著者

飯川 雄 石橋 清成 野﨑 貴裕 武次 幸治 高杉 潤

出版者

脳機能とリハビリテーション研究会

雑誌

Journal of Rehabilitation Neurosciences (ISSN:24342629)

巻号頁・発行日

vol.22, no.JPN, pp.222601, 2022 (Released:2022-12-30)

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The function of the insular cortex (IC) in humans is poorly understood because brain injuries with a focal lesion in this area are extremely rare. Here, we compare the clinical presentation of two patients with cerebral infarction with major lesions in the left anterior and right posterior IC, respectively, and discuss the functions of these areas. Patient 1 (man in his 70s; cerebral infarctions in the left anterior IC, left inferior frontal gyrus, and dorsolateral left frontal lobe) did not show any motor or sensory function deficit. He presented with transient aphasia and global attention dysfunction that persisted for 3 months after onset, but he was able to return to work and resume driving. Patient 2 (woman in her 60s; cerebral infarctions in the right posterior IC, right supramarginal gyrus, and right parieto-occipital subcortical) presented with transient motor paralysis of the left side of the face and left upper limb and hypoalgesia of the left upper and lower limb. She showed decreased stereognostic sense in the left hand and disturbances in taste, olfaction, and interoception. The different clinical presentations of these two patients suggest that the anterior and posterior areas of the IC have different functions: the anterior area is mainly involved in cognitive functions, whereas the posterior area is mainly involved in sensorimotor functions. Our patients did not have focal lesion of the IC, and more cases need to be evaluated to reveal the IC’s function in humans.