What is the Cognitive Footprint of Insular Glioma?

Overview

Journal Front Hum Neurosci

Specialty Neurology

Date 2024 Jun 11

PMID 38859993

Authors

Noah M Nichols

Bahie Ezzat

Allison C Waters

Fedor Panov

Raymund L Yong

Isabelle M Germano

Affiliations

Soon will be listed here.

Abstract

Cognitive impairment has a profound deleterious impact on long-term outcomes of glioma surgery. The human insula, a deep cortical structure covered by the operculum, plays a role in a wide range of cognitive functions including interceptive thoughts and salience processing. Both low-grade (LGG) and high-grade gliomas (HGG) involve the insula, representing up to 25% of LGG and 10% of HGG. Surgical series from the past 30 years support the role of primary cytoreductive surgery for insular glioma patients; however, reported cognitive outcomes are often limited to speech and language function. The breath of recent neuroscience literature demonstrates that the insula plays a broader role in cognition including interoceptive thoughts and salience processing. This article summarizes the vast functional role of the healthy human insula highlighting how this knowledge can be leveraged to improve the care of patients with insular gliomas.

References

Duffau H, Taillandier L, Gatignol P, Capelle L . The insular lobe and brain plasticity: Lessons from tumor surgery. Clin Neurol Neurosurg. 2005; 108(6):543-8. DOI: 10.1016/j.clineuro.2005.09.004. View

Segerdahl A, Mezue M, Okell T, Farrar J, Tracey I . The dorsal posterior insula subserves a fundamental role in human pain. Nat Neurosci. 2015; 18(4):499-500. PMC: 6783299. DOI: 10.1038/nn.3969. View

Ham T, Leff A, De Boissezon X, Joffe A, Sharp D . Cognitive control and the salience network: an investigation of error processing and effective connectivity. J Neurosci. 2013; 33(16):7091-8. PMC: 6618896. DOI: 10.1523/JNEUROSCI.4692-12.2013. View

Seeley W, Menon V, Schatzberg A, Keller J, Glover G, Kenna H . Dissociable intrinsic connectivity networks for salience processing and executive control. J Neurosci. 2007; 27(9):2349-56. PMC: 2680293. DOI: 10.1523/JNEUROSCI.5587-06.2007. View

Li Z, Li G, Liu Z, Pan Y, Hou Z, Wu L . Transcortical approach for insular gliomas: a series of 253 patients. J Neurooncol. 2020; 147(1):59-66. DOI: 10.1007/s11060-020-03390-2. View

Tucha O, Smely C, Preier M, Lange K . Cognitive deficits before treatment among patients with brain tumors. Neurosurgery. 2000; 47(2):324-33; discussion 333-4. DOI: 10.1097/00006123-200008000-00011. View

Pitskhelauri D, Bykanov A, Konovalov A, Danilov G, Buklina S, Sanikidze A . Transsylvian Insular Glioma Surgery: New Classification System, Clinical Outcome in a Consecutive Series of 79 Cases. Oper Neurosurg (Hagerstown). 2021; 20(6):541-548. DOI: 10.1093/ons/opab051. View

Gomez-Andres A, Cunillera T, Rico I, Naval-Baudin P, Camins A, Fernandez-Coello A . The role of the anterior insular cortex in self-monitoring: A novel study protocol with electrical stimulation mapping and functional magnetic resonance imaging. Cortex. 2022; 157:231-244. DOI: 10.1016/j.cortex.2022.09.008. View

Uddin L . Salience processing and insular cortical function and dysfunction. Nat Rev Neurosci. 2014; 16(1):55-61. DOI: 10.1038/nrn3857. View

10.

Hameed N, Qiu T, Zhuang D, Lu J, Yu Z, Wu S . Transcortical insular glioma resection: clinical outcome and predictors. J Neurosurg. 2018; 131(3):706-716. DOI: 10.3171/2018.4.JNS18424. View

11.

Blustajn J, Krystal S, Taussig D, Ferrand-Sorbets S, Dorfmuller G, Fohlen M . Optimizing the Detection of Subtle Insular Lesions on MRI When Insular Epilepsy Is Suspected. AJNR Am J Neuroradiol. 2019; 40(9):1581-1585. PMC: 7048439. DOI: 10.3174/ajnr.A6143. View

12.

Oh A, Duerden E, Pang E . The role of the insula in speech and language processing. Brain Lang. 2014; 135:96-103. PMC: 4885738. DOI: 10.1016/j.bandl.2014.06.003. View

13.

Zu Eulenburg P, Baumgartner U, Treede R, Dieterich M . Interoceptive and multimodal functions of the operculo-insular cortex: tactile, nociceptive and vestibular representations. Neuroimage. 2013; 83:75-86. DOI: 10.1016/j.neuroimage.2013.06.057. View

14.

Naidich T, Kang E, Fatterpekar G, Delman B, Gultekin S, Wolfe D . The insula: anatomic study and MR imaging display at 1.5 T. AJNR Am J Neuroradiol. 2004; 25(2):222-32. PMC: 7974606. View

15.

Nomi J, Farrant K, Damaraju E, Rachakonda S, Calhoun V, Uddin L . Dynamic functional network connectivity reveals unique and overlapping profiles of insula subdivisions. Hum Brain Mapp. 2016; 37(5):1770-87. PMC: 4837017. DOI: 10.1002/hbm.23135. View

16.

Duffau H, Moritz-Gasser S, Gatignol P . Functional outcome after language mapping for insular World Health Organization Grade II gliomas in the dominant hemisphere: experience with 24 patients. Neurosurg Focus. 2009; 27(2):E7. DOI: 10.3171/2009.5.FOCUS0938. View

17.

Briggs R, Young I, Dadario N, Fonseka R, Hormovas J, Allan P . Parcellation-based tractographic modeling of the salience network through meta-analysis. Brain Behav. 2022; 12(7):e2646. PMC: 9304834. DOI: 10.1002/brb3.2646. View

18.

Wu A, Witgert M, Lang F, Xiao L, Bekele B, Meyers C . Neurocognitive function before and after surgery for insular gliomas. J Neurosurg. 2011; 115(6):1115-25. DOI: 10.3171/2011.8.JNS11488. View

19.

Mazzola L, Isnard J, Peyron R, Guenot M, Mauguiere F . Somatotopic organization of pain responses to direct electrical stimulation of the human insular cortex. Pain. 2009; 146(1-2):99-104. DOI: 10.1016/j.pain.2009.07.014. View

20.

PENFIELD W, FAULK Jr M . The insula; further observations on its function. Brain. 1955; 78(4):445-70. DOI: 10.1093/brain/78.4.445. View