A common role of insula in feelings, empathy and uncertainty

Although accumulating evidence highlights a crucial role of the insular cortex in feelings, empathy and processing uncertainty in the context of decision making, neuroscientific models of affective learning and decision making have mostly focused on structures such as the amygdala and the striatum. Here, we propose a unifying model in which insula cortex supports different levels of representation of current and predictive states allowing for error-based learning of both feeling states and uncertainty. This information is then integrated in a general subjective feeling state which is modulated by individual preferences such as risk aversion and contextual appraisal. Such mechanisms could facilitate affective learning and regulation of body homeostasis, and could also guide decision making in complex and uncertain environments.