Cognitive Connie
Vad är insula?
Vik tillbaka frontalloben och temporalloben längs lateralfåran och du exponerar en begravd ö av cortex — insula, från latinets "ö". Länge förbisedd utöver sin roll i smak och viscerala sensationer transformerades insulans status av A. D. Craigs forskning: den anteriora insula är den kortikala navet för interoception — hjärnans kontinuerliga övervakning av kroppens fysiologiska tillstånd — och, genom integrering av dessa signaler med emotion och kognition, ett centralt substrat för subjektiva känslor.
Nyckelpersoner
A. D. (Bud) Craig
1950–Neuroanatomist at the Barrow Neurological Institute whose discovery of a dedicated interoceptive pathway (lamina I → VMpo → posterior insula) and his subsequent model of the anterior insula as the substrate of subjective feelings reshaped understanding of the insular cortex. His 2002 Nature Reviews Neuroscience paper and 2009 follow-up are among the most cited papers in affective neuroscience. His book How Do You Feel? (2015) presented the framework for a general audience.
Tania Singer
1969–Neuroscientist formerly at the Max Planck Institute whose fMRI studies demonstrated shared neural representations for one's own and others' pain in the anterior insula, providing a neural basis for empathy. Her laboratory has conducted extensive research on the neuroscience of empathy, compassion, and prosocial behaviour, including how contemplative practice affects insula function.
Vittorio Insausti
Multiple investigators, including Critchley and colleagues, have established the role of the insula in interoceptive awareness using cardiac detection paradigms, showing that individual differences in interoceptive accuracy correlate with grey matter volume in the right anterior insula.
Nyckelbegrepp
Interoception
The sense of the physiological condition of the body — including signals from the cardiovascular system (heartbeat, blood pressure), respiratory system, gastrointestinal tract, musculoskeletal system, and skin. A. D. Craig proposed that a distinct afferent pathway (the lamina I spinothalamic tract → posterior insular cortex) conveys all interoceptive signals to the cortex. The anterior insula integrates these signals into a holistic bodily state representation that underlies subjective "feelings." Individual differences in interoceptive accuracy (measured by heartbeat detection tasks) predict emotional awareness, decision-making under uncertainty, and vulnerability to anxiety and depression.
Posterior insula
The primary interoceptive cortex, receiving ascending homeostatic signals from the body via the thalamus (particularly the ventromedial posterior nucleus, VMpo). The posterior insula is the primary somatosensory cortex for pain (specifically the affective-motivational dimension), temperature, itch, touch, and visceral sensations. It also functions as primary gustatory cortex — Penfield's stimulation studies showed that electrical stimulation of the posterior insula produced taste sensations.
Anterior insula
The integrative hub of the insula, where posterior interoceptive signals are combined with emotional context, salience, and cognitive signals arriving from the orbitofrontal cortex, anterior cingulate, and amygdala. The anterior insula is activated by pain (especially its unpleasantness), disgust, empathy, risk and uncertainty, craving, moral emotions, love, music, laughter, and the subjective sense of agency. Craig proposed the anterior insula as the substrate of a "global emotional moment" — the bodily grounding of consciousness.
Disgust and the insula
Disgust — an emotion evolved to reject contaminated food and social threats — is the most consistently insula-linked emotion. The insula and basal ganglia (particularly the putamen) reliably activate during disgust experience and during viewing images of disgusting stimuli. Patients with Huntington's disease, which damages the insula and striatum, show specific deficits in recognising disgust in facial expressions while leaving other emotion recognition largely intact (Calder et al., 2000). The connection reflects the insula's gustatory and visceral monitoring role: disgust is a visceral rejection response that the insula implements cortically.
Empathy and the insula
Tania Singer's landmark (2004) neuroimaging study showed that the anterior insula activates both when participants experience pain themselves and when they observe a partner in pain. This "shared representation" of pain — mediated by the anterior insula and anterior cingulate cortex — is thought to underpin empathy: we feel another's pain through the neural circuits used for our own. Individual differences in insula activation during empathy correlate with self-reported empathic concern. The insula is also activated during empathy for other emotional states (fear, disgust, physical contact).
Insula and addiction craving
Naqvi et al. (2007) found that smokers who sustained insula damage were dramatically more likely to quit smoking immediately and without craving or relapse compared to smokers with damage elsewhere. This implicated the insula in the interoceptive dimension of craving — the bodily "urge" that drives drug-seeking. Subsequent research has found insula involvement in craving for alcohol, cocaine, opioids, and food, establishing it as a potential therapeutic target. The insula appears to represent the bodily state associated with drug effects, which when activated by cues generates the felt urge to use.
Salience network
A large-scale brain network centred on the anterior insula and dorsal anterior cingulate cortex, identified through resting-state fMRI connectivity analyses. The salience network responds to emotionally, biologically, or cognitively relevant stimuli and is proposed to coordinate switching between the default mode network (self-referential, resting) and the central executive network (task-focused). Disruption of the salience network — particularly anterior insula dysfunction — has been implicated in schizophrenia, frontotemporal dementia, autism spectrum disorder, and major depression.
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Senast granskad augusti 2025- 1.
Craig, A. D. (2009). How do you feel — now? The anterior insula and human awareness. Nature Reviews Neuroscience, 10(1), 59–70.
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Landmark review proposing the anterior insula as the cortical substrate of subjective feelings, synthesising evidence from anatomy, physiology, and neuroimaging.
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Singer, T., Seymour, B., O'Doherty, J., Kaube, H., Dolan, R. J., & Frith, C. D. (2004). Empathy for pain involves the affective but not sensory components of pain. Science, 303(5661), 1157–1162.
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fMRI study demonstrating shared anterior insula activation for first-person pain and empathic pain, establishing a neural basis for empathy.
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Naqvi, N. H., Rudrauf, D., Damasio, H., & Bechara, A. (2007). Damage to the insula disrupts addiction to cigarette smoking. Science, 315(5811), 531–534.
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Lesion study showing that insular damage dramatically increases spontaneous smoking cessation, implicating the insula in addiction craving.
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Menon, V., & Uddin, L. Q. (2010). Saliency, switching, attention and control: A network model of insula function. Brain Structure and Function, 214(5–6), 655–667.
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Proposal of the salience network model, with the anterior insula as a key node for detecting relevant stimuli and coordinating large-scale network dynamics.