Abstract
Schizophrenia is a neuropsychiatric disorder characterized by broad cognitive and functional impairments, including deficits in executive attention, working memory, and social cognition, as well as the presence of delusional thinking and hallucinatory experiences. The insula is a target of structural alteration in schizophrenia, suffering losses in gray matter, white matter, and cortical surface area that correspond to abnormalities in its functional connectivity. Given the wide diversity of neurocognitive functions subserved by the insula, insular dysfunction may explain several symptoms of schizophrenia. We review here the morphometric and functional alterations of the insula over the course of schizophrenia and their relation to resulting neurological deficits.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Insel TR. Rethinking schizophrenia. Nature. 2010;468:187ā93.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261ā76.
Foussias G, Agid O, Fervaha G, Remington G. Negative symptoms of schizophrenia: clinical features, relevance to real world functioning and specificity versus other CNS disorders. Eur Neuropsychopharmacol. 2014;24:693ā709.
Bowie CR, Harvey PD. Cognitive deficits and functional outcome in schizophrenia. Neuropsychiatr Dis Treat. 2006;2:531ā6.
Jepsen JR, Fagerlund B, Pagsberg AK, Christensen AM, Nordentoft M, Mortensen EL. Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early-onset schizophrenia patients. Scand J Psychol. 2013;54:363ā70.
Puig O, Baeza I, de la Serna E, Cabrera B, Mezquida G, Bioque M, Lobo A, Gonzalez-Pinto A, Parellada M, Corripio I, Vieta E, Bobes J, Usall J, Contreras F, Cuesta MJ, Bernardo M, Castro-Fornieles J, Group TP. Persistent negative symptoms in first-episode psychosis: early cognitive and social functioning correlates and differences between early and adult onset. J Clin Psychiatry. 2017;78:1414ā22.
Mesholam-Gately RI, Giuliano AJ, Goff KP, Faraone SV, Seidman LJ. Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology. 2009;23:315ā36.
Niemi LT, Suvisaari JM, Tuulio-Henriksson A, Lonnqvist JK. Childhood developmental abnormalities in schizophrenia: evidence from high-risk studies. Schizophr Res. 2003;60:239ā58.
Erlenmeyer-Kimling L, Rock D, Roberts SA, Janal M, Kestenbaum C, Cornblatt B, Adamo UH, Gottesman II. Attention, memory, and motor skills as childhood predictors of schizophrenia-related psychoses: the New York High-Risk Project. Am J Psychiatry. 2000;157:1416ā22.
Matheson SL, Vijayan H, Dickson H, Shepherd AM, Carr VJ, Laurens KR. Systematic meta-analysis of childhood social withdrawal in schizophrenia, and comparison with data from at-risk children aged 9ā14 years. J Psychiatr Res. 2013;47:1061ā8.
Schiffman J, Walker E, Ekstrom M, Schulsinger F, Sorensen H, Mednick S. Childhood videotaped social and neuromotor precursors of schizophrenia: a prospective investigation. Am J Psychiatry. 2004;161:2021ā7.
Tsuji T, Kline E, Sorensen HJ, Mortensen EL, Michelsen NM, Ekstrom M, Mednick S, Schiffman J. Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: a high-risk prospective investigation. Schizophr Res. 2013;151:270ā3.
Bliksted V, Videbech P, Fagerlund B, Frith C. The effect of positive symptoms on social cognition in first-episode schizophrenia is modified by the presence of negative symptoms. Neuropsychology. 2017;31:209ā19.
Green MF. Cognitive impairment and functional outcome in schizophrenia and bipolar disorder. J Clin Psychiatry. 2006;67(Suppl 9):3ā8. discussion 36ā42
Nuechterlein KH, Subotnik KL, Green MF, Ventura J, Asarnow RF, Gitlin MJ, Yee CM, Gretchen-Doorly D, Mintz J. Neurocognitive predictors of work outcome in recent-onset schizophrenia. Schizophr Bull. 2011;37(Suppl 2):S33ā40.
