less well described. Since the insula processes and relays afferent inputs from brain areas involved in these functions to areas involved in higher cortical function such as frontal, temporal, and parietal regions, it may be implicated as a brain region that translates the signals of altered internal milieu in migraine, along with other chronic pain conditions, through the insula into complex behaviors. Here we review how the insula function and structure is altered in migraine. As a brain region of a number of brain functions, it may serve as a model to study new potential clinical perspectives for migraine treatment.

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  • Interoceptive awareness localizes to the insula, a brain area considered a hub of activity in migraine that plays a key role in integrating sensory, autonomic, cognitive, and emotional processes.

    “Interoceptive awareness localizes to the insula,39 an area of the brain considered a “hub of activity” in migraine, playing a key role in integrating many of the dynamic processes of migraine (sensory, autonomic, cognitive, and emotional).40”

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Authors
Borsook, D., Veggeberg, R., Erpelding, N., Borra, R., Linnman, C., Burstein, R., & Becerra, L.
Affiliations
  • Boston Children's Hospital (US)
  • Beth Israel Deaconess Medical Center (US)
Corresponding author
Borsook, David
Venue
The Neuroscientist
Published
2016-07-07
Volume
22
Issue
6
Pages
632-652
ISSN
  • 1073-8584 (ISSN-L)
  • 1089-4098
OpenAlex
W1758874480
Cited by
146
References
276
Citations by year
2026: 7 · 2025: 17 · 2024: 11 · 2023: 16 · 2022: 14 · 2021: 17 · 2020: 20 · 2019: 14 · 2018: 8 · 2017: 15 · 2016: 6 · 2014: 1
FWCI
1.33
Type
journal article
Language
en
Open access
Locations
  • The Neuroscientist (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Funders
  • National Institutes of Health
  • National Institute of Neurological Disorders and Stroke (R01NS056195, K24NS064050)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
insula, migraine, interoception, somatosensory perception, autonomic regulation, conscious awareness, error detection, goal-directed cognition, chronic pain, migraine treatment
MeSH terms
Animals, Brain Mapping, Cerebral Cortex, Cognition, Humans, Migraine Disorders, Nerve Net, Neural Pathways

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