GABA in the insula — a predictor of the neural response to interoceptive awareness

Wiebking, Christine; Duncan, Niall W.; Tiret, Brice; Hayes, D. K.; Marjańska, Małgorzata; Doyon, Julien; Bajbouj, Malek; Northoff, Georg

doi:10.1016/j.neuroimage.2013.04.042

Cited by 109 publications

(105 citation statements)

References 74 publications

(106 reference statements)

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“…Animal models have corroborated these effects of insula damage on drug self-administration, with lesions centered on posterior, granular insula (43,44). Therapeutic strategies to reduce insula responsivity, such as mindfulness-or meditationbased techniques (45,46) or GABAergic medications (47), may usefully augment cognitive therapy for psychological distortions in the treatment of problem gambling.…”

Section: Discussionmentioning

confidence: 97%

Damage to insula abolishes cognitive distortions during simulated gambling

Clark

Studer

Bruss³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

107

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Gambling is a naturalistic example of risky decision-making. During gambling, players typically display an array of cognitive biases that create a distorted expectancy of winning. This study investigated brain regions underpinning gambling-related cognitive distortions, contrasting patients with focal brain lesions to the ventromedial prefrontal cortex (vmPFC), insula, or amygdala ("target patients") against healthy comparison participants and lesion comparison patients (i.e., with lesions that spare the target regions). A slot machine task was used to deliver near-miss outcomes (i.e., nonwins that fall spatially close to a jackpot), and a roulette game was used to examine the gambler's fallacy (color decisions following outcome runs). Comparison groups displayed a heightened motivation to play following near misses (compared with full misses), and manifested a classic gambler's fallacy effect. Both effects were also observed in patients with vmPFC and amygdala damage, but were absent in patients with insula damage. Our findings indicate that the distorted cognitive processing of near-miss outcomes and event sequences may be ordinarily supported by the recruitment of the insula. Interventions to reduce insula reactivity could show promise in the treatment of disordered gambling.G ambling is a widespread activity with a lifetime prevalence of 78% in the United States (1) and a past-year prevalence of 73% in the United Kingdom (2). The widespread recognition that "the house always wins," reflecting the negative expected value of gambling, makes gambling an enduring puzzle for psychological and economic models of choice behavior. Cognitive approaches to gambling explain this nonnormative behavior with reference to a number of cognitive distortions and irrational beliefs that occur during gambling play, which cause the gambler to overestimate his likelihood of winning (3, 4). The illusion of control refers to how superficial features of a game, such as a choice or instrumental response, promote erroneous perceptions of skill over outcomes that are determined only by chance (5). Near-miss outcomes (nonwins that fall close to the jackpot) increase motivations to play, plausibly by fueling beliefs about skill acquisition (6). The gambler's fallacy is a bias in the processing of randomness, whereby recent consecutive outcomes are considered less likely to repeat, and conversely, outcomes that have not occurred in the recent history are perceived as "due" (7).These distortions are reliably observed in field studies, e.g., casino environments (8), and are not confined to gambling; illusory control and the gambler's fallacy are observed in stock traders (9), and near misses influence decision-making in occupational settings (10). In the laboratory, these distortions can be elicited with gambling games, allowing the comparison of these biases between different clinical groups. The overall level of distorted thinking is elevated in people with gambling problems (11,12), and these cognitions can be targeted effectively in psy...

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Section: Discussionmentioning

confidence: 97%

Damage to insula abolishes cognitive distortions during simulated gambling

Clark

Studer

Bruss³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

107

View full text Add to dashboard Cite

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“…Self-related) and external (i.e. environment-related) mental contents (Vanhaudenhuyse et al, 2011;Wiebking et al, 2014) [18,19].…”

Section: Neurobiological Correlates Of Core Symptoms In Anorexiamentioning

confidence: 99%

Neurobiological Correlates of Core Symptoms in Anorexia:Abnormal Spatiotemporal Structure in the Resting-StateActivity and Troubles of the Self

Amianto¹

2015

Acta Psychopathologica

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“…Targeting the question formulated above regarding the biochemical underpinnings of interoceptive awareness in the insula in healthy participants, Wiebking et al [38] conducted the first study combining fMRI during interoceptive awareness and MRS in the insula. To ensure the reproducibility of neuroimaging studies and in line with good practice, a wellestablished paradigm in fMRI was used as introduced by Critchley and Pollatos [12,39].…”

Section: Neuroimaging In Interoceptive Awareness Combining Fmri Anmentioning

confidence: 99%

Interoceptive awareness and the insula - Application of Neuroimaging Techniques in Psychotherapy

Wiebking

Northoff

2014

GSTF J Psych

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Abstract-Interoceptive awareness is defined as the awareness of stimuli originating inside one's own body such as the heartbeat. The emergence of new brain imaging techniques like functional magnetic resonance imaging (fMRI) or magnetic resonance spectroscopy (MRS) has increased our knowledge of neural substrates underlying interoceptive awareness. In particular, the bilateral brain structure of the insula has been identified as a key region involved in interoceptive processes in healthy populations. In line with prominent theories of human emotion, the insula has an important function in connecting interoceptive awareness with affective experience. This connection hinging on the insula between interoception and emotional processing is suggestive of an involvement of the insula in mood disorders such as major depressive disorder (MDD). Multilayered deficits in the insula cortex of depressed individuals such as abnormal function, biochemistry, and anatomy support this hypothesis.The aim of the present article is a) to describe the importance of the insula for the interplay between interoception and emotional processing and b) how this might be figured into psychotherapeutic treatment of depressed patients using new imaging techniques like real-time fMRI.The article begins with a brief introduction about neuroanatomical settings of the insula (I. IntroductionNeuroanatomical background of the insula). Afterwards, early behavioral studies to investigate interoceptive awareness are described (II. A step Back-First attempts to investigate interoceptive awareness), followed by a description of more recent imaging studies outlining neural mechanisms underlying interoceptive awareness and emotional processing in the insula (III. The insula as key region involved in functional interoception and emotion.) Throughout, the article addresses the question of why the investigation of individuals suffering from depression might provide novel insights into the neural underpinnings of interoceptive awareness and its link to abnormal behavior (IV. Why study interoceptive awareness in depressed participants?).Following the description of a selected study that combines for the first time functional results of interoception (using fMRI) with biochemical results of the insula (using MRS) (V. Neuroimaging in interoceptive awareness combining fMRI and MRS -A specific study), the article concludes with a perspective outlining the potential for using imaging techniques like real-time fMRI to enhance neural activity in the insula during interoceptive awareness. This approach potentially leads to faster recovery in depressed patients and might be the first therapeutic application of functional imaging in psychiatry (VI. Perspectives: Neurofeedback in major depression using real-time fMRI).

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GABA in the insula — a predictor of the neural response to interoceptive awareness

Cited by 109 publications

References 74 publications

Damage to insula abolishes cognitive distortions during simulated gambling

Damage to insula abolishes cognitive distortions during simulated gambling

Neurobiological Correlates of Core Symptoms in Anorexia:Abnormal Spatiotemporal Structure in the Resting-StateActivity and Troubles of the Self

Interoceptive awareness and the insula - Application of Neuroimaging Techniques in Psychotherapy

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