Neuropsychological Deficits Due to Insular Damage

  • Olivier Boucher
  • Daphné Citherlet
  • Benjamin Hébert-Seropian
  • Dang Khoa NguyenEmail author


Although our comprehension on the functions of the human insula has greatly benefited from functional neuroimaging and cortical stimulation studies over the past two decades, lesion studies provide unique insights on the role(s) it exerts in neuropsychological functioning. However, cerebral damage confined to the insular cortex is extremely uncommon. The characterization of the neuropsychological deficits due to insular injury is further complicated by the possible specialization of insular functions in each cerebral hemisphere, by the variety of clinical presentations associated with lesions damaging different parts of the insula, and by the fact that almost all insular lesions are unilateral. This chapter reviews the literature on the neuropsychological consequences of insular lesions in humans. A selective review of the literature is performed, with more consideration given to isolated ischemic insular strokes. The effects of insular damage are very heterogeneous, with neuropsychological deficits being reported in the sensory (somatosensory, interoceptive, and vestibular processing, neglect, audition, olfaction, and taste), cognitive (speech, memory, attention, and executive functions), and affective (emotional experience, social cognitive, and risky decision-making) domains. In many cases, the neuropsychological consequences are transient or alleviated with time. The various clinical presentations of insular injury are congruent with the widespread connectivity of the insula with other brain regions.


Cognition Damage Deficit Emotion Impairment Insula Lesion Neuropsychology Sensory Stroke 


  1. 1.
    Uddin LQ, Nomi JS, Hébert-Seropian B, Ghaziri J, Boucher O. Structure and function of the human insula. J Clin Neurophysiol. 2017;34:300–6.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Kurth F, Zilles K, Fox PT, Laird AR, Eickhoff SB. A link between the systems: functional differentiation and integration within the human insula revealed by meta-analysis. Brain Struct Fucnt. 2010;214:519–34.CrossRefGoogle Scholar
  3. 3.
    Mazzola L, Mauguière F, Isnard J. Electrical stimulations of the human insula: their contribution to the ictal semiology of insular seizures. J Clin Neurophysiol. 2017;34:307–14.PubMedCrossRefGoogle Scholar
  4. 4.
    Ibañez A, Gleichgerrcht E, Manes F. Clinical effects of insular damage in humans. Brain Struct Funct. 2010;214:397–410.PubMedCrossRefGoogle Scholar
  5. 5.
    Türe U, Yaşargil MG, Al-Mefty O, Yaşargil DC. Arteries of the insula. J Neurosurg. 2000;92:676–87.PubMedCrossRefGoogle Scholar
  6. 6.
    Cereda C, Ghika J, Maeder P, Bogousslavsky J. Strokes restricted to the insular cortex. Neurology. 2002;59:1950–5.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Dronkers NF. A new brain region for coordinating speech articulation. Nature. 1996;384:159–61.PubMedCrossRefGoogle Scholar
  8. 8.
    Karnath HO, Baier B, Nagele T. Awareness of the functioning of one’s own limbs mediated by the insular cortex? J Neurosci. 2005;25:7134–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Bates E, Wilson SM, Saygin AP, Dick F, Sereno MI, Knight RT, et al. Voxel-based lesion-symptom mapping. Nat Neurosci. 2003;6:448–50.PubMedCrossRefGoogle Scholar
  10. 10.
