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The cardioinhibitory responses of the right posterior insular cortex in an epileptic patient.
MedLine Citation:
PMID:  21051928     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The insular cortex (IC) has long been implicated in the central regulation of the autonomic nervous system but its precise role remains to be determined. We studied the role of IC in cardiovascular control using a multimodality approach consisting of isometric handgrip exercises, functional magnetic resonance imaging (fMRI) activation during handgrip exercises, and direct electrical stimulations of the posterior right IC in a single patient.
METHOD: A 24-year-old patient had medically intractable epilepsy secondary to a small ganglioglioma in the right posterior IC. His cardiovascular responses to 30 and 70% maximum voluntary contraction (MVC) handgrip exercises were recorded in the lab and during fMRI and compared to those of 10 healthy control subjects. He subsequently underwent stereo-electroencephalography with depth electrodes in the right posterior IC and further study of the cardiovascular responses to electrical stimulation at rest and during MVC handgrip exercises.
RESULT: fMRI data showed nearly absent activation in the right IC relative to healthy subjects. At rest, electrical stimulation of the right posterior inferior IC but not the superior IC suppressed heart rate (HR) by 3 beats per minute. During exercise, the HR response to isometric handgrip contraction was weakened when the right posterior inferior IC was simultaneously stimulated.
CONCLUSION: This study shows that, in this patient, the right posterior inferior IC is an important cardioinhibitory center and interference with this region alters the cardiac response to handgrip exercise. Further investigations are required to examine the cardiovascular control of the IC.
Authors:
Faisal Al-Otaibi; Savio W H Wong; J Kevin Shoemaker; Andrew G Parrent; Seyed M Mirsattari
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-08
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  88     ISSN:  1423-0372     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2010  
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  390-7     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London, Ont., Canada. faisalruwais@gmail.com
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