What is the insular?

The insular cortex is located deep within the lateral fissure, between the frontal and temporal lobes. The insular has connections with the thalamus, amygdala and cortex, with suggested functions including the integration of sensory, affective and cognitive components of a painful stimulus to create the sensation of pain; homeostatic regulation; as well as motor control such as speech articulation; it has also been linked with internal awareness.

What is the evidence for insular alterations?

Moderate quality evidence suggests bilateral reductions in grey matter in the insular in both chronic and first-episode schizophrenia, as well as in people at high risk of schizophrenia, compared to controls. People at high-risk of schizophrenia showed reductions in the right insular only. Moderate to low quality evidence suggests reductions in the grey matter volume of the insular cortex and superior temporal gyrus were associated with increased severity of auditory hallucinations.

Moderate quality evidence suggests people with schizophrenia show increased functional activity in the right insular during executive function tasks compared to controls. Moderate to low quality evidence suggests reduced functional activity in the insular cortex during working memory tasks.

March 2019

Last updated at: 4:02 am, 28th March 2019
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