    Moon HI, Pyun SB, Tae WS, Kwon HK. Neural substrates of lower extremity motor, balance, and gait function after supratentorial stroke using voxel-based lesion symptom mapping. Neuroradiology. 2016;58:723–31.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Kodumuri N, Sebastian R, Davis C, Posner J, Kim EH, Tippett DC, et al. The association of insular stroke with lesion volume. Neuroimage Clin. 2016;11:41–5.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Gras-Combe G, Minotti L, Hoffmann D, Krainik A, Kahane P, Chabardes S. Surgery for nontumoral insular epilepsy explored by stereoelectroencephalography. Neurosurgery. 2016;79:578–88.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Kalani MY, Kalani MA, Gwinn R, Keogh B, Tse VC. Embryological development of the human insula and its implications for the spread and resection of insular gliomas. Neurosurg Focus. 2009;27:E2.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Skrap M, Mondani M, Tomasino B, Weis L, Budai R, Pauletto G, et al. Surgery of insular nonenhancing gliomas: volumetric analysis of tumoral resection, clinical outcome, and survival in a consecutive series of 66 cases. Neurosurgery. 2012;70:1081–93.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Finet P, Nguyen DK, Bouthillier A. Vascular consequences of operculoinsular corticectomy for refractory epilepsy. J Neurosurg. 2015;122:1293–8.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Simon M, Neuloh G, von Lehe M, Meyer B, Schramm J. Insular gliomas: the case for surgical management. J Neurosurg. 2009;110:685–95.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Mesulam MM, Mufson EJ. Insula of the old world monkey. III: efferent cortical output and comments on function. J Comput Neurosci. 1982;212:38–52.CrossRefGoogle Scholar
  18. 18.
    Greenspan JD, Lee RR, Lenz FA. Pain Sensitivity alterations as a function of lesion location in the parasylvian cortex. Pain. 1999;81:273–82.PubMedCrossRefGoogle Scholar
  19. 19.
    Starr CJ, Sawaki L, Wittenberg GF, Burdette JH, Oshiro Y, Quevedo AS, Coghill RC. Roles of the insular cortex in the modulation of pain: insights from brain lesions. J Neurosci. 2009;29:2684–94.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Berthier M, Starkstein S, Leiguarda R. Asymbolia for pain: a sensory-limbic disconnection syndrome. Ann Neurol. 1988;24:41–9.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Garcia-Larrea L, Perchet C, Creac'h C, Convers P, Peyron R, Laurent B, et al. Operculo-insular pain parasylvian pain: a distinct central pain syndrome. Brain. 2010;133:2528–39.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Denis DJ, Marouf R, Rainville P, Bouthillier A, Nguyen DK. Effects of insular stimulation on thermal nociception. Eur J Pain. 2016;20:800–10.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Birklein F, Rolke R, Müller-Forell W. Isolated insular infarction eliminates contralateral cold, cold pain, and pinprick perception. Neurology. 2005;65:1381.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Baier B, zu Eulenburg P, Geber C, Rohde F, Rolke R, Maihöfner C, et al. Insula and sensory insular cortex and somatosensory control in patients with insular stroke. Eur J Pain. 2014;18:1385–93.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Cattaneo L, Chierici E, Cucurachi L, Cobelli R, Pavesi G. Posterior insular stroke causing selective loss of contralateral nonpainful thermal sensation. Neurology. 2007;68:237.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Augustine JR. Circuitry and functional aspects of he insular lobe in primates including humans. Brain Res Brain Res Rev. 1996;22:229–44.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Fifer RC. Insular stroke causing unilateral auditory processing disorder: case report. J Am Acad Audiol. 1993;4:364–9.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Habib M, Daguin G, Milandre L, Royere ML, Rey M, Lanteri A, et al. Mutism and auditory agnosia due to bilateral insular damage – role of the insula in human communication. Neuropsychologia. 1995;33:327–39.PubMedCrossRefGoogle Scholar
  29. 29.
    Griffiths TD, Rees A, Witton C, Cross PM, Shakir RA, Green GG. Spatial and temporal auditory processing deficits following right hemisphere infarction. A psychophysical study. Brain. 1997;120:785–94.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Ayotte J, Peretz I, Rousseau I, Bard C, Bojanowski M. Patterns of music agnosia associated with middle cerebral artery infarcts. Brain. 2000;123:1926–38.PubMedCrossRefGoogle Scholar
  31. 31.
    Griffiths TD, Warren JD, Dean JL, Howard D. “When the feeling’s gone”: a selective loss of musical emotion. J Neurol Neurosurg Psychiatry. 2004;75:344–5.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Bamiou DE, Musiek FE, Stow I, Stevens J, Cipolotti L, Brown MM, et al. Auditory temporal processing deficits in patients with insular stroke. Neurology. 2006;67:614–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Boucher O, Turgeon C, Chapoux S, Ménard L, Rouleau I, Lassonde M, et al. Hyperacusis following unilateral damage to the insular cortex: a three-case report. Brain Res. 2015;1606:102–12.PubMedCrossRefGoogle Scholar
  34. 34.
    Tomasino B, Marin D, Canderan C, Maieron M, Skrap M, Rumiati RI. Neuropsychological patterns following lesions of the anterior insula in a series of forty neurosurgical patients. AIMS Neurosci. 2014;1:225–44.CrossRefGoogle Scholar
  35. 35.
    Mak YE, Simmons KB, Gitelman DR, Small DM. Taste and olfactory intensity perception changes following left insular stroke. Behav Neurosci. 2005;119:1693–700.PubMedCrossRefGoogle Scholar
  36. 36.
    Ribas ES, Duffau H. Permanent anosmia and ageusia after resection of a left temporoinsular low-grade glioma: anatomofunctional considerations. J Neurosurg. 2012;116:1007–13.PubMedCrossRefGoogle Scholar
  37. 37.
    Metin B, Melda B, Birsen I. Unusual clinical manifestation of a cerebral infarction restricted to the insulate cortex. Neurocase. 2007;13:94–6.PubMedCrossRefGoogle Scholar
  38. 38.
    Beume LA, Klingler A, Reinhard M, Niesen WD. Olfactory hallucinations as primary symptom for ischemia in the right posterior insula. J Neurol Sci. 2015;354:138–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Pritchard TC, Macaluso DA, Eslinger PJ. Taste perception in patients with insular cortex lesions. Behav Neurosci. 1999;113:663–71.PubMedCrossRefGoogle Scholar
  40. 40.
    Stevenson RJ, Miller LA, McGrillen K. The lateralization of gustatory function and the flow of information from tongue to cortex. Neuropsychologia. 2013;51:1408–16.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Mazzola L, Lopez C, Faillenot I, Chouchou F, Mauguière F, Isnard J. Vestibular responses to direct stimulation of the human insular cortex. Ann Neurol. 2014;76:609–19.PubMedCrossRefGoogle Scholar
  42. 42.
    Lopez C, Blanke O, Mast FW. The human vestibular cortex revealed by coordinate-based activation likelihood estimation meta-analysis. Neuroscience. 2012;212:159–79.PubMedCrossRefGoogle Scholar
  43. 43.
    zu Eulenburg P, Caspers S, Roski C, Eickhoff SB. Meta-analytical definition and functional connectivity of the human vestibular cortex. NeuroImage. 2012;60:162–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Papathanasiou ES, Papacostas SS, Charalambous M, Eracleous E, Thodi C, Pantzaris M. Vertigo and imbalance caused by a small lesion in the anterior insula. Electromyogr Clin Neurophysiol. 2006;46:185–92.PubMedGoogle Scholar
  45. 45.
    Baier B, Conrad J, Zu Eulenburg P, Best C, Müller-Forell W, Birklein F, et al. Insular strokes cause no vestibular deficits. Stroke. 2013;44:2604–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Khalsa SS, Rudrauf D, Feinstein JS, Tranel D. The pathways of interoceptive awareness. Nat Neurosci. 2009;12:1494–6.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Grossi D, De Vita A, Palermo L, Sabatini U, Trojano L, Guariglia C. The brain network for self-feeling: a symptom-lesion mapping study. Neuropsychologia. 2014;63:92–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Ronchi R, Bello-Ruiz J, Lukowska M, Herbelin B, Cabrilo I, Schaller K, Blanke O. Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness. Neuropsychologia. 2015;70:11–20.PubMedCrossRefGoogle Scholar
  49. 49.
    Schandry R. Heart beat perception and emotional experience. Psychophysiology. 1981;18:483–8.PubMedCrossRefGoogle Scholar
  50. 50.
    Damasio A. Descartes’ error: emotion, reason and the human brain. Grosset/Putnam: New York, NY; 1994.Google Scholar
  51. 51.
    Craig AD. How do you feel—now? The anterior insula and human awareness. Nat Rev Neurosci. 2009;10:59–70.PubMedCrossRefGoogle Scholar
  52. 52.
    Philippi CL, Feinstein JS, Khalsa SS, Damasio A, Tranel D, Landini G, et al. Preserved self-awareness following extensive bilateral brain damage to the insula, anterior cingulate, and medial prefrontal cortices. PLoS One. 2012;7:e38413.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Karnath HO, Berger MF, Küker W, Rorden C. The anatomy of spatial neglect based on voxelwise statistical analysis: a study of 140 patients. Cereb Cortex. 2004;14:1164–72.PubMedCrossRefGoogle Scholar
  54. 54.
    Berthier M, Starkstein S, Leiguarda R. Behavioral effects of damage to the right insula and surrounding regions. Cortex. 1987;23:673–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Manes F, Paradiso S, Springer JA, Lamberty G, Robinson RG. Neglect after right insular cortex infarction. Stroke. 1999;30:946–8.PubMedCrossRefGoogle Scholar
  56. 56.
    Golay L, Schnider A, Ptak R. Cortical and subcortical anatomy of chronic spatial neglect following vascular damage. Behav Brain Funct. 2008;4:43.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Chechlacz M, Rotshtein P, Roberts KL, Bickerton WL, Lau JKL, Humphreys GW. The prognosis of allocentric and egocentric neglect: evidence from clinical scans. PLoS One. 2012;7:e47821.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Kenzie JM, Girgulis K, Semrau JA, Findlater SE, Desai JA, Dukelow SP. Lesion sites associated with allocentric and egocentric visuospatial neglect in acute stroke. Brain Connect. 2015;5:413–22.PubMedCrossRefGoogle Scholar
  59. 59.
    Pedrazzini E, Schnider A, Ptak R. A neuroanatomical model of space-based and object-centered processing in spatial neglect. Brain Struct Funct. 2017;222(8):3605–13. Scholar
  60. 60.
    Smith DV, Clithero JA, Rorden C, Karnath HO. Decoding the anatomical network of spatial attention. Proc Natl Acad Sci U S A. 2013;110:1518–23.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Shuren J. Insula and aphasia. J Neurol. 1993;240:216–8.PubMedCrossRefGoogle Scholar
  62. 62.
    Borovsky A, Saygin AP, Bates E, Dronkers N. Lesion correlates of conversational speech production deficits. Neuropsychologia. 2007;45:2525–33.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    Marshall RS, Laza RM, Mohr JP, Van Heertum RL, Mast H. “Semantic” conduction aphasia from a posterior insular cortex infarction. J Neuroimaging. 1996;6:189–91.PubMedCrossRefGoogle Scholar
  64. 64.
    Carota A, Annoni JM, Marangolo P. Repeating through the insula: evidence from two consecutive strokes. Neuroreport. 2007;18:1367–70.PubMedCrossRefGoogle Scholar
  65. 65.
    Kreisler A, Godefroy O, Delmaire C, Debachy B, Leclercq M, Pruvo JP, et al. The anatomy of aphasia revisited. Neurology. 2000;54:1117–23.PubMedCrossRefGoogle Scholar
  66. 66.
    Nagao M, Takeda K, Komori T, Isozaki E, Hirai S. Apraxia of speech associated with an infarct in the precentral gyrus of the insula. Neuroradiology. 1999;41:356–7.PubMedCrossRefGoogle Scholar
  67. 67.
    Baldo JV, Wilkins DP, Ogar J, Willock S, Dronkers NF. Role of the precentral gyrus of the insula in complex articulation. Cortex. 2011;47:800–7.PubMedCrossRefGoogle Scholar
  68. 68.
    Hiraga A, Tanaka S, Kamitsukasa I. Pure dysarthria due to an insular infarction. J Clin Neurosci. 2010;17:812–3.PubMedCrossRefGoogle Scholar
  69. 69.
    Boucher O, Rouleau I, Escudier F, Malenfant A, Denault C, Charbonneau S, et al. Neuropsychological performance before and after partial or complete insulectomy in patients with epilepsy. Epilepsy Behav. 2015;43:53–60.PubMedCrossRefGoogle Scholar
  70. 70.
