The insular region: Part of the prefrontal cortex?

Moral conduct and social behavior

Over the past 150 years, the frontal lobes (FLs) have been implicated in the neural mediation of both normal and abnormal moral conduct and social behavior (MCSB). Despite the remarkable advances that have permeated this period up to the present, a comprehensive account of the neural underpinnings of MCSB has stubbornly defied the best minds of psychology, psychiatry, and neurology. The goal of this chapter is to review a few practical and conceptual achievements that have proved heuristically valuable as an impetus for further advance of knowledge. In virtually all cases in which MCSB was compromised by brain damage, the injuries were located (i) in the prefrontal cortices, (ii) in their connections with the temporal poles and anterior insula, or (iii) in related subcortical structures and pathways, such as the thalamic dorsomedial nucleus or the anterior thalamic radiation. The clinicoanatomic associations among these structures originated the "frontal network systems" concept, which satisfactorily explains the occurrence of classical FL syndromes in patients with lesions outside the prefrontal cortices. Overall, clinicoanatomic observational studies and experimental evidence from patients with acquired sociopathy/psychopathy indicate that abnormalities of MCSB are the final common pathway of single or mixed impairments of subordinate psychologic and neural domains that support MCSB. Independent studies on normal volunteers concur with this view, indicating that MCSB is shaped by the dynamic interplay of subordinate psychologic domains, such as moral sensitivity and judgment, and their neural correlates.

Parabrachio-cortical connections with the lateral hemisphere in the madagascan hedgehog tenrec: prominent projections to layer 1, weak projections from layer 6

The present study was undertaken to further characterize and subdivide the rhinal cortex (insular and perirhinal areas) in the hedgehog tenrec (Echinops telfairi), a placental mammal with a rather low encephalisation index. Injections of wheat germ agglutinin-horseradish peroxidase into the dorsolateral pontine tegmentum revealed a prominent layer 1 projection to several rhinal target areas, while the rhinal cortex only stained weakly for the calcitonin gene-related peptide. Among the regions retrogradely labeled following tracer injections into the rhinal cortex, the parabrachial nucleus was considered the main origin of the tegmento-cortical projection. This conclusion was based on the circumscribed pattern of termination, as well as the differences noted between the pattern of anterograde labeling and the pattern obtained by thyrosine hydroxylase immunohistochemistry. The tracer injections into the dorsolateral tegmentum also revealed numerous retrogradely labeled cells in the layer 5 of the dorsomedial frontal cortex. In contrast, the rhinal cortex only showed few labeled cells and most of these cells were located in the layer 6/7. A comparison with other species indicates that the tenrec's parabrachial nucleus gives rise to the most extensive cortical projections but receives the least prominent input from the lateral cerebral hemisphere. The layer 6/7 projection may be a common mammalian feature but it is overshadowed by the layer 5 projection in higher mammals.

Efferent connections of the medial prefrontal cortex in the rabbit

The different cytoarchitectonic regions of the medial prefrontal cortex (mPFC) have recently been shown to play divergent roles in associative learning in rabbits. To determine if these subareas of the mPFC, including areas 24 (anterior cingulate cortex), 25 (infralimbic cortex), and 32 (prelimbic cortex) have differential efferent connections with other cortical and subcortical areas in the rabbit, anterograde and retrograde tracing experiments were performed using the Phaseolus vulgaris leukoagglutinin (PHA-L), and horseradish peroxidase (HRP) techniques. All three areas showed local dorsal-ventral projections into each of the other areas, and a contralateral projection to the homologous area on the other side of the brain. All three also revealed a trajectory through the striatum, resulting in heavy innervation of the caudate nucleus, the claustrum, and a lighter projection to the agranular insular cortex. The thalamic projections of areas 24 and 32 were similar, but not identical, with projections to the mediodorsal nucleus (MD) and all of the midline nuclei. However, the primary thalamic projections from area 25 were to the intralaminar and midline nuclei. All three areas also projected to the ventromedial and to a lesser extent to the ventral posterior thalamic nuclei. Projections were also observed in the lateral hypothalamus, in an area just lateral to the descending limb of the fornix. Amygdala projections from areas 32 and 24 were primarily to the lateral, basolateral and basomedial nuclei, but area 25 also projected to the central nucleus. All three areas also showed projections to the midbrain periaqueductal central gray, median raphe nucleus, ventral tegmental area, substantia nigra, locus coeruleus and pontine nuclei. However, only areas 24 and the more dorsal portions of area 32 projected to the superior colliculus. Area 25 and the ventral portions of area 32 also showed a bilateral projection to the parabrachial nuclei and dorsal and ventral medulla. The dorsal portions of area 32, and all of area 24 were, however, devoid of these projections. It is suggested that these differential projections are responsible for the diverse roles that the cytoarchitectonic subfields of the mPFC have been demonstrated to play in associative learning.