Honea R, Crow TJ, Passingham D, Mackay CE. Regional deficits in brain volume in schizophrenia: a meta-analysis of voxel-based morphometry studies. Am J Psychiatry. 2005;162:2233ā45.
Vita A, De Peri L, Deste G, Sacchetti E. Progressive loss of cortical gray matter in schizophrenia: a meta-analysis and meta-regression of longitudinal MRI studies. Transl Psychiatry. 2012;2:e190.
Wright IC, Ellison ZR, Sharma T, Friston KJ, Murray RM, McGuire PK. Mapping of grey matter changes in schizophrenia. Schizophr Res. 1999;35:1ā14.
Sigmundsson T, Suckling J, Maier M, Williams S, Bullmore E, Greenwood K, Fukuda R, Ron M, Toone B. Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. Am J Psychiatry. 2001;158:234ā43.
Bora E, Fornito A, Radua J, Walterfang M, Seal M, Wood SJ, Yucel M, Velakoulis D, Pantelis C. Neuroanatomical abnormalities in schizophrenia: a multimodal voxelwise meta-analysis and meta-regression analysis. Schizophr Res. 2011;127:46ā57.
Fusar-Poli P, Smieskova R, Serafini G, Politi P, Borgwardt S. Neuroanatomical markers of genetic liability to psychosis and first episode psychosis: a voxelwise meta-analytical comparison. World J Biol Psychiatry. 2014;15:219ā28.
Shepherd AM, Laurens KR, Matheson SL, Carr VJ, Green MJ. Systematic meta-review and quality assessment of the structural brain alterations in schizophrenia. Neurosci Biobehav Rev. 2012;36:1342ā56.
Takahashi T, Wood SJ, Soulsby B, Tanino R, Wong MT, McGorry PD, Suzuki M, Velakoulis D, Pantelis C. Diagnostic specificity of the insular cortex abnormalities in first-episode psychotic disorders. Prog Neuro-Psychopharmacol Biol Psychiatry. 2009;33:651ā7.
Makris N, Goldstein JM, Kennedy D, Hodge SM, Caviness VS, Faraone SV, Tsuang MT, Seidman LJ. Decreased volume of left and total anterior insular lobule in schizophrenia. Schizophr Res. 2006;83:155ā71.
Crespo-Facorro B, Kim J, Andreasen NC, OāLeary DS, Bockholt HJ, Magnotta V. Insular cortex abnormalities in schizophrenia: a structural magnetic resonance imaging study of first-episode patients. Schizophr Res. 2000;46:35ā43.
Paillere-Martinot M, Caclin A, Artiges E, Poline JB, Joliot M, Mallet L, Recasens C, Attar-Levy D, Martinot JL. Cerebral gray and white matter reductions and clinical correlates in patients with early onset schizophrenia. Schizophr Res. 2001;50:19ā26.
Yamada M, Hirao K, Namiki C, Hanakawa T, Fukuyama H, Hayashi T, Murai T. Social cognition and frontal lobe pathology in schizophrenia: a voxel-based morphometric study. NeuroImage. 2007;35:292ā8.
Chan RC, Di X, McAlonan GM, Gong QY. Brain anatomical abnormalities in high-risk individuals, first-episode, and chronic schizophrenia: an activation likelihood estimation meta-analysis of illness progression. Schizophr Bull. 2011;37:177ā88.
Marcelis M, Suckling J, Woodruff P, Hofman P, Bullmore E, van Os J. Searching for a structural endophenotype in psychosis using computational morphometry. Psychiatry Res. 2003;122:153ā67.
Kuperberg GR, Broome MR, McGuire PK, David AS, Eddy M, Ozawa F, Goff D, West WC, Williams SC, van der Kouwe AJ, Salat DH, Dale AM, Fischl B. Regionally localized thinning of the cerebral cortex in schizophrenia. Arch Gen Psychiatry. 2003;60:878ā88.
