Vestibular responses to direct stimulation of the human insular cortex
Version of Record online: 30 AUG 2014
© 2014 American Neurological Association
Annals of Neurology
Volume 76, Issue 4, pages 609–619, October 2014
How to Cite
Mazzola, L., Lopez, C., Faillenot, I., Chouchou, F., Mauguière, F. and Isnard, J. (2014), Vestibular responses to direct stimulation of the human insular cortex. Ann Neurol., 76: 609–619. doi: 10.1002/ana.24252
- Issue online: 8 OCT 2014
- Version of Record online: 30 AUG 2014
- Accepted manuscript online: 20 AUG 2014 11:22AM EST
- Manuscript Accepted: 11 AUG 2014
- Manuscript Revised: 8 AUG 2014
- Manuscript Received: 30 OCT 2013
The present study provides a functional mapping of vestibular responses in the human insular cortex.
A total of 642 electrical stimulations of the insula were performed in 219 patients, using stereotactically implanted depth electrodes, during the presurgical evaluation of drug-refractory partial epilepsy. We retrospectively identified 41 contacts where stimulation elicited vestibular sensations (VSs) and analyzed their location with respect to (1) their stereotactic coordinates (for all contacts), (2) the anatomy of insula gyri (for 20 vestibular sites), and (3) the probabilistic cytoarchitectonic maps of the insula (for 9 vestibular sites).
VSs occurred in 7.6% of the 541 evoked sensations after electrical stimulations of the insula. VSs were mostly obtained after stimulation of the posterior insula, that is, in the granular insular cortex and the postcentral insular gyrus. The data also suggest a spatial segregation of the responses in the insula, with the rotatory and translational VSs being evoked at more posterior stimulation sites than other less definable VSs. No left–right differences were observed.
These results demonstrate vestibular sensory processing in the insula that is centered on its posterior part. The present data add to the understanding of the multiple sensory functions of the insular cortex and of the cortical processing of vestibular signals. The data also indicate that lesion or dysfunction in the posterior insula should be considered during the evaluation of vestibular epileptic seizures. Ann Neurol 2014;76:609–619