3H-2-deoxyglucose uptake after electrical stimulation of cardioactive sites in insular cortex and mediodorsal nucleus of the thalamus in rabbits

The uptake of 3H-2-deoxyglucose (3H-2-DG) in selected brain structures was determined subsequent to electrical stimulation of insular cortex (Ins) and the mediodorsal (MD) nucleus of the thalamus in rabbits. Stimulation of Ins elicited parasympathetic-like responding (i.e., bradycardia and depressor responses); whereas MD stimulation produced sympathetic-like responses (bradycardia and pressor responses). Stimulation of Ins also resulted in increased 3H-2-DG activity in ipsilateral MD and the ventromedial/ventroposterior complex as well as the contralateral Ins compared to nonstimulated control subjects. The central nucleus of the amygdala also showed increased activity after Ins stimulation. In 2 animals stimulation of Ins resulted in increased 3H-2-DG activity in the caudate/putamen complex. Stimulation of MD resulted in ipsilateral increases in 3H-2-DG activity in the midline, agranular prefrontal cortex, as well as the ipsilateral Ins, and the caudate nucleus and putamen/globus pallidus complex. Two animals also showed increases in 3H-2-DG activity in ipsilateral substantia nigra. However, no increased activity was observed in the lateral hypothalamus, the parabrachial nuclei, the nucleus tractus solitarius, or the dorsal motor nucleus of the vagus, although it has been shown that efferents from Ins reach these areas. A more significant finding however, was that the reciprocal connections of MD and Ins appear to be activated by stimulation of either structure, even though their relationship to autonomic function appears to be quite different.

Visual localization and discrimination after ibotenic lesion of the cat orbito-insular cortex

Behavioral tasks were used to investigate how the orbito-insular cortex (OIC) of the cat is involved in complex operations such as the orienting reaction towards a novel stimulus. Six cats were trained preoperatively on a perimetry test to assess their ability to orient the head and eyes to objects presented in restricted regions of the visual field, and on brightness, pattern and form discrimination tasks for food reward in a two-choice discrimination apparatus. Two animals then underwent unilateral chemical lesion of the OIC using injections of ibotenic acid, two others received bilateral lesions of this same area, and the remaining two cats were used as normal controls. Postoperative performance of brightness, pattern and form discrimination was normal following OIC lesions, and no lack of retention was observed. In contrast, the cats with OIC lesions had significant deficits in their visually guided behavior. The cats ignored objects presented in the monocular segment of both sides of the visual field, even after unilateral lesion, and there was an effect on the ability to attend and fixate the central preconditioned stimulus.

Diencephalic and mesencephalic afferents of the rat claustrum

The retrograde fluorescent tracers Fast Blue (FB) and Diamidino Yellow (DY) have been used to study subcortical afferents of the claustrum. DY or FB was injected into the claustrum. The greatest amount of labeled cell bodies were observed in the posterior thalamic nuclear complex. They were especially abundant in its caudal part, lying between the medial geniculate body and the pretectal area. In comparison to the numerous labeled cells near the diencephalic-mesencephalic junction, the number of fluorescing neurons in the brain stem was considerably lower. These neurons were mostly concentrated in the monoaminergic cell groups. The results indicate the presence of a substantial projection from the posterior thalamic and anterior pretectal region to the claustrum.

Cortical and subcortical afferent connections of the primate's temporal pole: a study of rhesus monkeys, squirrel monkeys, and marmosets

The afferent connections of the primate's temporopolar cortex were investigated with the retrograde horseradish peroxidase technique. Old World and New World monkeys received small unilateral injections of horseradish peroxidase. These labeled cells in a number of cortical, thalamic, and brainstem regions and in a few further telencephalic and diencephalic regions. Cortically, the neighboring areas of the inferior and superior temporal gyrus and the insula contained a considerable number of labeled cells. Furthermore, a substantial projection arose from the orbitofrontal and the frontopolar cortex. The cingulate gyrus contained only very few labeled cells. Interhemispherically, corticocortical connections arose mainly from temporal lobe areas. Labeled cells were seen in various regions of the basal forebrain and cells labeled only faintly in the lateral and basal accessory nuclei of the amygdala. The claustrum contained labeled neurons only in one rhesus monkey. On the diencephalic level, the caudal medial portion of the medial pulvinar was the principal thalamic source of afferents to the temporopolar cortex. Furthermore, labeled cells were found in the neighboring, caudal part of the mediodorsal nucleus, within and along the nucleus limitans, in the medial geniculate nucleus, and in several nuclei of the nonspecific system. The fields of Forel, the zona incerta, and lateral and dorsomedial hypothalamic areas contained a few labeled cells. Within the brainstem of the rhesus monkeys those regions projecting diffusely to the cortex contained a few labeled neurons. Furthermore, these brains had some labeled cells in the regions of the nuclei medialis annuli aqueductus, tractus mesencephalicus nervi trigemini, and trochlearis. Although among the three species differences in the cortical and thalamic projection patterns were observed, the regions projecting most densely to the temporal pole were similar in principle. This statement holds in particular for cortical and thalamic sites. However, the greatest number of labeled cells was found in the rhesus monkey, a fact that cannot be attributed solely to the size of the horseradish peroxidase injections and the size of the brain, but that appears rather to represent a true species difference. From our results we conclude that the temporopolar cortex constitutes a cortical area necessary for effective affectional-sensory integration.

Cortical and thalamic afferent connections of the insular and adjacent cortex of the cat

The thalamo-cortical and cortico-cortical afferents of the cat's insular cortex were investigated with the retrograde horseradish peroxidase technique. The most prominent loci of thalamic labeling were the suprageniculate nucleus and parts of the posterolateral nucleus. Injections into the anterior part of the insular cortex also resulted in labeled cells in the ventromedial posterior nucleus and in the intralaminar nuclei, while injections into posterior parts revealed projections from the medial and dorsal parts of the medial geniculate nucleus. Only the anterior and most ventral parts of the insular cortex overlying the anterior rhinal sulcus were connected with the mediodorsal nucleus of the thalamus. All injections into the gyrus sylvius anterior showed a specific pattern of cortical afferents: With the exception of the labeling in the prefrontal cortex and the inferotemporal region, the labeled cells were very narrowly restricted to the presylvian, the suprasylvian, and the splenial sulcus. The thalamic neurons projecting to the cortex were generally organized in a bandlike pattern which crossed nuclear borders. The majority of the cortico-cortical connections originated from sulcal areas next to the prefrontal, parietal, and cingulate cortex, that is, next to so-called association cortices. In the light of the present results the role of the insular cortex as a multifunctional association area is discussed, as well as its relation to other cortical centers.