Nesvag R, Lawyer G, Varnas K, Fjell AM, Walhovd KB, Frigessi A, Jonsson EG, Agartz I. Regional thinning of the cerebral cortex in schizophrenia: effects of diagnosis, age and antipsychotic medication. Schizophr Res. 2008;98:16ā28.
Leung M, Cheung C, Yu K, Yip B, Sham P, Li Q, Chua S, McAlonan G. Gray matter in first-episode schizophrenia before and after antipsychotic drug treatment. Anatomical likelihood estimation meta-analyses with sample size weighting. Schizophr Bull. 2011;37:199ā211.
Fusar-Poli P, Radua J, McGuire P, Borgwardt S. Neuroanatomical maps of psychosis onset: voxel-wise meta-analysis of antipsychotic-naive VBM studies. Schizophr Bull. 2012;38:1297ā307.
Kasai K, Shenton ME, Salisbury DF, Onitsuka T, Toner SK, Yurgelun-Todd D, Kikinis R, Jolesz FA, McCarley RW. Differences and similarities in insular and temporal pole MRI gray matter volume abnormalities in first-episode schizophrenia and affective psychosis. Arch Gen Psychiatry. 2003;60:1069ā77.
Kubicki M, Shenton ME, Salisbury DF, Hirayasu Y, Kasai K, Kikinis R, Jolesz FA, McCarley RW. Voxel-based morphometric analysis of gray matter in first episode schizophrenia. NeuroImage. 2002;17:1711ā9.
Job DE, Whalley HC, McConnell S, Glabus M, Johnstone EC, Lawrie SM. Structural gray matter differences between first-episode schizophrenics and normal controls using voxel-based morphometry. NeuroImage. 2002;17:880ā9.
Hulshoff Pol HE, Schnack HG, Mandl RC, van Haren NE, Koning H, Collins DL, Evans AC, Kahn RS. Focal gray matter density changes in schizophrenia. Arch Gen Psychiatry. 2001;58:1118ā25.
Wilke M, Kaufmann C, Grabner A, Putz B, Wetter TC, Auer DP. Gray matter-changes and correlates of disease severity in schizophrenia: a statistical parametric mapping study. NeuroImage. 2001;13:814ā24.
Garcia-Marti G, Aguilar EJ, Lull JJ, Marti-Bonmati L, Escarti MJ, Manjon JV, Moratal D, Robles M, Sanjuan J. Schizophrenia with auditory hallucinations: a voxel-based morphometry study. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:72ā80.
Chang LJ, Yarkoni T, Khaw MW, Sanfey AG. Decoding the role of the insula in human cognition: functional parcellation and large-scale reverse inference. Cereb Cortex. 2013;23:739ā49.
Deen B, Pitskel NB, Pelphrey KA. Three systems of insular functional connectivity identified with cluster analysis. Cereb Cortex. 2011;21:1498ā506.
Uddin LQ, Kinnison J, Pessoa L, Anderson ML. Beyond the tripartite cognition-emotion-interoception model of the human insular cortex. J Cogn Neurosci. 2014;26:16ā27.
Saze T, Hirao K, Namiki C, Fukuyama H, Hayashi T, Murai T. Insular volume reduction in schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2007;257:473ā9.
Takahashi T, Wood SJ, Soulsby B, McGorry PD, Tanino R, Suzuki M, Velakoulis D, Pantelis C. Follow-up MRI study of the insular cortex in first-episode psychosis and chronic schizophrenia. Schizophr Res. 2009;108:49ā56.
Pressler M, Nopoulos P, Ho BC, Andreasen NC. Insular cortex abnormalities in schizophrenia: relationship to symptoms and typical neuroleptic exposure. Biol Psychiatry. 2005;57:394ā8.
Crespo-Facorro B, Roiz-Santianez R, Quintero C, Perez-Iglesias R, Tordesillas-Gutierrez D, Mata I, Rodriguez-Sanchez JM, Gutierrez A, Vazquez-Barquero JL. Insular cortex morphometry in first-episode schizophrenia-spectrum patients: diagnostic specificity and clinical correlations. J Psychiatr Res. 2010;44:314ā20.
