Format

Send to

Choose Destination
Brain Imaging Behav. 2019 Apr 23. doi: 10.1007/s11682-019-00099-3. [Epub ahead of print]

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

Author information

1
Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands. y.fathy@vumc.nl.
2
Department of Neurology, Erasmus Medical Center, Postbus, 2040 3000, Rotterdam, CA, Netherlands.
3
Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands.
4
Department of Anatomy and Neurosciences, Section Neuropsychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, The Netherlands.
5
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands.
6
Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands.

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.

KEYWORDS:

Alzheimer’s disease; Anatomic likelihood estimation; Cognition; Emotion; Frontotemporal dementia; Insular cortex; Neurodegeneration; Parkinson’s disease; Perception; Voxel based morphometry

PMID:
31011951
DOI:
10.1007/s11682-019-00099-3

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center