Strokes restricted to the insular cortex

Abstract

Strokes restricted to the posterior insula may present with pseudothalamic sensory and vestibular-like syndromes as prominent clinical manifestations, but also dysarthria and aphasia (in left lesions), somatoparaphrenia (right lesions) and gustatory dysfunction and blood pressure with hypertensive episodes in right lesions; we did not find acute dysphagia reported in anterior, insular strokes.

Dominant hemisphere functional networks compensate for structural connectivity loss to preserve phonological retrieval with aging

“…This is in keeping with previous literature on phonology, which supports the involvement of left rather than right hemispheric regions (Cereda et al. 2002; Shafto et al. 2007).…”

The role of the insula in speech and language processing

“…The classic neuropsychological models point to the left inferior frontal gyrus, or Broca's area, as the hub of speech and language production (Broca, 1861;Geschwind-Wernicke, 1979). However, based on lesion studies with patients with articulation difficulties, the insula has also been put forth as a brain region involved in the motor control of speech production (Cereda et al 2002;Dronkers 1996;Duffau et al 2001 ;Starkstein et al 1988). …”

Altered Taste and Stroke: A Case Report and Literature Review

“…17 The insular cortex has also been suggested as a primary gustatory cortex, 7,11,13 with its importance in the processing of gustatory information supported by several case series 7,[11][12][13]18 and a prospective observational study. 9 Recent work by Chen et al supports the existence of a gustotopic map in the mammalian insular cortex, in which each taste modality is encoded by a specific group of neurons.…”

“…[1][2][3][4][5][6][7][8][9][10] Several case reports have detailed altered taste as a result of isolated pontine lesions [2][3][4][5][6]10 as well as both isolated right and left insular lesions. 11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described. 7,9,10 Taste perception was initially thought to be processed without decussation, 2 but more recently complete or bilateral decreased perception has been attributed to isolated left insular infarcts, 7,[11][12][13] suggesting that this site may receive contralateral projections or function as an important higher order center for taste perception.…”

“…11,12 Deficits including ageusia (inability to taste), hypogeusia (decreased ability to taste), and dysgeusia (distorted ability to taste) have also been described. 7,9,10 Taste perception was initially thought to be processed without decussation, 2 but more recently complete or bilateral decreased perception has been attributed to isolated left insular infarcts, 7,[11][12][13] suggesting that this site may receive contralateral projections or function as an important higher order center for taste perception. Isolated insular infarcts affecting taste are uncommon, and thus the symptoms of altered taste may go unrecognized in patients experiencing larger middle cerebral artery (MCA) territorial infarcts, thereby limiting patient recovery and resulting in worse outcomes.…”