Duggal HS, Muddasani S, Keshavan MS. Insular volumes in first-episode schizophrenia: gender effect. Schizophr Res. 2005;73:113ā20.
Roiz-Santianez R, Perez-Iglesias R, Quintero C, Tordesillas-Gutierrez D, Mata I, Ayesa R, Sanchez JM, Gutierrez A, Sanchez E, Vazquez-Barquero JL, Crespo-Facorro B. Insular cortex thinning in first episode schizophrenia patients. Psychiatry Res. 2010;182:216ā22.
Smieskova R, Fusar-Poli P, Allen P, Bendfeldt K, Stieglitz RD, Drewe J, Radue EW, McGuire PK, Riecher-Rossler A, Borgwardt SJ. The effects of antipsychotics on the brain: what have we learnt from structural imaging of schizophrenia? A systematic review. Curr Pharm Des. 2009;15:2535ā49.
Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry. 2011;68:128ā37.
Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, Keefe RS, Green AI, Gur RE, McEvoy J, Perkins D, Hamer RM, Gu H, Tohen M. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry. 2005;62:361ā70.
Crespo-Facorro B, Roiz-Santianez R, Perez-Iglesias R, Pelayo-Teran JM, Rodriguez-Sanchez JM, Tordesillas-Gutierrez D, Ramirez M, Martinez O, Gutierrez A, de Lucas EM, Vazquez-Barquero JL. Effect of antipsychotic drugs on brain morphometry. A randomized controlled one-year follow-up study of haloperidol, risperidone and olanzapine. Prog Neuro-Psychopharmacol Biol Psychiatry. 2008;32:1936ā43.
Roiz-Santianez R, Tordesillas-Gutierrez D, Ortiz-Garcia de la Foz V, Ayesa-Arriola R, Gutierrez A, Tabares-Seisdedos R, Vazquez-Barquero JL, Crespo-Facorro B. Effect of antipsychotic drugs on cortical thickness. A randomized controlled one-year follow-up study of haloperidol, risperidone and olanzapine. Schizophr Res. 2012;141:22ā8.
Vita A, De Peri L, Deste G, Barlati S, Sacchetti E. The effect of antipsychotic treatment on cortical gray matter changes in schizophrenia: does the class matter? A meta-analysis and meta-regression of longitudinal magnetic resonance imaging studies. Biol Psychiatry. 2015;78:403ā12.
Fusar-Poli P, Broome MR, Matthiasson P, Williams SC, Brammer M, McGuire PK. Effects of acute antipsychotic treatment on brain activation in first episode psychosis: an fMRI study. Eur Neuropsychopharmacol. 2007;17:492ā500.
Borgwardt SJ, Picchioni MM, Ettinger U, Toulopoulou T, Murray R, McGuire PK. Regional gray matter volume in monozygotic twins concordant and discordant for schizophrenia. Biol Psychiatry. 2010;67:956ā64.
Andreasen NC, Nopoulos P, Magnotta V, Pierson R, Ziebell S, Ho BC. Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia. Biol Psychiatry. 2011;70:672ā9.
Olabi B, Ellison-Wright I, McIntosh AM, Wood SJ, Bullmore E, Lawrie SM. Are there progressive brain changes in schizophrenia? A meta-analysis of structural magnetic resonance imaging studies. Biol Psychiatry. 2011;70:88ā96.
Borgwardt SJ, Riecher-Rossler A, Dazzan P, Chitnis X, Aston J, Drewe M, Gschwandtner U, Haller S, Pfluger M, Rechsteiner E, DāSouza M, Stieglitz RD, Radu EW, McGuire PK. Regional gray matter volume abnormalities in the at risk mental state. Biol Psychiatry. 2007;61:1148ā56.
