Skip to main content

Lesions of Left Basal Ganglia and Insula Structures Impair Executive Functions but not Emotion Recognition: A Case Report

  • Domagoj Švegar (a1), Ronald Antulov (a2), Mladenka Tkalčić (a1) and Igor Antončić (a2)

Increasing research evidence suggests that basal ganglia are an important part of frontal-subcortical circuit which is involved not only in motor control but also in affective, cognitive and executive functions. In this article, we describe the ability of facial emotion recognition and cognitive functioning in a patient with left basal ganglia and insula damage. The patient's ability to recognise facial emotional expressions was intact in spite of unilateral injury of the left insula and basal ganglia. He showed preserved intellectual function in general, but experienced difficulties on subsets of the executive functions: set-shifting and ability to activate or generate cognitive strategies, commonly found in patients with caudate lesions. This case contributes to evidence that striatal structures are important for executive functions.

Corresponding author
Address for correspondence: Domagoj Švegar, Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Filozofski fakultet u Rijeci, Odsjek za psihologiju, Sveucilisna avenija 4, 51000 Rijeka, Croatia (HR). Phone: +385 51 265 770. E-mail:
Hide All
Adolphs, R., Damasio, H., Tranel, D., Cooper, G., & Damasio, A.R. (2000). A role for somatosensory cortices in the visual recognition of emotion as revealed by three-dimensional lesion mapping. The Journal of Neuroscience, 20 (7), 26832690.
Adolphs, R., Tranel, D., Koenigs, M., & Damasio, A.R. (2005). Preferring one taste over another without recognizing either. Nature Neuroscience, 8 (7), 860861.
Alexander, G.E., DeLong, M.R., & Strick, P.L. (1986). Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9 (1), 357381.
Anderson, A.K., Christoff, K., Panitz, D., De Rosa, E., & Gabrieli, J.D. (2003). Neural correlates of the automatic processing of threat facial signals. The Journal of Neuroscience, 23 (13), 56275633.
Backman, L., Robins-Wahlin, T.B., Lundin, A., Ginovart, N., & Farde, L. (1997). Cognitive deficits in Huntington's disease are predicted by dopaminergic PET markers and brain volumes. Brain, 120 (12), 22072217.
Birn, R.M., Kenworthy, L., Case, L., Caravella, R., Jones, T.B., Bandettini, P.A., & Martin, A. (2010). Neural systems supporting lexical search guided by letter and semantic category cues: A self-paced overt response fMRI study of verbal fluency. Neuroimage, 49 (1), 10991107.
Bonelli, R.M., & Cummings, J.L. (2007). Frontal-subcortical circuitry and behavior. Dialogues in Clinical Neuroscience, 9 (2), 141.
Calder, A.J., Keane, J., Manes, F., Antoun, N., & Young, A.W. (2000). Impaired recognition and experience of disgust following brain injury. Nature Neuroscience, 3 (11), 10771078.
Calvo, M.G., & Lundqvist, D. (2008). Facial expressions of emotion (KDEF): Identification under different display-duration conditions. Behavior Research Methods, 40 (1), 109115.
Ekman, P., & Friesen, W.V. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.
Elliott, R. (2003). Executive functions and their disorders. British Medical Bulletin, 65 (1), 4959.
Galić, S. (2002). Neuropsihologijska procjena: Testovi i tehnike. Jastrebarsko: Naklada Slap.
Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., & Curtiss, J. (1993). Wisconsin card sorting test manual. Odessa, FL: Psychological Assessment Resources.
Huang, Y., Tang, S., Helmeste, D., Shioiri, T., & Someya, T. (2001). Differential judgement of static facial expressions of emotions in three cultures. Psychiatry and Clinical Neurosciences, 55 (5), 479483.
Johnson, S.A., Stout, J.C., Solomon, A.C., Langbehn, D.R., Aylward, E.H., Cruce, C.B., . . . & Predict-HD Investigators of the Huntington Study Group. (2007). Beyond disgust: Impaired recognition of negative emotions prior to diagnosis in Huntington's disease. Brain, 130 (7), 17321744.
