New observations on the functions attributed to the insular cortex: an integrative literature review




Insula; Autonomic nervous system; Von economo cells; Physiology; Functions.


Introduction: The insula is a brain lobe that grows less during development and, therefore, is covered by the frontal, temporal and parietal lobes. Some of its functions are somatosensory processing, visceral information processing, interoception and empathy. Objective: Recognize the structure and functions of the insular cortex, as it is an area of the human cerebral cortex not yet fully understood. Methodology: This is a literature review, carried out in March 2022, in the following databases: National Library of Medicine (PubMed MEDLINE), Scientific Electronic Library Online (Scielo), Cochrane Database of Systematic Reviews (CDSR), Google Scholar, Virtual Health Library (VHL), Virtual Health Library (VHL) and EBSCO Information Services. Results and Discussion: Current evidence suggests that the insula plays a strong role in conscious feelings by anticipating the body's effects of emotional events. The insular cortex, activated by homeostatic imbalance, or by reward cues, plays a key role in this balancing process, so it is not surprising that the insula is heavily involved in addictive behaviors. In addition, an appropriate level of insular activity is required to provide a warning signal to initiate brain responses to salient stimuli. Conclusion: It is evident that the understanding of the anatomy and functionality of the insular cortex is essential for the elucidation of several neurosensory aspects of the human being, since the insula is functionally heterogeneous, with distinct patterns of connectivity with large-scale brain networks associated with numerous functions and behaviors.


Berntson, G. G., Norman, G. J., Bechara, A., Bruss, J., Tranel, D. & Cacioppo, T. (2010). The Insula and Evaluative Processes. Psychological Science. 22 (1), 80-86.

Caruana, F., Jezzini, A., Fioretti, B. S., Rizzolatti, G. & Gallese, V. (2011). Emotional and Social Behaviors Elicited by Electrical Stimulation of the Insula in the Macaque Monkey. Current Biology. 21 (1), 195-199.

Cauda, F., D’Agata, F., Sacco, K., Duca, S., Germiniani, G. & Vercelli, A. (2011). Functional connectivity of the insula in the resting brain. Neuroimage. 55 (1), 8-23.

Cereda, C., Ghika, J., Maeder, P. & Bogousslavsky, J. (2002). Acidentes vasculares cerebrais restritos ao córtex insular. Neurology. 59 (12).

Coutreras, M., Ceric, F. & Torrealba, F. (2007). Inactivation of the Interoceptive Insula Disrupts Drug Craving and Malaise Induced by Lithium. Science. 318 (26), 655-658.

Craig, A. D. (2011). Significance of the insula for the evolution of human awareness of feelings from the body. Ann. N.Y. Acad. Sci. 1225 (1), 72-82.

Doutrman, V., Read, S. J. & Bechara, A. (2015). Revisiting the role of the insula in addiction. Trends in Cognitive Sciences. 19 (7), 414-420.

Duerden, E. G., Arsalidou, M., Lee, M. & Taylor, M. J. (2013). Lateralization of affective processing in the insula. Neuroimage. 78 (1), 159-175.

Garavan, H. (2010). Ínsula e desejo por drogas. Brain Struct Funct. 214 (1), 593-601.

Gasqoine, P. G. (2014). Contributions of the Insula to Cognition and Emotion. Neuropsychol Rev. 24 (2), 77-87.

Gogolla, N. (2017). O córtex insular. Current Biology. 27 (12), 580-586.

Ibrahim, C., Kahana, D. S. R., Pushparaj, A., Musiol, M., Blumberger, D. M., Daskalakis, Z. J., Zangen, A. & Foll, B. L. (2019). The Insula: a brain simulation target for the treatment of addiction. Frontiers in Pharmacology. 10 (720), 1-18.

Machado, A., Haertel, L. M. (2021). Neuroanatomia funcional. 4ª ed. São Paulo: Atheneu Editora, 2021.

Menon, V. & Uddin, Q. L. (2010). Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 214 (1), 655-667.

Namkung, H., Kim, S. H. & Sawa, A. (2017). The Insula: An Underestimated Brain Area in Clinical Neuroscience, Psychiatry, and Neurology. Trends in Neurosciences. 40 (4), 200-207.

Naqvi, N. H., et al. (2009). The hidden island of addicção: a insula. Trends Neurosci. 32 (1), 56-67.

