The analysis of insula lobe function based on the Stereo-electroencephalography_Journal of Epilepsy

Authors：

 WANGLihui , XUJiwen ,  YEXiaolai , ZHOUHongyu , LIUQiangqiang , MAJunfeng

Department of Functional neurosurgery, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200001, China;

Corresponding author：

YEXiaolai, Email: xiao-lai.ye@hotmail.com

Keywords：

Refractory epilepsy; Insula; Stereo-electroencephalography; Direct electric stimulation; Brain mapping

DOI：

10.7507/2096-0247.20150030

Video：

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Objective To understand the relationship between the anatomy and the function of the insula lobe cortex based on the stereo-electro encephalography (SEEG) by direct electric stimulation of the insula cortex performed in the patients who suffered from the refractory epilepsy. Methods Retrospective review was performed on 12 individuals with refractory epilepsy who were diagnosed in the Department of Functional neurosurgery of RenJi Hospital from December 2013 to September 2015. We studied all the SEEG electrodes implanted in the brain with contacts in the insula cortex. Direct electric stimulation was given to gain the brain mapping of the insula. Results 12 consecutive patients with refractory epilepsy were implanted SEEG electrodes into the insula cortex. In all, 176 contacts were in the insula cortex, and 154 were included. The main clinical manifestations obtained by the stimulation were somatosensory abnormalities, laryngeal constriction, dyspnea, nausea, flustered. While somatosensory symptoms were located in the posterior insula, visceral sensory symptoms distribute relatively in the anterior insula, and other symptoms were mainly in the central and anterior part. Conclusions The symptoms of the insula present mainly according to the anatomy, but some of them are mixed. In addition, the manifestations of the insula are usually complex and individually.

Citation： WANGLihui, XUJiwen, YEXiaolai, ZHOUHongyu, LIUQiangqiang, MAJunfeng. The analysis of insula lobe function based on the Stereo-electroencephalography. Journal of Epilepsy, 2015, 1(3): 193-197. doi: 10.7507/2096-0247.20150030 Copy

1.	Guenot M, Isnard J, Sindou M. Surgical anatomy of the insula. Adv Tech Stand Neurosurg, 2004, 29(5):265-288.
2.	梁鹏, 刘恩重, 赵世光, 等.手术全切岛叶基底节区胶质瘤21例报告.中国微侵袭神经外科杂志, 2004, 9(4):157-159.
3.	Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg, 2004, 100(5):891-992.
4.	Isnard J, Guenot M, Sindou M. et al. Clinical manifestations ofinsular lobe seizures:a stereo-electroencephalographic study. Epilepsia, 2004, 45(9):1079-1090.
5.	VonLehe M, Wellmer J, Urbach H, et al. Insular lesion ectomy for refractory epilepsy:management and outcome. Brain, 2009, 132(4):1048-1056.
6.	Friedman DP, Murray EA, ONeill JB, et al. Cortical connections of the somatosensory fields of the lateral sulcus of macaques:evidence for acorticolimbic pathway for touch. J Comp Neur, 1986, 252(3):323-347.
7.	Chikama M, Mcfarland NR, Amaral DG, et al. Insular cortical projections to functional regions of the striatum correlate with cortical cytoarchitectoifie organization in the primate. J Neurosci, 1997, 17(24):9686-9705.
8.	Kurth F, Zilles K, Fox PT, et al. A link between the systems:functional differentiation and integration within the human insula revealed by meta-analysis. Brain StructFunct, 2010, 214 (5/6):519-534.
9.	Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Struct Funct, 2011, 216(2):137-149.
10.	Craig AD. The sentient self. Brain StructFunct, 2010, 214(5/6):563-577.
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13.	Nestor PJ, Graham NL, Fryer TD, et al. Progressive non-fluent aphasia is associated with hypo metabolism centred on the left anterior insula. Brain, 2003, 126(Pt 11):2406-2418.
14.	Price CJ. The anatomy of language:contributions from functional neuro imaging. J Anat, 2000, 197(Pt 3):335-359.
15.	伊慧明, 周媛, 张权, 等.岛叶的任务态和静息态功能磁共振成像.中国医学影像技术, 2010, 26(3):439-443.
16.	Small DM, Prescott J. Odor/taste integration and the perception of flavor. Exp Brain Res, 2005, 166(3-4):345-357.
17.	Coria F, Bahillo Marcos E, Moral Blanco M, et al. Late-onset isolated gelastic epilepsy secondary to entrapment of the right temporal horn. Neurologia, 2000, 15(5):204-207.
18.	Garcia A, Gutierrez MA, Barrasa J, et al. Cryptogenic gelastic epilepsy of frontal lobe origin:a paediatric case report. Seizure, 2000, 9 (4):297-300.
19.	孙涛.岛叶癫痫.中华神经外科杂志, 2014, 30(10):976-978.

