, Volume 259, Issue 4, pp 764-767
Date: 28 Sep 2011

Social-emotional dysfunction after isolated right anterior insular infarction

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Dear Sirs,

Recent human functional neuroimaging studies have demonstrated intrinsic functional connectivity among the anterior insula (AI), anterior cingulate cortex (ACC), amygdala, thalamus, hypothalamus, striatum, and brainstem. These regions have been collectively referred to as the “salience network” due to their consistent activation by diverse, homeostatically relevant stimuli that carry emotional weight [8]. Evidence supporting a role for the salience network in social–emotional function comes from patients with behavioral variant frontotemporal dementia (bvFTD), an early age-of-onset neurodegenerative disorder that produces dramatic changes in social behavior [6, 7]. The right ventral anterior insula, a focus of degeneration in bvFTD, has been proposed as a key hub within this network [9], and functional imaging studies reveal consistent activation of this region during social–emotional processing [3]. The consequences of isolated, destructive anterior insula lesions, however, ...