Specific disgust processing in the left insula: New evidence from direct electrical stimulation

Costanza Papagno, Alberto Pisoni, Giulia Mattavelli, Alessandra Casarotti, Alessandro Comi, Francesca Fumagalli, Mirta Vernice, Enrica Fava, Marco Riva, Lorenzo Bello

Research output: Contribution to journalArticlepeer-review


Neuropsychological and neuroimaging studies yielded controversial results concerning the specific role of the insula in recognizing the facial expression of disgust. To verify whether the insula has a selective role in facial disgust processing, emotion recognition was studied in thirteen patients during intraoperative stimulation of the insula in awake surgery performed for removal of a glioma close to this structure. Direct electrical stimulation of the left insula produced a general decrease in emotion recognition but only in the case of disgust there was a statistically significant detrimental effect (p=0.004). Happiness and anger were the best and the worst recognized emotion, respectively. The worst baseline performance with anger and, partly, fear could be explained with the involvement of the left temporal regions, striatum, and the connection between the striatum and the frontal lobe, as suggested in previous studies. Therefore, upon these intra-operative evidences, we argue for a selective role of the left insula in disgust recognition, although a (non significant) decrease in the recognition of other negative emotions was found. However, additional networks can develop, as demonstrated by the fact that disgust recognition was not impaired after surgery even in patients with insular resection in the current as in previous studies.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
Publication statusPublished - Apr 1 2016


  • Awake surgery
  • Disgust
  • Emotions
  • Glioma
  • Insular cortex

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Cognitive Neuroscience
  • Experimental and Cognitive Psychology


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