Representation of pain and somatic sensation in the human insula:: a study of responses to direct electrical cortical stimulation
Representation of pain and somatic sensation in the human insula:: a study of responses to direct electrical cortical stimulation
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DOI：
10.1093/cercor/12.4.376
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发表时间：
2002-04-01
期刊：
影响因子：
3.7
通讯作者：
Mauguière, F
中科院分区：
文献类型：
--
作者：
Ostrowsky, K;Magnin, M;Mauguière, F
我们研究了43例药物难治性颞叶癫痫患者的岛叶皮层直接电刺激引起的疼痛和非疼痛躯体感觉，使用立体定向植入深度电极。14名患者的岛叶皮质上后部诱发了疼痛感觉，主要发生在右半球。16例患者在两个半球的岛叶皮质后部引起非疼痛感觉。因此，痛苦的和非痛苦的躯体感觉表征在人类大脑中是重叠的。这两种类型的反应都显示出一种向躯体组织发展的趋势。这些结果与以前的解剖和单位记录研究表明参与的岛屿皮质的后部在处理有害和无害的躯体感觉刺激猴子同意。在人类中，已经使用功能成像在岛叶皮质内描述了后部和前部疼痛相关的皮质区。我们的研究结果有助于确定这两个岛屿地区各自的功能作用。最后，疼痛感诱发部位的右脑偏侧化与该半球在物种生存中的优势作用的假设是一致的。
We studied painful and non-painful somaesthetic sensations elicited by direct electrical stimulations of the insular cortex performed in 43 patients with drug refractory temporal lobe epilepsy, using stereotactically implanted depth electrodes. Painful sensations were evoked in the upper posterior part of the insular cortex in 14 patients, mostly in the right hemisphere. Non-painful sensations were elicited in the posterior part of the insular cortex in 16 patients, in both hemispheres. Thus, painful and non-painful somaesthetic representations in the human insula overlap. Both types of responses showed a trend toward a somatotopic organization. These results agree with previous anatomical and unit recording studies in monkeys indicating a participation of the posterior part of the insular cortex in processing both noxious and innocuous somaesthetic stimuli. In humans, both a posterior and an anterior pain-related cortical area have been described within the insular cortex using functional imaging. Our results help to define the respective functional roles of these two insular areas. Finally, lateralization in the right hemisphere of sites where painful sensations were evoked is coherent with the hypothesis of a preponderant role of this hemisphere in species survival.