Cited by 1,272Heart Rate Variability and Autonomic ControlVagus Nerve Stimulation ResearchEpilepsy research and treatment

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Cardiovascular effects of human insular cortex stimulation

Oppenheimer, Stephen M., Gelb, Adrian, Girvin, John P., Hachinski, Vladimir C.·1992·Neurology

DOI 10.1212/wnl.42.9.1727

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Abstract

Recent investigations indicate a site of cardiac representation within the left insular cortex of the rat. Moreover, the results of lesion studies suggest left-sided insular dominance for sympathetic cardiovascular effects. It is unclear whether similar representation exists within the human insular cortex. Five epileptic patients underwent intraoperative insular stimulation prior to temporal lobectomy for seizure control. On stimulation of the left insular cortex, bradycardia and depressor responses were more frequently produced than tachycardia and pressor effects (p less than 0.005). The converse applied for the right insular cortex. We believe this to be the first demonstration of cardiovascular changes elicitable during insular stimulation in humans, and of lateralization of such responses for a cortical site. In humans, unlike the rat, there appears to be right-sided dominance for sympathetic effects. These findings may be of relevance in predicting the autonomic effects of stroke in humans and in the explanation of sudden unexpected epileptic death.

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“The insula is interconnected with the amygdala, thalamus, and orbitofrontal cortex [18], regulates the autonomic nervous system [19], and is involved in the recognition and experience of aversive states [20] and threat processing [21].”
Background
Acute right insular ischaemic lesions and poststroke left ventricular dysfunction
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Neurocardiology
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Self-citation
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Ictal Modulation of Cardiac Repolarization, but Not of Heart Rate, Is Lateralized in Mesial Temporal Lobe Epilepsy
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Authors: Oppenheimer, S. M., Gelb, A., Girvin, J. P., & Hachinski, V. C.
Affiliations: Johns Hopkins University (US)
ORCID: Gelb, Adrian
Hachinski, Vladimir C.
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1992-09
Volume: 42
Issue: 9
Pages: 1727-1727
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.42.9.1727
OpenAlex: W2169985903
Cited by: 1,272
References: 22
Citations by year: 2026: 40 · 2025: 31 · 2024: 38 · 2023: 39 · 2022: 47 · 2021: 48 · 2020: 49 · 2019: 64 · 2018: 62 · 2017: 59 · 2016: 63 · 2015: 57 · 2014: 59 · 2013: 50 · 2012: 48
FWCI: 6.24
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
Keywords: insula, cardiovascular effects, electrical brain stimulation, bradycardia, tachycardia, hemispheric lateralization, epilepsy, sudden unexpected death in epilepsy
MeSH terms: Adolescent, Adult, Analysis of Variance, Blood Pressure, Cardiovascular Physiological Phenomena, Cerebral Cortex, Craniotomy, Epilepsy, Heart Rate, Humans, Male, Chi-Square Distribution

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Cardiovascular effects of human insular cortex stimulation

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