Highlights in basic autonomic neuroscience: insular cortex injury leads to cardiovascular dysfunction.

Abstract

The prefrontal cortex, comprised of lateral prefrontal cortex (or insular cortex) and themedial prefrontal cortex, is involved in autonomic nervous system modulation. Insular cortex has neuronal connections with brain regions that are involved in central autonomic control, such as the hypothalamus, the nucleus of the solitary tract (NTS), and dorsal vagal nucleus and nucleus of ambiguus which contain preganglionic parasympathetic neurons. The insular cortex thus integrates sensory and visceral signals from the peripheral receptors. Recent clinical evaluation also indicates that injury of the insular cortex, by such as stroke, causes cardiovascular dysfunction. An interesting feature of the insular cortex involvement in central autonomic regulation is its differential role related to the sub-regions of the insular cortex, and particularly the lateralization of the insular cortex in terms of autonomic regulation.