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Hum Brain Mapp. 2016 Apr;37(4):1375-92. doi: 10.1002/hbm.23109. Epub 2016 Jan 22.

Contribution of insula in Parkinson's disease: A quantitative meta-analysis study.

Criaud M1,2,3,4,5,6, Christopher L1,2,3, Boulinguez P4,5,6, Ballanger B4,5,6, Lang AE1, Cho SS1,2,3, Houle S2, Strafella AP1,2,3.

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Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Toronto Western Hospital, UHN, University of Toronto, Ontario, Canada.
Research Imaging Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, UHN, University of Toronto, Ontario, Canada.
Université Lyon 1, Villeurbanne, France.
Centre De Neuroscience Cognitive, CNRS, UMR5229, Bron, France.
Université De Lyon, Lyon, F-69622, France.


The insula region is known to be an integrating hub interacting with multiple brain networks involved in cognitive, affective, sensory, and autonomic processes. There is growing evidence suggesting that this region may have an important role in Parkinson's disease (PD). Thus, to investigate the functional organization of the insular cortex and its potential role in parkinsonian features, we used a coordinate-based quantitative meta-analysis approach, the activation likelihood estimation. A total of 132 insular foci were selected from 96 published experiments comprising the five functional categories: cognition, affective/behavioral symptoms, bodily awareness/autonomic function, sensorimotor function, and nonspecific resting functional changes associated with the disease. We found a significant convergence of activation maxima related to PD in different insular regions including anterior and posterior regions bilaterally. This study provides evidence of an important functional distribution of different domains within the insular cortex in PD, particularly in relation to nonmotor aspects, with an influence of medication effect.


Parkinson's disease; behavior; cognition; dopamine; insula; nonmotor symptoms

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