title: Specific disgust processing in the left insula: New evidence from direct electrical stimulation.
abstract: Neuropsychological and neuroimaging studies yielded controversial results concerning the specific role of the insula in recognizing the facial expression of disgust. To verify whether the insula has a selective role in facial disgust processing, emotion recognition was studied in thirteen patients during intraoperative stimulation of the insula in awake surgery performed for removal of a glioma close to this structure. Direct electrical stimulation of the left insula produced a general decrease in emotion recognition but only in the case of disgust there was a statistically significant detrimental effect (p=0.004). Happiness and anger were the best and the worst recognized emotion, respectively. The worst baseline performance with anger and, partly, fear could be explained with the involvement of the left temporal regions, striatum, and the connection between the striatum and the frontal lobe, as suggested in previous studies. Therefore, upon these intra-operative evidences, we argue for a selective role of the left insula in disgust recognition, although a (non significant) decrease in the recognition of other negative emotions was found. However, additional networks can develop, as demonstrated by the fact that disgust recognition was not impaired after surgery even in patients with insular resection in the current as in previous studies.
authors.affiliation: Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy; Centro di Neuroscienze NeuroMi, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy. Electronic address: costanza.papagno@unimib.it.
authors.forename: Costanza
authors.initials: C
authors.lastname: Papagno
authors.affiliation: Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy; Centro di Neuroscienze NeuroMi, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pisoni
authors.affiliation: Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy; Centro di Neuroscienze NeuroMi, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Mattavelli
authors.affiliation: Unit of Surgical Neurooncology, Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 (MI), Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casarotti
authors.affiliation: Unit of Surgical Neurooncology, Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 (MI), Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Comi
authors.affiliation: Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fumagalli
authors.affiliation: Dipartimento di Psicologia, Università di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy.
authors.forename: Mirta
authors.initials: M
authors.lastname: Vernice
authors.affiliation: Unit of Surgical Neurooncology, Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 (MI), Italy; Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, via Manzoni 56, Rozzano, 20089 (MI), ITALY.
authors.forename: Enrica
authors.initials: E
authors.lastname: Fava
authors.affiliation: Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, via Manzoni 56, Rozzano, 20089 (MI), ITALY.
authors.forename: Marco
authors.initials: M
authors.lastname: Riva
authors.affiliation: Unit of Surgical Neurooncology, Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089 (MI), Italy; Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, via Manzoni 56, Rozzano, 20089 (MI), ITALY.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bello
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D004558:Electric Stimulation / Q000379:methods; D004644:Emotions / Q000502:physiology*; D000066499:Facial Recognition / Q000502:physiology*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome
keywords: awake surgery; disgust; emotions; glioma; insular cortex