1. Guenot M, Isnard J, Sindou M. Surgical anatomy of the insula. Adv Tech Stand Neurosurg, 2004, 29(5):265-288.
2. 梁鹏, 刘恩重, 赵世光, 等.手术全切岛叶基底节区胶质瘤21例报告.中国微侵袭神经外科杂志, 2004, 9(4):157-159.
3. Tanriover N, Rhoton AL Jr, Kawashima M, et al. Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg, 2004, 100(5):891-992.
4. Isnard J, Guenot M, Sindou M. et al. Clinical manifestations ofinsular lobe seizures:a stereo-electroencephalographic study. Epilepsia, 2004, 45(9):1079-1090.
5. VonLehe M, Wellmer J, Urbach H, et al. Insular lesion ectomy for refractory epilepsy:management and outcome. Brain, 2009, 132(4):1048-1056.
6. Friedman DP, Murray EA, ONeill JB, et al. Cortical connections of the somatosensory fields of the lateral sulcus of macaques:evidence for acorticolimbic pathway for touch. J Comp Neur, 1986, 252(3):323-347.
7. Chikama M, Mcfarland NR, Amaral DG, et al. Insular cortical projections to functional regions of the striatum correlate with cortical cytoarchitectoifie organization in the primate. J Neurosci, 1997, 17(24):9686-9705.
8. Kurth F, Zilles K, Fox PT, et al. A link between the systems:functional differentiation and integration within the human insula revealed by meta-analysis. Brain StructFunct, 2010, 214 (5/6):519-534.
9. Stephani C, Fernandez-Baca Vaca G, Maciunas R, et al. Functional neuroanatomy of the insular lobe. Brain Struct Funct, 2011, 216(2):137-149.
10. Craig AD. The sentient self. Brain StructFunct, 2010, 214(5/6):563-577.
11. Augustine JR. Circuitry and functional aspects of the insularlobe in primates including humans. Brain Res Brain Res Rev, 1996, 22(3):229-244.
12. Carota A, Annoni JM, Marangolo P. Repeating through the insula:evidence from two consecutive strokes. Neuroreport, 2007, 18(13):1367-1370.
13. Nestor PJ, Graham NL, Fryer TD, et al. Progressive non-fluent aphasia is associated with hypo metabolism centred on the left anterior insula. Brain, 2003, 126(Pt 11):2406-2418.
14. Price CJ. The anatomy of language:contributions from functional neuro imaging. J Anat, 2000, 197(Pt 3):335-359.
15. 伊慧明, 周媛, 张权, 等.岛叶的任务态和静息态功能磁共振成像.中国医学影像技术, 2010, 26(3):439-443.
16. Small DM, Prescott J. Odor/taste integration and the perception of flavor. Exp Brain Res, 2005, 166(3-4):345-357.
17. Coria F, Bahillo Marcos E, Moral Blanco M, et al. Late-onset isolated gelastic epilepsy secondary to entrapment of the right temporal horn. Neurologia, 2000, 15(5):204-207.
18. Garcia A, Gutierrez MA, Barrasa J, et al. Cryptogenic gelastic epilepsy of frontal lobe origin:a paediatric case report. Seizure, 2000, 9 (4):297-300.
19. 孙涛.岛叶癫痫.中华神经外科杂志, 2014, 30(10):976-978.

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