It's more than just interoception: The insular cortex involvement in alcohol use disorder

J Neurochem. 2021 Jun;157(5):1644-1651. doi: 10.1111/jnc.15310. Epub 2021 Feb 10.

Abstract

Understanding brain structures and circuits impacted by alcohol use disorder is critical for improving our future prevention techniques and treatment options. A brain region that has recently gained traction for its involvement in substance use disorder is the insular cortex. This brain region is multi-functional and spatially complex, resulting in a relative lack of understanding of the involvement of the insular cortex in alcohol use disorder. Here we discuss the role of the insular cortex in alcohol use disorder, particularly during periods of abstinence and in response to alcohol and alcohol-related cues and contexts. We also discuss a broader role of the insular in alcohol-associated risky decision making and impulse control. Finally, we canvas potential challenges associated with targeting the insular cortex to treat individuals with alcohol use disorder.

Keywords: alcohol; aversion-resistance; corticostriatal pathways; insular cortex; relapse; risky decision making.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alcoholism / physiopathology*
  • Alcoholism / psychology
  • Animals
  • Cerebral Cortex / physiopathology*
  • Cues
  • Decision Making
  • Humans
  • Interoception*
  • Nerve Net / physiopathology
  • Recurrence