Naqvi, N. H., et al. (2010). The insula and drug addiction: an interoceptive view of pleasure, urges, and decision-making. Brain Struct Funct. 214 (5), 435-450.

Naqvi, N. H., Rudrauf, D., Damasio, H. & Bechara, A. (2007). Science. 315 (26), 531-534.

Nguyen, D. K., et al. (2009). Revisitando o papel da ínsula na epilepsia parcial refratária. Epilepsia. 50 (3), 510-520.

Papagno, C., et al. (2016). Processamento de nojo específico na ínsula esquerda: novas evidências de estimulação elétrica direta. Neuropsicologia, 84 (1), 29-35.

Paulus, M. P., Rogalsky, C.,Simmons, A., Feinstein, J. S. & Stein, M. B. (2003). Increased activation in the right insula during risk-taking decision making is related to harm avoidance and neuroticism. Neuroimage. 19 (1), 1349-1448.

Preuschoff, K., Quartz, S. R. & Bossaerts, P. (2008). Human Insula Activation Reflects Risk Prediction Errors As Well As Risk. The Journal of Neuroscience. 28 (11), 2745-2752.

Regner, M. F., Tregellas, J., Kluger, B., Wylie, K., Gowin, J. L. & Tanabe, J. (2019). A ínsula no transtorno do uso de nicotina: neuroimagem funcional e implicações para a neuromodulação. Neuroscience and Biobehavioral Reviews. 103 (1), 414-424.

Sabin, G. S., Klumpp, H., Angstadt, M., Nathan, B. J. & Phan, L. K. (2009). Amygdala and insula response to emotional images in patients with generalized social anxiety disorder. J Psychiatry Neurosci. 34 (4), 296-302.

Shura, R. D., Hurley, R. A.; Taber, K. H. (2014). Insular cortex: structural and functional neuroanatomy. The journal of neuropsychiatry and clinical neurosciences. 26 (4). 276-282.

Singer, T., Critchley, HD e Preuschoff, K. (2009). Um papel comum da ínsula em sentimentos, empatia e incerteza. Trends in Cognitive Sciences, 13 (8), 334-340.

Stein, M. B., Simmons, A. N., Feinstein, J. S. & Paulus, M. P. (2007). Increased Amygdala and Insula Activation During Emotion Processing in Anxiety-Prone Subjects. Am J Psychiatry.164 (2), 318-327.

Tippett, D. C., Godin, B. R., Oishi, K., Davis, C., Gomez, B. S. Y., Trupe, L. A., Kim, E. H. & Hillis, A. E. (2018). Impaired Recognition of Emotional Faces after Stroke Involving Right Amygdala or Insula. Semin Speech Lang. 39 (1), 87-100.

Treadway, M. T. & Zald, D. H. (2013). Parsing anhedonia: trans-modelos nacionais de déficits de processamento de recompensa em psicopatologia. Curr. Dir. Psychol. Sci. 22 (1), 244-249.

Turel, O., He, Q., Wei, L. & Bechara, A. (2020). The role of the insula in internet gaming disorder. Addiction Biology. 26 (2), 1-11.

Uddin, L. Q., et al. (2017). Estrutura e função da ínsula humana. Journal of Clinical Neurophysiology, 34 (4), 300-306.

Uddin, L. Q., Nomi, J. S., Seropian, B. H., Ghaziri, J. & Boucher, O. (2017). Structure and function of the human insula. J Clin Neurophysiol. 34 (4), 300-306.

Ullsperger, M., Harsay, H. A., Wessel, J. R. & Ridderinkhof, R. (2010). Conscious perception of errors and its relation to the anterior insula. Brain Struct Funct. 214 (1), 629-643.



How to Cite

FIGUEIREDO, B. Q. de .; ARAÚJO, C. Q. L. de .; BRITO, E. N. D.; TEIXEIRA, G. S. de B.; COSTA, J. S. C.; BARBOSA, M. M. S. New observations on the functions attributed to the insular cortex: an integrative literature review. Research, Society and Development, [S. l.], v. 11, n. 6, p. e24911629192, 2022. DOI: 10.33448/rsd-v11i6.29192. Disponível em: Acesso em: 20 jun. 2024.



Health Sciences