Fusar-Poli P, Borgwardt S, Crescini A, Deste G, Kempton MJ, Lawrie S, Mc Guire P, Sacchetti E. Neuroanatomy of vulnerability to psychosis: a voxel-based meta-analysis. Neurosci Biobehav Rev. 2011;35:1175ā85.
Takahashi T, Wood SJ, Yung AR, Phillips LJ, Soulsby B, McGorry PD, Tanino R, Zhou SY, Suzuki M, Velakoulis D, Pantelis C. Insular cortex gray matter changes in individuals at ultra-high-risk of developing psychosis. Schizophr Res. 2009;111:94ā102.
Horan WP, Jimenez AM, Lee J, Wynn JK, Eisenberger NI, Green MF. Pain empathy in schizophrenia: an fMRI study. Soc Cogn Affect Neurosci. 2016;11:783ā92.
Cechetto DF. Cortical control of the autonomic nervous system. Exp Physiol. 2014;99:326ā31.
Craig AD. How do you feelānow? The anterior insula and human awareness. Nat Rev Neurosci. 2009;10:59ā70.
Benedetti F, Bernasconi A, Bosia M, Cavallaro R, Dallaspezia S, Falini A, Poletti S, Radaelli D, Riccaboni R, Scotti G, Smeraldi E. Functional and structural brain correlates of theory of mind and empathy deficits in schizophrenia. Schizophr Res. 2009;114:154ā60.
Pinkham AE. Social cognition in schizophrenia. J Clin Psychiatry. 2014;75(Suppl 2):14ā9.
Craig AD. Interoception: the sense of the physiological condition of the body. Curr Opin Neurobiol. 2003;13:500ā5.
Gu X, Hof PR, Friston KJ, Fan J. Anterior insular cortex and emotional awareness. J Comp Neurol. 2013;521:3371ā88.
Garrison J, Erdeniz B, Done J. Prediction error in reinforcement learning: a meta-analysis of neuroimaging studies. Neurosci Biobehav Rev. 2013;37:1297ā310.
Critchley HD, Wiens S, Rotshtein P, Ohman A, Dolan RJ. Neural systems supporting interoceptive awareness. Nat Neurosci. 2004;7:189ā95.
Palaniyappan L, Simmonite M, White TP, Liddle EB, Liddle PF. Neural primacy of the salience processing system in schizophrenia. Neuron. 2013;79:814ā28.
Werner NS, Jung K, Duschek S, Schandry R. Enhanced cardiac perception is associated with benefits in decision-making. Psychophysiology. 2009;46:1123ā9.
Ferri F, Ardizzi M, Ambrosecchia M, Gallese V. Closing the gap between the inside and the outside: interoceptive sensitivity and social distances. PLoS One. 2013;8:e75758.
Lovero KL, Simmons AN, Aron JL, Paulus MP. Anterior insular cortex anticipates impending stimulus significance. NeuroImage. 2009;45:976ā83.
Ardizzi M, Ambrosecchia M, Buratta L, Ferri F, Peciccia M, Donnari S, Mazzeschi C, Gallese V. Interoception and positive symptoms in schizophrenia. Front Hum Neurosci. 2016;10:379.
Palaniyappan L, Mallikarjun P, Joseph V, Liddle PF. Appreciating symptoms and deficits in schizophrenia: right posterior insula and poor insight. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35:523ā7.
Antonius D, Prudent V, Rebani Y, DāAngelo D, Ardekani BA, Malaspina D, Hoptman MJ. White matter integrity and lack of insight in schizophrenia and schizoaffective disorder. Schizophr Res. 2011;128:76ā82.
Linnman C, Coombs G, Goff DC, Holt DJ. Lack of insula reactivity to aversive stimuli in schizophrenia. Schizophr Res. 2013;143:150ā7.
Pollatos O, Herbert BM, Matthias E, Schandry R. Heart rate response after emotional picture presentation is modulated by interoceptive awareness. Int J Psychophysiol. 2007;63:117ā24.
Lang PJ. The varieties of emotional experience: a meditation on James-Lange theory. Psychol Rev. 1994;101:211ā21.