Jones-Gotman, M., & Milner, B. (1977). Design fluency: The invention of nonsense drawings after focal cortical lesions. Neuropsychologia, 15 (4–5), 653674.
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test. Philadelphia: Lea & Febiger.
Levy, R., & Dubois, B. (2006). Apathy and the functional anatomy of the prefrontal cortex-basal ganglia circuits. Cerebral Cortex, 16 (7), 916928.
Lezak, M.D., Howieson, D.B., Bigler, E.D., & Tranel, D. (2012). Neuropsychological assessment. New York: Oxford University Press.
Lichter, D.G., & Cummings, J.L. (Eds.) (2001). Frontal-subcortical circuits in psychiatric and neurological disorders. New York: The Guilford Univeristy Press.
Lundqvist, D., Flykt, A., & Öhman, A. (1998). The Karolinska Directed Emotional Faces - KDEF, CD ROM from Department of Clinical Neuroscience, Psychology section, Karolinska Institutet, ISBN 91-630-7164-9.
Matsumoto, D., & Ekman, P. (1988). Japanese and caucasian facial expressions of emotion (JACFEE) and neutral faces. San Francisco: Department of Psychiatry, University of California.
Meyers, J.E. & Meyers, K.R. (1995). Rey complex figure test and recognition trial : RCFT : professional manual. Odessa: PAR.
Middleton, F.A., & Strick, P.L. (2002). Basal-ganglia ‘projections’ to the prefrontal cortex of the primate. Cerebral Cortex, 12 (9), 926935.
Milovanović, T., Švegar, D., & Kardum, I. (2013). Efekti anksioznosti i depresivnosti na prepoznavanje emocionalnih izraza lica. Psihologijske teme, 22 (1), 2949.
Palermo, R., & Coltheart, M. (2004). Photographs of facial expression: Accuracy, response times, and ratings of intensity. Behavior Research Methods, Instruments, & Computers, 36 (4), 634638.
Phillips, M.L., Williams, L.M., Heining, M., Herba, C.M., Russell, T., Andrew, C., . . . Gray, J.A. (2004). Differential neural responses to overt and covert presentations of facial expressions of fear and disgust. Neuroimage, 21 (4), 14841496.
Phillips, M.L., Young, A.W., Senior, C., Brammer, M., Andrew, C., Calder, A.J., . . . David, A.S. (1997). A specific neural substrate for perceiving facial expressions of disgust. Nature, 389 (6650), 495498.
Postuma, R.B., & Dagher, A. (2006). Basal ganglia functional connectivity based on a meta-analysis of 126 positron emission tomography and functional magnetic resonance imaging publications. Cerebral Cortex, 16 (10), 15081521.
Ruiz, S., Lee, S., Soekadar, S.R., Caria, A., Veit, R., Kircher, T., . . . Sitaram, R. (2013). Acquired self‐control of insula cortex modulates emotion recognition and brain network connectivity in schizophrenia. Human Brain Mapping, 34 (1), 200212.
Salmon, D.P., Heindel, W.C., & Hamilton, J.M. (2001). Cognitive abilities mediated by frontal-subcortical circuits. In Lichter, D.G. and Cummings, J.L. (Eds.), Frontal-subcortical circuits in psychiatric and neurological disorders (pp. 114150). New York: The Guilford Univeristy Press.
Schroeder, U., Hennenlotter, A., Erhard, P., Haslinger, B., Stahl, R., Lange, K.W., & Ceballos‐Baumann, A.O. (2004). Functional neuroanatomy of perceiving surprised faces. Human Brain Mapping, 23 (4), 181187.
Shulman, K.I. (2000). Clock‐drawing: is it the ideal cognitive screening test?. International Journal of Geriatric Psychiatry, 15 (6), 548561.
Sprengelmeyer, R., Rausch, M., Eysel, U.T., & Przuntek, H. (1998). Neural structures associated with recognition of facial expressions of basic emotions. Proceedings of the Royal Society of London B: Biological Sciences, 265 (1409), 19271931.
Strauss, E., Sherman, E.M.S., & Spreen, O. (2006). A compendium of neuropsychological tests. Administration, norms, and commentary. Oxford: Oxford University Press.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Brain Impairment
  • ISSN: 1443-9646
  • EISSN: 1839-5252
  • URL: /core/journals/brain-impairment
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed