Differential insular cortex sub-regional atrophy in neurodegenerative diseases: a systematic review and meta-analysis

Yasmine Y Fathy*, Susanne E Hoogers, Henk W Berendse, Ysbrand D van der Werf, Pieter J Visser, Frank J de Jong, Wilma D J van de Berg

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

The insular cortex is proposed to function as a central brain hub characterized by wide-spread connections and diverse functional roles. As a result, its centrality in the brain confers high metabolic demands predisposing it to dysfunction in disease. However, the functional profile and vulnerability to degeneration varies across the insular sub-regions. The aim of this systematic review and meta-analysis is to summarize and quantitatively analyze the relationship between insular cortex sub-regional atrophy, studied by voxel based morphometry, with cognitive and neuropsychiatric deficits in frontotemporal dementia (FTD), Alzheimer's disease (AD), Parkinson's disease (PD), and dementia with Lewy bodies (DLB). We systematically searched through Pubmed and Embase and identified 519 studies that fit our criteria. A total of 41 studies (n = 2261 subjects) fulfilled the inclusion criteria for the meta-analysis. The peak insular coordinates were pooled and analyzed using Anatomic Likelihood Estimation. Our results showed greater left anterior insular cortex atrophy in FTD whereas the right anterior dorsal insular cortex showed larger clusters of atrophy in AD and PD/DLB. Yet contrast analyses did not reveal significant differences between disease groups. Functional analysis showed that left anterior insular cortex atrophy is associated with speech, emotion, and affective-cognitive deficits, and right dorsal atrophy with perception and cognitive deficits. In conclusion, insular sub-regional atrophy, particularly the anterior dorsal region, may contribute to cognitive and neuropsychiatric deficits in neurodegeneration. Our results support anterior insular cortex vulnerability and convey the differential involvement of the insular sub-regions in functional deficits in neurodegenerative diseases.

Original languageEnglish
Pages (from-to)2799-2816
Number of pages18
JournalBrain Imaging and Behavior
Volume14
Issue number6
Early online date23 Apr 2019
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Insular cortex
  • Parkinson&#8217
  • s disease
  • Frontotemporal dementia
  • Alzheimer&#8217
  • Voxel based morphometry
  • Cognition
  • Emotion
  • Perception
  • Anatomic likelihood estimation
  • Neurodegeneration
  • VOXEL-BASED MORPHOMETRY
  • MILD COGNITIVE IMPAIRMENT
  • VON ECONOMO NEURONS
  • BEHAVIORAL-VARIANT
  • PARKINSONS-DISEASE
  • ALZHEIMERS-DISEASE
  • NEUROPSYCHIATRIC SYMPTOMS
  • FRONTOTEMPORAL DEMENTIA
  • EMOTION RECOGNITION
  • ANTERIOR INSULA

Fingerprint

Dive into the research topics of 'Differential insular cortex sub-regional atrophy in neurodegenerative diseases: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this