Insula Damage and Quitting Smoking

Abstract

In their Report “Damage to the insula disrupts addiction to cigarette smoking” (26 Jan., p. 531), which is based on a retrospective study of patients who had brain lesions, N. H. Naqvi et al. conclude that damage to the insula was responsible for the disruption of nicotine dependence in some cases. The claim is consistent with an earlier report describing a young man who lost interest in abuse of substances after a selective bilateral stroke of the globus pallidus (1), which is an important neural target of the insula (2). However, methodological limitations inherent in brain lesion studies undermine the validity of conclusions derived from this study.