Table 1

Neuropsychological studies of the effects of insula lesions on humans: summary of human neuropsychological studies examining the role of the insula either studying patients with relatively focal lesions, or studying larger groups of patients and inferring the critical lesion site for a given symptom using lesion-symptom mapping methods

StudyPatients (n)Mean time postonset (months)HemisphereInsula regionObservations
Case report
Hyman and Tranel1310LeftPosteriorAphasia
Fifer14a1RightUndefinedAuditory agnosia
Habib et al151BilateralUndefinedTransient mutism, non-verbal auditory agnosia, amusia
Griffiths et al1614RightPosteriorAuditory agnosia
Griffiths et al17112LeftAnteriorAmusia
Carota et al18a1<1LeftAnteriorAphasia
Starr et al19a2>5 yearsLeftUndefinedHypersensitivity to pain
Case series
Manes et al20101–2Right (n=4)
Left (n=6)
UndefinedImpaired verbal memory (more severe in left lesion patients)
Pritchard et al216>1 yearRight (n=1)
Left (n=5)
Rostrodorsal versus non-rostrodorsalImpaired taste recognition and magnitude estimate (taste intensity) in patients with rostrodorsal lesions
Greenspan et al226Right (cases BB, KB and CM)
Left (cases MC, KH and JE)
Anterior (CM and JE)
Posterior (MC)
Retro (KH, BB and KB)
Deficits in:
(1) heat pain threshold (MC and KH)
(2) mechanical pain threshold (MC, KH and BB)
(3) cold pain tolerance (MC and CM)
(4) innocuous cool threshold MC, KH and BB)
Cereda et al234>1Right (cases 1 and 4)
Left (cases 2 and 3)
Posterior (all)Sensory deficits including transient pain syndrome and in other modalities (cases 2 and 4)
Taste recognition deficits (case 2)
Acute pseudovestibular syndrome (cases 1, 2 and 4)
Somatoparaphrenia (case 4)
Aphasia (cases 2 and 3)
Lesion symptom mapping
Dronkers2425LeftAnteriorApraxia of Speech
Daniels and Foundas254Right (cases 1 and 2)
Left (cases 3 and 4)
Anterior (cases 1, 2 and 3)
Posterior (cases 2 and 4)
Dysphagia (cases 1, 2 and 3)
Manes et al2692Right (n=4)
Left (n=5)
UndefinedNeglect (tactile, auditory and visual) right > left lesions
Naqvi et al2719Right (n=6)
Left (n=13)
UndefinedDisruption of smoking addiction
Clark et al2813>12Right (n=6)
Left (n=7)
AnteriorImpaired risk adjustment
Weller et al2910>3Right (n=5)
Left (n=5)
UndefinedImpaired risk processing (insensitivity to probability)
Voxel-based lesion-symptom mapping
Karnath et al3014<1RightPosteriorAnosognosia for hemiplegia and hemianaesthesia
Borovsky et al3150>12LeftAnteriorImpaired production of fluent and complex speech
Spinazzola et al3242RightPosteriorAgnosia for hemianaesthesia
Golay et al33282RightPosteriorNeglect