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Chapter 16 - Neuropsychology of Insular Epilepsy

from Section 3 - Noninvasive Investigation of Insular Epilepsy

Published online by Cambridge University Press:  09 June 2022

By
Olivier Boucher ,
Sallie Baxendale ,
Alain Bouthillier  and
Dang Khoa Nguyen
Edited by
Dang Nguyen ,
Jean Isnard  and
Philippe Kahane
Dang Nguyen
Affiliation:
Université de Montréal
Jean Isnard
Affiliation:
Claude Bernard University Lyon
Philippe Kahane
Affiliation:
Grenoble-Alpes University Hospital
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Summary

Epilepsy surgery patients played a pioneering role in our early understanding of the insula in Penfield’s stimulation studies. Following the advent of functional imaging, epilepsy patients are once again helping us understand the role of this critical structure in human behavior. The insular cortex is involved in a wide range of complex human functions, including auditory processing, language function, attention, emotional processing, social cognition, and decision-making. In this chapter, we review this literature and report new data on the postoperative neuropsychological function of a series of 31 patients who have undergone partial or complete insular resections at the Centre Hospitalier de l’Université de Montréal (CHUM). Standard neuropsychological assessments reveal few cognitive impairments specific to insular epilepsy or its surgery. Specialized assessments are required to fully assess the impact of insular resection on socio-emotional processing and behavioral features of executive function that can be compromised following surgery.

Keywords

neuropsychologycognitive functionsemotional processingsocial cognitiondecision-making
Type
Chapter
Information
Insular Epilepsies , pp. 194 - 202
Publisher: Cambridge University Press
Print publication year: 2022

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References

Cereda, C, Ghika, J, Maeder, P, Bogousslavsky, J. Strokes restricted to the insular cortex. Neurology. 2002;59:1950–1955.CrossRefGoogle Scholar
Penfield, W, Faulk, ME. The insula: Further observations on its function. Brain. 1955;78:445–470.CrossRefGoogle ScholarPubMed
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 Funct. 2010;214:519–537.CrossRefGoogle ScholarPubMed
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;307–314.CrossRefGoogle Scholar
Bamiou, DE, Musiek, FE, Luxon, LM. The insula (island of Reil) and its role in auditory processing. Literature review. Brain Res Brain Res Rev. 2003;42:143–154.CrossRefGoogle ScholarPubMed
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;67:614–619.CrossRefGoogle ScholarPubMed
Spreen, O, Benton, AL, Fincham, RW. Auditory agnosia without aphasia. Arch Neurol. 1965;13:84–92.CrossRefGoogle ScholarPubMed
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;33:327–339.CrossRefGoogle ScholarPubMed
Griffiths, TD, Warren, JD, Dean, JL, Howard, D. “When the feeling’s gone”: a selective loss of musical emotion. J Neurol Neurosurg Psychiatry. 2004;75:344–345.CrossRefGoogle ScholarPubMed
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;1606:102–112.CrossRefGoogle Scholar
Boucher, O, Citherlet, D, Hébert-Seropian, Nguyen DK. Neuropsychological deficits due to insular damage. In Turgut, M, Yurttaş, C, Tubbs, RS (eds.), Island of Reil (Insula) in the Human Brain. Springer International Publising AG, 2018:223–238.CrossRefGoogle Scholar
Borovsky, A, Saygin, AP, Bates, E, Dronkers, N. Lesion, correlates of conversational speech production deficits. Neuropsychologia. 2007;45:2525–2533.CrossRefGoogle ScholarPubMed
Baier, B, Conrad, J, Zu Eulenberg, P, Best, C, Müller-Forell, W, Birklein, F, et al. Insular strokes cause no vestibular deficits. Stroke. 2013;44:2604–2606.CrossRefGoogle ScholarPubMed
Menon, V, Uddin, LQ. Saliency, switching, attention, and control: A network model of insula function. Brain Struct Funct. 2010;214:655–667.Google Scholar
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;115:1115–1125.Google Scholar
Sanai, N, Polley, MY, Berger, MS. Insular glioma resection: assessment of patient morbidity, survival, and tumor progression. J Neurosurg. 2010;112:1–9.CrossRefGoogle ScholarPubMed
Baxendale, S, Wilson, SJ, Baker, GA, Barr, W, Helmstaedter, C, Hermann, BP, et al. Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults. Epileptic Disord. 2019;21:221–234.Google ScholarPubMed
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.CrossRefGoogle Scholar
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;259:764–767.CrossRefGoogle ScholarPubMed
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;150:121–127.CrossRefGoogle ScholarPubMed
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;389:495–498.CrossRefGoogle ScholarPubMed
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;40:655–664.CrossRefGoogle Scholar
Bernhardt, BC, Singer, T. The neural basis of empathy. Ann Rev Neurosci. 2012;35:1–23.CrossRefGoogle ScholarPubMed
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;25:160–166.Google Scholar
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;16:962–975.Google Scholar
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;131:1311–1322.CrossRefGoogle ScholarPubMed
Weller, JA, Levin, IP, Shiv, B, Bechara, A. The effects of insula damage on decision-making for risky gains and losses. Soc Neurosci. 2009;4:347–358.Google Scholar
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;111:6098–6103.CrossRefGoogle ScholarPubMed
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.Google Scholar
Denis, DJ, Marouf, R, Rainville, P, Bouthillier, A, Nguyen, DK. Effects of insular stimulation on thermal nociception. Eur J Pain. 2016;20:800–810.CrossRefGoogle ScholarPubMed
Hébert-Seropian, B, Boucher, O, Sénéchal, C, Rouleau, I, Bouthillier, A, Lepore, F, et al. Does unilateral resection disturb personality? A study with epileptic patients. J Clin Neurosci. 2017;43:121–125.Google Scholar
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.Google Scholar
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;12:128–137.Google ScholarPubMed

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