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Middle short gyrus of the insula implicated in pain processing
Afif Afif1, Dominique Hoffmann, Lorella Minotti
1Neurosurgery Department, INSERM U318, Grenoble University Hospital, BP 217, 38043 Grenoble Cedex 9, France Neurology Department, INSERM U704, Grenoble University Hospital, BP 217, 38043 Grenoble Cedex 9, France.
Pain
|March 28, 2008
Summary
Electrical stimulation of the insular cortex in epilepsy patients revealed specific pain processing areas. The middle short gyrus of the insula appears crucial for pain perception.
Area of Science:
- Neuroscience
- Pain Research
- Epilepsy Studies
Background:
- The insular cortex is implicated in pain processing, evidenced by functional neuroimaging and direct electrical stimulation (ES) studies.
- Invasive evaluation of epilepsy patients offers unique opportunities to study brain responses to ES in awake individuals.
Purpose of the Study:
- To investigate the role of the insular cortex in pain processing by analyzing responses to electrical stimulation in epilepsy patients.
- To identify specific subregions within the insula responsible for generating pain sensations.
Main Methods:
- Utilized deep brain electrodes stereotactically implanted in the insular cortex of 25 drug-refractory focal epilepsy patients.
- Analyzed patient-reported sensations following ES, correlating them with precise anatomical localization of stimulation sites using image fusion (3D MRI and CT scans).
Main Results:
- Out of 83 ES responses, 8 (9.6%) in 5 patients elicited painful sensations.
- Painful sensations included cephalic and upper limb/trunk pinprick sensations.
- All pain-inducing stimulation sites were localized to the upper portion of the middle short gyrus of the insula.
Conclusions:
- The middle short gyrus of the insula plays a significant role in processing pain-producing stimuli.
- This study provides direct evidence for the insula's involvement in the sensory aspects of pain.
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