Fusar-Poli P, Placentino A, Carletti F, Landi P, Allen P, Surguladze S, Benedetti F, Abbamonte M, Gasparotti R, Barale F, Perez J, McGuire P, Politi P. Functional atlas of emotional faces processing: a voxel-based meta-analysis of 105 functional magnetic resonance imaging studies. J Psychiatry Neurosci. 2009;34:418ā32.
Pelletier-Baldelli A, Bernard JA, Mittal VA. Intrinsic functional connectivity in salience and default mode networks and aberrant social processes in youth at ultra-high risk for psychosis. PLoS One. 2015;10:e0134936.
Jani M, Kasparek T. Emotion recognition and theory of mind in schizophrenia: a meta-analysis of neuroimaging studies. World J Biol Psychiatry. 2017:1ā11.
Mothersill O, Knee-Zaska C, Donohoe G. Emotion and theory of mind in schizophrenia-investigating the role of the cerebellum. Cerebellum. 2016;15:357ā68.
Lamm C, Singer T. The role of anterior insular cortex in social emotions. Brain Struct Funct. 2010;214:579ā91.
Bernhardt BC, Singer T. The neural basis of empathy. Annu Rev Neurosci. 2012;35:1ā23.
Lamm C, Decety J, Singer T. Meta-analytic evidence for common and distinct neural networks associated with directly experienced pain and empathy for pain. NeuroImage. 2011;54:2492ā502.
Gu X, Gao Z, Wang X, Liu X, Knight RT, Hof PR, Fan J. Anterior insular cortex is necessary for empathetic pain perception. Brain J Neurol. 2012;135:2726ā35.
Belin P, Fecteau S, Bedard C. Thinking the voice: neural correlates of voice perception. Trends Cogn Sci. 2004;8:129ā35.
Bestelmeyer PEG, Maurage P, Rouger J, Latinus M, Belin P. Adaptation to vocal expressions reveals multistep perception of auditory emotion. J Neurosci. 2014;34:8098ā105.
Bach DR, Grandjean D, Sander D, Herdener M, Strik WK, Seifritz E. The effect of appraisal level on processing of emotional prosody in meaningless speech. NeuroImage. 2008;42:919ā27.
Hoekert M, Kahn RS, Pijnenborg M, Aleman A. Impaired recognition and expression of emotional prosody in schizophrenia: review and meta-analysis. Schizophr Res. 2007;96:135ā45.
Kantrowitz JT, Leitman DI, Lehrfeld JM, Laukka P, Juslin PN, Butler PD, Silipo G, Javitt DC. Reduction in tonal discriminations predicts receptive emotion processing deficits in schizophrenia and schizoaffective disorder. Schizophr Bull. 2013;39:86ā93.
Pijnenborg GH, Withaar FK, Bosch RJ, Brouwer WH. Impaired perception of negative emotional prosody in schizophrenia. Clin Neuropsychol. 2007;21:762ā75.
Kantrowitz JT, Hoptman MJ, Leitman DI, Moreno-Ortega M, Lehrfeld JM, Dias E, Sehatpour P, Laukka P, Silipo G, Javitt DC. Neural substrates of auditory emotion recognition deficits in schizophrenia. J Neurosci. 2015;35:14909ā21.
Bach DR, Buxtorf K, Strik WK, Neuhoff JG, Seifritz E. Evidence for impaired sound intensity processing in schizophrenia. Schizophr Bull. 2011;37:426ā31.
Leitman DI, Laukka P, Juslin PN, Saccente E, Butler P, Javitt DC. Getting the cue: sensory contributions to auditory emotion recognition impairments in schizophrenia. Schizophr Bull. 2010;36:545ā56.
Gold R, Butler P, Revheim N, Leitman DI, Hansen JA, Gur RC, Kantrowitz JT, Laukka P, Juslin PN, Silipo GS, Javitt DC. Auditory emotion recognition impairments in schizophrenia: relationship to acoustic features and cognition. Am J Psychiatry. 2012;169:424ā32.