Selective prefrontal cortical projections to the region of the locus coeruleus and raphe nuclei in the rhesus monkey

Descending cortical projections to the region of the noradrenergic locus coeruleus (LC) and the serotonergic dorsal and central superior raphe nuclei were analyzed in the rhesus monkey using anterograde labeling techniques. HRP pellets or tritiated leucine were injected into one of 7 cortical areas: the dorsolateral prefrontal cortex, the dorsomedial prefrontal cortex, the orbital prefrontal cortex, the parietal association cortex, somatosensory cortex, the anterior portion of the inferior temporal gyrus, and the posterior portion of the inferior temporal gyrus. Anterogradely labeled fibers were found in and adjacent to the LC and raphe nuclei only following the dorsolateral and dorsomedial prefrontal cortical injections. Terminal labeling was densest at rostral levels of the LC, particularly in the area directly medial to the nucleus. Labeled fibers could not be followed beyond caudal levels of the LC. The projections to the contralateral LC and raphe nuclei were similar to, but less dense than that to the ipsilateral region. Injections into cortical areas other than the dorsal prefrontal cortex resulted in anterograde labeling of the pontine nuclei or pyramids, but not the LC/raphe region. These data, in conjunction with studies in the rat, suggest that the dorsal prefrontal cortex may be the only cortical area to have direct influence on the LC and raphe nuclei and secondary influence on the monoaminergic innervation of large areas of cerebral cortex.

Basal forebrain efferents reach the whole cerebral cortex of the cat

Efferent projections from the basal forebrain to the cat's cerebral cortex were traced with the retrograde horseradish peroxidase technique. Different areas of the cerebral cortex of 51 cats were injected with small amounts of horseradish peroxidase. The entire basal forebrain was screened for labeled neurons. Following all injections, retrogradely labeled neurons could be detected in either the medial septum, or the vertical and horizontal limb of the diagonal band of Broca, or the substantia innominata, or in several of these structures. All three basal forebrain structures project heavily to allocortical regions, but only weakly to neocortical regions. An exception is the medial prefrontal cortex which is densily innervated by the substantia innominata (i.e., comparably dense as allocortical regions are innervated by the substantia innominata). Large injections into he basal temporal cortex (including the perirhinal cortex) and into the insular cortex also led to a considerable number of labeled cells in the substantia innominata. The results indicate a widespread innervation of the cat's cerebral cortex by the basal forebrain. This diffuse projection to the cortex has recently been found also in monkeys and rats. Anatomical and functional implications of these projections in the cat are discussed and related to findings in other species.

Convergence of basolateral amygdaloid and mediodorsal thalamic projections in different areas of the frontal cortex in the rat

The extent of convergence of mediodorsal thalamic and amygdalar afferents on the rat's frontal cortex was studied by tracing retrogradely labeled cells following injections of horseradish peroxidase (HRP). HRP was applied iontophoretically in extremely small injections throughout all areas of the frontal cortex. The following organization was revealed: Converging inputs from the mediodorsal nucleus and the amygdala are observed in the posterior parts of the pre- and infralimbic areas, in the posterior half of the dorsal and ventral agranular insular areas and in the lateral and dorsal precentral areas. Both mediodorsal and amygdaloid afferents reach the dorsal tip of the frontal cortex. Only the mediodorsal afferents were found to terminate in the anterior parts of the pre- and infralimbic areas and in the anterior part of the dorsal division of the anterior cingulate area and in the medial precentral area. On the lateral side of the hemisphere the anterior halves of the dorsal and ventral agranular insular areas receive mediodorsal afferents. Amygdaloid, but not mediodorsal afferents, were found following injections into the more posterior parts of the lateral precentral area. These results are discussed with respect to the extent of the prefrontal cortex in the rat and its definability as a target area of subcortical nuclei. Functional aspects of the anatomical convergence of connections within the so-called basolateral limbic circuit are outlined.