    Lang FF, Olansen NE, DeMonte F, Gokaslan ZL, Holland EC, Kalhorn C, et al. Surgical resection of intrinsic insular tumors: complication avoidance. J Neurosurg. 2001;95:638–50.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Duffau H, Taillandier L, Gatignol P, Capelle L. The insular lobe and brain plasticity: lessons from tumor surgery. Clin Neurol Neurosurg. 2006;108:543–8.PubMedCrossRefGoogle Scholar
  72. 72.
    Sanai N, Polley MY, Berger MS. Insular gioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg. 2010;112:1–9.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Manes F, Springer J, Jorge R, Robinson RG. Verbal memory impairment after left insular cortex infarction. J Neurol Neurosurg Psychiatry. 1999;67(4):532.PubMedPubMedCentralCrossRefGoogle Scholar
  74. 74.
    Wu AS, Witgert ME, Lang FF, Xiao L, Bekele BN, Meyers CA, et al. Neurocognitive function before and after surgery for insular gliomas. J Neurosurg. 2011;115:1115–25.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Menon V, Uddin LQ. Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 2010;214:655–67.PubMedPubMedCentralCrossRefGoogle Scholar
  76. 76.
    Markostamou I, Rudolf J, Tsiptsious I, Kosmidis MH. Impaired executive functioning after left anterior insular stroke: a case report. Neurocase. 2014;21:148–53.PubMedCrossRefGoogle Scholar
  77. 77.
    Borg C, Bedoin N, Peyron R, Bogey S, Laurent B, Thomas-Antérion C. Impaired emotional processing in a patient with a left posterior insula-SII lesion. Neurocase. 2013;19:592–603.PubMedCrossRefGoogle Scholar
  78. 78.
    Calder AJ, Keane J, Manes F, Antoun N, Young AW. Impaired recognition and experience of disgust following brain injury. Nat Neurosci. 2000;3:1077–8.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Brown S, Gao X, Tisdelle L, Eickhoff SB, Liotti M. Naturalizing aesthetics: brain areas for aesthetic appraisal across sensory modalities. NeuroImage. 2011;58:250–8.PubMedCrossRefGoogle Scholar
  80. 80.
    Phillips ML, Young AW, Senior C, Brammer M, Andrew C, Calder AJ, et al. A specific neural substrate for perceiving facial expressions of disgust. Nature. 1997;389:495–8.PubMedCrossRefGoogle Scholar
  81. 81.
    Stark R, Zimmermann M, Kagerer S, Schienle A, Walter B, Weygandt M, et al. Hemodynamic brain correlates of disgust and fear ratings. NeuroImage. 2007;37:663–73.PubMedCrossRefGoogle Scholar
  82. 82.
    Straube T, Weisbrod A, Schmidt S, Raschdorf C, Preul C, Mentzel HJ, et al. No impairment of recognition and experience of disgust in a patient with a right-hemispheric lesion of the insula and basal ganglia. Neuropsychologia. 2010;48:1735–41.PubMedCrossRefGoogle Scholar
  83. 83.
    Wicker B, Keysers C, Plailly J, Royet JP, Gallese V, Rizzolatti G. Both of us disgusted in my insula: the common neural basis of seeing and feeling disgust. Neuron. 2003;40:655–64.PubMedCrossRefGoogle Scholar
  84. 84.
    Manes F, Paradiso S, Robinson RG. Neuropsychiatric effects of insular stroke. J Nerv Ment Dis. 1999;187(12):707.PubMedCrossRefGoogle Scholar
  85. 85.
    Thomas-Antérion C, Creac’h C, Dionet E, Borg C, Extier C, Faillenot I, et al. De novo artistic activity following insular-SII ischemia. Pain. 2010;150:121–7.PubMedCrossRefGoogle Scholar
  86. 86.
    Hébert-Seropian B, Boucher O, Sénéchal C, Rouleau I, Bouthillier A, Lepore F, et al. Does unilateral insular resection disturb personality? A study with epileptic patients. J Clin Neurosci. 2017;43:121–5. Scholar
  87. 87.
    Cho HJ, Kim SJ, Hwang SJ, Jo MK, Kim HJ, Seeley WW, et al. Social-emotional dysfunction after isolated right anterior insular infarction. J Neurol. 2012;259:764–7.PubMedCrossRefGoogle Scholar
  88. 88.