Leitman DI, Sehatpour P, Garidis C, Gomez-Ramirez M, Javitt DC. Preliminary evidence of pre-attentive distinctions of frequency-modulated tones that convey affect. Front Hum Neurosci. 2011;5:96.
Jardri R, Pouchet A, Pins D, Thomas P. Cortical activations during auditory verbal hallucinations in schizophrenia: a coordinate-based meta-analysis. Am J Psychiatry. 2011;168:73ā81.
Bressler SL, Menon V. Large-scale brain networks in cognition: emerging methods and principles. Trends Cogn Sci. 2010;14:277ā90.
Uddin LQ, Supekar KS, Ryali S, Menon V. Dynamic reconfiguration of structural and functional connectivity across core neurocognitive brain networks with development. J Neurosci. 2011;31:18578ā89.
Greicius MD, Krasnow B, Reiss AL, Menon V. Functional connectivity in the resting brain: a network analysis of the default mode hypothesis. Proc Natl Acad Sci U S A. 2003;100:253ā8.
Dodell-Feder D, DeLisi LE, Hooker CI. The relationship between default mode network connectivity and social functioning in individuals at familial high-risk for schizophrenia. Schizophr Res. 2014;156:87ā95.
Andrews-Hanna JR, Smallwood J, Spreng RN. The default network and self-generated thought: component processes, dynamic control, and clinical relevance. Ann N Y Acad Sci. 2014;1316:29ā52.
Manoliu A, Riedl V, Doll A, BƤuml JG, MĆ¼hlau M, Schwerthƶffer D, Scherr M, Zimmer C, Fƶrstl H, BƤuml J, WohlschlƤger AM, Koch K, Sorg C. Insular dysfunction reflects altered between-network connectivity and severity of negative symptoms in schizophrenia during psychotic remission. Front Hum Neurosci. 2013;7:216.
Seeley WW, Menon V, Schatzberg AF, Keller J, Glover GH, Kenna H, Reiss AL, Greicius MD. Dissociable intrinsic connectivity networks for salience processing and executive control. J Neurosci. 2007;27:2349ā56.
Palaniyappan L, Liddle PF. Does the salience network play a cardinal role in psychosis? An emerging hypothesis of insular dysfunction. J Psychiatry Neurosci. 2012;37:17ā27.
Dosenbach NU, Fair DA, Miezin FM, Cohen AL, Wenger KK, Dosenbach RA, Fox MD, Snyder AZ, Vincent JL, Raichle ME, Schlaggar BL, Petersen SE. Distinct brain networks for adaptive and stable task control in humans. Proc Natl Acad Sci U S A. 2007;104:11073ā8.
Walter A, Suenderhauf C, Smieskova R, Lenz C, Harrisberger F, Schmidt A, Vogel T, Lang UE, Riecher-Rossler A, Eckert A, Borgwardt S. Altered insular function during aberrant salience processing in relation to the severity of psychotic symptoms. Front Psych. 2016;7:189.
Sridharan D, Levitin DJ, Menon V. A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks. Proc Natl Acad Sci U S A. 2008;105:12569ā74.
Menon V, Uddin LQ. Saliency, switching, attention and control: a network model of insula function. Brain Struct Funct. 2010;214:655ā67.
Manoliu A, Riedl V, Zherdin A, MĆ¼hlau M, Schwerthƶffer D, Scherr M, Peters H, Zimmer C, Fƶrstl H, BƤuml J, WohlschlƤger AM, Sorg C. Aberrant dependence of default mode/central executive network interactions on anterior insular salience network activity in schizophrenia. Schizophr Bull. 2014;40:428ā37.
Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. 2003;160:13ā23.
Fletcher PC, Frith CD. Perceiving is believing: a Bayesian approach to explaining the positive symptoms of schizophrenia. Nat Rev Neurosci. 2009;10:48ā58.