Cortical and thalamic afferent connections of the insular and adjacent cortex of the rat

Thalamic and cortical afferents to the insular and perirhinal cortex of the rat were investigated. Unilateral injections of horseradish peroxidase (HRP) were made iontophoretically along the rhinal sulcus. HRP injections covered or invaded areas along the rhinal fissure from about the level of the middle cerebral artery to the posterior end of the fissure. The most anterior injection labeled a few cells in the mediodorsal nucleus. More posterior injections labeled neurons in the basal portion of the nucleus ventralis medialis, thus suggesting that this cortical region constitutes the rat's gustatory (insular) cortex. We consider the cortex situated posterior to the gustatory cortex in and above the rhinal sulcus as the core region of the rat's (associative) insular cortex, as this cortex receives afferents from the regions of and between the nuclei suprageniculatus and geniculatus medialis, pars magnocellularis. It includes parts of the cortex termed perirhinal in other studies. The cortex dorsal and posterior to the insular cortex we consider auditory cortex, as it receives afferents from the principal part of the medial geniculate nucleus, and the cortex ventral to the insular cortex (below the fundus of the rhinal sulcus) we consider to constitute the prepiriform cortex, which is athalamic. The posterior part of the perirhinal cortex (area 35) receives afferents from nonspecific thalamic nuclei (midline nuclei). Cortical afferents to the injection loci arise from a number of regions, above all from regions of the medial and sulcal prefrontal cortex. Those injections confined to the projection cortex of the suprageniculate-magnocellular medial geniculate nuclear complex also led to labeling in contralateral prefrontal regions, particularly in area 25 (infralimbic region). A comparison of our results with those on the insular cortex of cats and monkeys suggests that on the basis of thalamocortical connections, topographical relations, and involvements of neurons in information processing and overt behavior, the insular cortex has to be regarded as a heterogeneous region which may be separated into prefrontal insular, gustatory (somatosensory) insular, and associative insular portions.

Thalamic mediodorsal nucleus and memory: a critical evaluation of studies in animals and man

Following a general description of the anatomical organization of the thalamic mediodorsal nucleus (MD) of animals and man, the involvement of this nucleus in the processing of memory related information has been evaluated by reviewing stimulation, electrophysiological, and lesion studies in animals, and by reviewing research on induced lesions, degenerative changes and vascular damage of MD in humans. Neither the results from animal experiments nor those from studies on humans provide clear-cut evidence for a specific, memory related role of MD. However, the findings here presented do support the theory that MD is one of several, possible memory related relay stations. While therapeutically induced and circumscribed lesions of MD rarely result in long-lasting memory deficits, pathological processes in MD are more likely to be followed by severe memory disturbances if one or more particular structures in addition to MD are included in the lesioned regions. Consequently, it is emphasized that only the disruption of more than one site along memory related pathways will result in severe and enduring memory deficits. To account for apparent inter-species differences in the involvement of MD in memory related processes, it has been argued that MD and its principal cortical target region might basically be involved in arousal and emotional processes, but that for primates and especially for man the phylogenetically young parvocellular sector of MD and its cortical projection region, the dorsolateral prefrontal cortex, are furthermore involved in memory functions, which are modulated by emotional factors via the rest of MD and the prefrontal cortex.

Delayed-alternation performance after selective lesions within the prefrontal cortex of the cat

On the basis of new neuroanatomical findings on relationships between subregions of the mediodorsal thalamic nucleus and the prefrontal cortex of the cat, it was attempted to investigate the relative importance of prefrontal subfields with the aim of obtaining evidence in favor of a functional inequality of different prefrontal subfields. Four areas, named presylvian (PRS), proreal (PR), dorsomedial (DM), and orbito-insular (OI) sectors, were ablated successfully in 30 adult animals. Performance of a 10-sec delayed-alternation task was compared pre- and postoperatively. Furthermore, most of the cats had to learn an extension of this task postoperatively, using a 20-sec delay period, and lastly, these animals were subjected to an extinction test. Significant performance differences were obtained between cats of different groups in all three tasks. Lesions of subregion PR, and even more of subregion PRS, led to severe behavioral deterioration, whereas lesions of subregion OI were without effect, when compared with the behavior of a sham-operated control group. PRS-cats, furthermore, showed motor disturbances during the first postoperative week. The results obtained suggest that it is possible to subdivide the cat's prefrontal cortex functionally. In addition, it is hypothesized that behavioral changes in cats of groups PRS and PR are due to an inability to use kinesthetic information properly.