ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Autonomic Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1665378
This article is part of the Research TopicAutonomic Nervous System-targeting Therapies for Cardiovascular DiseasesView all 3 articles
Topography of the Insular Cortex in Heart Rate Control: High-Precision Mapping Reveals Critical Role of the Middle Short Gyrus
Provisionally accepted
Xiaolin Tian
Jing Wang
Xiongfei Wang
Xue Yang
Tianfu Li
Jiahui DengChongyang TangMengyang Wang
Guoming Luan*- Sanbo Brain Hospital, Capital Medical University, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Aims: Although accumulating evidence has demonstrated the involvement of the insular cortex in autonomic regulation, the precise functional topography of insular subdivisions mediating cardiovascular control remains controversial. This study aimed to investigate the role of the insula, with high anatomic precision, in regulating heart rate (HR). Methods: Overall, 487 electrical stimulations (E-stim) in patients with refractory epilepsy were used to investigate the incidence of evoked cardiac response after insula E-stim. Correlations between the parameters of E-stim, insula subdivision, and the HR shift profile were analyzed. Results: Briefly, 40.8% of insula stimulations evoked a cardiac response. The left insula was more likely to induce cardiac responses. Compared to the electrode contacts in the declining HR group, those in the elevated HR group were predominantly distributed in the posterior insula. Notably, the middle short gyri can rapidly elicit a significant decrease in HR. Conclusions: Our findings suggest that the middle short gyrus of the insula may serve as the primary cortical region mediating HR reduction. This provides new insights for the prevention and treatment of arrhythmias and sudden unexpected death in epilepsy (SUDEP).
Keywords: neurostimulation, insula, Heart rate variability, Intracranial electrical stimulation, SUDEP
Received: 14 Jul 2025; Accepted: 29 Aug 2025.
Copyright: © 2025 Tian, Wang, Wang, Yang, Li, Deng, Tang, Wang and Luan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Guoming Luan, Sanbo Brain Hospital, Capital Medical University, Beijing, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.