title: Impaired Recognition and Regulation of Disgust Is Associated with Distinct but Partially Overlapping Patterns of Decreased Gray Matter Volume in the Ventroanterior Insula.
abstract: BACKGROUND
  The ventroanterior insula is implicated in the experience, expression, and recognition of disgust; however, whether this brain region is required for recognizing disgust or regulating disgusting behaviors remains unknown.
  
  
  METHODS
  We examined the brain correlates of the presence of disgusting behavior and impaired recognition of disgust using voxel-based morphometry in a sample of 305 patients with heterogeneous patterns of neurodegeneration. Permutation-based analyses were used to determine regions of decreased gray matter volume at a significance level p <= .05 corrected for family-wise error across the whole brain and within the insula.
  
  
  RESULTS
  Patients with behavioral variant frontotemporal dementia and semantic variant primary progressive aphasia were most likely to exhibit disgusting behaviors and were, on average, the most impaired at recognizing disgust in others. Imaging analysis revealed that patients who exhibited disgusting behaviors had significantly less gray matter volume bilaterally in the ventral anterior insula. A region of interest analysis restricted to behavioral variant frontotemporal dementia and semantic variant primary progressive aphasia patients alone confirmed this result. Moreover, impaired recognition of disgust was associated with decreased gray matter volume in the bilateral ventroanterior and ventral middle regions of the insula. There was an area of overlap in the bilateral anterior insula where decreased gray matter volume was associated with both the presence of disgusting behavior and impairments in recognizing disgust.
  
  
  CONCLUSIONS
  These findings suggest that regulating disgusting behaviors and recognizing disgust in others involve two partially overlapping neural systems within the insula. Moreover, the ventral anterior insula is required for both processes.
authors.affiliation: Department of Psychiatry, University of California San Francisco; San Francisco Department of Veterans Affairs Medical Center, San Francisco, California. Electronic address: Josh.Woolley@ucsf.edu.
authors.forename: Josh D
authors.initials: JD
authors.lastname: Woolley
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Eric V
authors.initials: EV
authors.lastname: Strobl
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Virginia E
authors.initials: VE
authors.lastname: Sturm
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Tal
authors.initials: T
authors.lastname: Shany-Ur
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Pardis
authors.initials: P
authors.lastname: Poorzand
authors.affiliation: University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Scott
authors.initials: S
authors.lastname: Grossman
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Lauren
authors.initials: L
authors.lastname: Nguyen
authors.affiliation: University of California Berkeley, Berkeley, California.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Eckart
authors.affiliation: University of California Berkeley, Berkeley, California.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Levenson
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: William W
authors.initials: WW
authors.lastname: Seeley
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Miller
authors.affiliation: University of California San Francisco Memory and Aging Center, University of California San Francisco, San Francisco, California.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Rankin
mesh_terms: D000368:Aged; D002540:Cerebral Cortex / Q000473:pathology*; D004644:Emotions / Q000502:physiology; D000066499:Facial Recognition / Q000502:physiology; D005190:Family; D005260:Female; D057180:Frontotemporal Dementia / Q000473:pathology / Q000523:psychology; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000473:pathology* / Q000523:psychology*; D009483:Neuropsychological Tests; D009929:Organ Size; D021641:Recognition, Psychology / Q000502:physiology; D012189:Retrospective Studies
keywords: Disgust; Emotion recognition; Frontotemporal dementia; Insula; Neurodegeneration; Voxel-based morphometry