Preuschoff K, Quartz SR, Bossaerts P. Human insula activation reflects risk prediction errors as well as risk. J Neurosci. 2008;28:2745ā52.
Clark L, Bechara A, Damasio H, Aitken MR, Sahakian BJ, Robbins TW. Differential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making. Brain J Neurol. 2008;131:1311ā22.
Murray GK, Corlett PR, Clark L, Pessiglione M, Blackwell AD, Honey G, Jones PB, Bullmore ET, Robbins TW, Fletcher PC. Substantia nigra/ventral tegmental reward prediction error disruption in psychosis. Mol Psychiatry. 2008;13(239):267ā76.
Mingoia G, Wagner G, Langbein K, Maitra R, Smesny S, Dietzek M, Burmeister HP, Reichenbach JR, Schlosser RG, Gaser C, Sauer H, Nenadic I. Default mode network activity in schizophrenia studied at resting state using probabilistic ICA. Schizophr Res. 2012;138:143ā9.
Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Hyperactivity of the default-mode network in first-episode, drug-naive schizophrenia at rest revealed by family-based caseācontrol and traditional caseācontrol designs. Medicine. 2017;96:e6223.
Littow H, Huossa V, Karjalainen S, JƤƤskelƤinen E, Haapea M, Miettunen J, Tervonen O, Isohanni M, Nikkinen J, Veijola J, Murray G, Kiviniemi VJ. Aberrant functional connectivity in the default mode and central executive networks in subjects with schizophreniaāa whole-brain resting-state ICA study. Front Psych. 2015;6:26.
Moran LV. Disruption of anterior insula modulation of large-scale brain networks in schizophrenia. Biol Psychiatry. 2013;74:467ā74.
White TP, Joseph V, Francis ST, Liddle PF. Aberrant salience network (bilateral insula and anterior cingulate cortex) connectivity during information processing in schizophrenia. Schizophr Res. 2010;123:105ā15.
Mikolas P, Melicher T, Skoch A, Matejka M, Slovakova A, Bakstein E, Hajek T, Spaniel F. Connectivity of the anterior insula differentiates participants with first-episode schizophrenia spectrum disorders from controls: a machine-learning study. Psychol Med. 2016;46:2695ā704.
Alonso-Solis A, Vives-Gilabert Y, Grasa E, Portella MJ, Rabella M, Sauras RB, Roldan A, Nunez-Marin F, Gomez-Anson B, Perez V, Alvarez E, Corripio I. Resting-state functional connectivity alterations in the default network of schizophrenia patients with persistent auditory verbal hallucinations. Schizophr Res. 2015;161:261ā8.
Gaebler AJ, Mathiak K, Koten JW Jr, Konig AA, Koush Y, Weyer D, Depner C, Matentzoglu S, Edgar JC, Willmes K, Zvyagintsev M. Auditory mismatch impairments are characterized by core neural dysfunctions in schizophrenia. Brain J Neurol. 2015;138:1410ā23.
Ruiz S, Lee S, Soekadar SR, Caria A, Veit R, Kircher T, Birbaumer N, Sitaram R. Acquired self-control of insula cortex modulates emotion recognition and brain network connectivity in schizophrenia. Hum Brain Mapp. 2013;34:200ā12.
Yao S, Becker B, Geng Y, Zhao Z, Xu X, Zhao W, Ren P, Kendrick KM. Voluntary control of anterior insula and its functional connections is feedback-independent and increases pain empathy. NeuroImage. 2016;130:230ā40.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
Ā© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Schmidt, C. (2018). The Role of theĀ Insula in Schizophrenia. In: Turgut, M., YurttaÅ , C., Tubbs, R. (eds) Island of Reil (Insula) in the Human Brain. Springer, Cham. https://doi.org/10.1007/978-3-319-75468-0_27
Download citation
DOI: https://doi.org/10.1007/978-3-319-75468-0_27
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-75467-3
Online ISBN: 978-3-319-75468-0
eBook Packages: MedicineMedicine (R0)