Neurology Department, University Hospital, Saint-Étienne.
Central Integration of Pain Team, Lyon Neuroscience Research Center, National Institute of Health and Medical Research Unit 1028, National Center for Scientific Research Mixed Unit of Research 5292, Lyon.
Ann Neurol. 2017 Sep;82(3):360-370. doi: 10.1002/ana.25010. Epub 2017 Aug 30.
Despite numerous studies suggesting the role of insular cortex in the processing of gustatory and olfactory inputs, the exact location of olfactogustatory representation in the insula remains controversial. Here we provide a functional mapping of olfactory-gustatory responses to stimulation of the human insular cortex.
We reviewed 651 electrical stimulations of the insula that were performed in 221 patients, using stereotactically implanted depth electrodes, during the presurgical evaluation of drug-refractory epilepsy.
Gustatory sensations were evoked in 15 (2.7%) of the 550 stimulations that elicited a clinical response. They were exclusively obtained after stimulation of a relatively delimited zone of insula, located in its mid-dorsal part (posterior short gyrus). Six olfactory sensations (1.1%) could be obtained during stimulations of an insular region that partially overlapped with the gustatory representation.
Our study provides a functional mapping of gustatory representation in the insular posterior short gyrus and the first detailed description of olfactory sensations obtained by direct stimulation of mid-dorsal insula. Our data also show a spatial overlap between gustatory, olfactory, and oral somatosensory representation in the mid-dorsal insula, and suggest that this part of the insula may be an integrated oral sensory region that plays a key role in flavor perception. It also indicates that dysfunction in this region should be considered during the evaluation of gustatory and olfactory epileptic seizures. Ann Neurol 2017;82:360-370.
尽管有大量研究表明岛叶在味觉和嗅觉输入处理中的作用，但岛叶内嗅觉味觉代表的确切位置仍存在争议。在此，我们提供了对人类岛叶刺激的嗅觉味觉反应的功能映射。
我们回顾了在 221 名药物难治性癫痫患者的术前评估中，使用立体定向植入的深部电极进行的 651 次岛叶刺激，其中有 550 次刺激引发了临床反应。
在 15 次（2.7%）引起临床反应的刺激中引起了味觉感觉。它们仅在岛叶的相对限定区域（后短回）刺激后获得。在与味觉代表部分重叠的岛叶区域刺激时，可获得 6 种嗅觉感觉（1.1%）。
我们的研究提供了岛叶后短回味觉代表的功能映射，以及首次详细描述了通过直接刺激中背侧岛叶获得的嗅觉感觉。我们的数据还显示，中背侧岛叶内的味觉、嗅觉和口腔体感代表之间存在空间重叠，并表明该岛叶的这一部分可能是一个集成的口腔感觉区域，在味觉感知中起关键作用。这也表明，在评估味觉和嗅觉癫痫发作时，应考虑该区域的功能障碍。
