title: Revisiting the role of the insula in addiction.
abstract: Brain lesions that damage the insular cortex (IC) interrupt addictive behaviors, suggesting that drug addiction sensitizes the insula. However, neuroimaging studies seem to lead to an opposite picture: structural neuroimaging studies show reduced gray matter volume of the IC of drug users, and functional neuroimaging studies show reduced IC activity when drug users perform decision-making tasks. These results have been interpreted as indicating that addictive behaviors are associated with reduced interoceptive signaling within the IC. Here, we use this apparent contradiction to examine the possible roles of the insula in addiction, identify open questions, and explore ways to address them.
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA, USA. Electronic address: vdroutman@gmail.com.
authors.forename: Vita
authors.initials: V
authors.lastname: Droutman
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Read
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA, USA; Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bechara
mesh_terms: D000818:Animals; D002540:Cerebral Cortex / Q000293:injuries / Q000502:physiology*; D006801:Humans; D059906:Neuroimaging; D019966:Substance-Related Disorders / Q000473:pathology*
keywords: decision-making; drug dependence; insular cortex; smoking