    Berntson GG, Norman GJ, Bechara A, Bruss J, Tranel D, Cacioppo JT. The insula and evaluative processes. Psychol Sci. 2011;22:80–6.PubMedCrossRefGoogle Scholar
  89. 89.
    Knutson KM, Rakowsky ST, Solomon J, Krueger F, Raymont V, Tierney MC, et al. Injured brain regions associated with anxiety in Vietnam veterans. Neuropsychologia. 2013;51:686–94.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Knutson KM, Monte OD, Raymont V, Wassermann EM, Krueger F, Grafman J. Neural correlates of apathy revealed by lesion mapping in participants with traumatic brain injuries. Hum Brain Mapp. 2014;35:943–53.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Hogeveen J, Bird G, Chau A, Krueger F, Grafman J. Acquired alexithymia following damage to the anterior insula. Neuropsychologia. 2016;82:142–8.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    Bernhardt BC, Singer T. The neural basis of empathy. Ann Rev Neurosci. 2012;35:1–23.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Terasawa Y, Kurosaki Y, Ibata Y, Moriguchi Y, Umeda S. Attenuated sensitivity to the emotions of others by insular lesion. Front Psychol. 2015;6:1314.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Adolphs R, Tranel D, Damasio A. Dissociable neural systems for recognizing emotions. Brain Cogn. 2003;52:61–9.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Dal Monte O, Krueger F, Solomon JM, Schintu S, Knutson KM, Strenziok M, et al. A voxel-based lesion study on facial emotion recognition after penetrating brain injury. Soc Cogn Affect Neurosci. 2013;8:632–9.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Driscoll DM, Dal Monte O, Solomon J, Krueger F, Grafman J. Empathic deficits in combat veterans with traumatic brain injury: a voxel-based lesion-symptom mapping study. Cogn Behav Neurol. 2012;25:160–6.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Boucher O, Rouleau I, Lassonde M, Lepore F, Bouthillier A, Nguyen DK. Social information processing following resection of the insular cortex. Neuropsychologia. 2015;71:1–10.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Gu X, Gao Z, Wang X, Liu X, Knight RT, Hof PR, Fan J. Anterior insular cortex is necessary for empathetic pain perception. Brain. 2012;135:2726–35.PubMedPubMedCentralCrossRefGoogle Scholar
  99. 99.
    Chen P, Wang G, Ma R, Jing F, Zhang Y, Wang Y, et al. Multidimensional assessment of empathic abilities in patients with insular glioma. Cogn Affect Behav Neurosci. 2016;16:962–75.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Clark L, Bechara A, Damasio H, Aitken MR, Sahakian BJ, Robbins TW. Differential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making. Brain. 2008;131:1311–22.PubMedPubMedCentralCrossRefGoogle Scholar
  101. 101.
    Weller JA, Levin IP, Shiv B, Bechara A. The effects of insula damage on decision-making for risky gains and losses. Soc Neurosci. 2009;4:347–58.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Von Siebenthal Z, Boucher O, Rouleau I, Lassonde M, Lepore F, Nguyen DK. Decision-making impairments following insular and medial temporal lobe resection for drug-resistant epilepsy. Soc Cogn Affect Neurosci. 2017;12:128–37.Google Scholar
  103. 103.
    Clark L, Studer B, Bruss J, Tranel D, Bechara A. Damage to insula abolishes cognitive distortions during simulated gambling. Proc Natl Acad Sci U S A. 2014;111:6098–103.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Sellitto M, Ciaramelli E, Mattioli F, di Pellegrino G. Reduced sensitivity to sooner reward during intertemporal decision-making following insula damage in humans. Front Behav Neurosci. 2016;9:367.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Olivier Boucher
    • 1
    • 2
  • Daphné Citherlet
    • 2
    • 3
  • Benjamin Hébert-Seropian
    • 1
    • 2
  • Dang Khoa Nguyen
    • 2
    • 3
    • 4
    Email author
  1. 1.Département de PsychologieUniversité de MontréalMontrealCanada
  2. 2.Centre de recherche du CHUMMontrealCanada
  3. 3.Département de NeurosciencesUniversité de MontréalMontrealCanada
  4. 4.Division of NeurologyCHUMMontrealCanada

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