Insula mediates heartbeat related effects on visual consciousness

Roy Salomon, Roberta Ronchi, Jonathan Dönz, Javier Bello-Ruiz, Bruno Herbelin, Nathan Faivre, Karl Schaller, Olaf Blanke

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Interoceptive signals, such as the heartbeat, are processed in a network of brain regions including the insular cortex. Recent studies have shown that such signals modulate perceptual and cognitive processing, and that they impact visual awareness. For example, visual stimuli presented synchronously to the heartbeat take longer to enter visual awareness than the same stimuli presented asynchronously to the heartbeat, and this is reflected in anterior insular activation. This finding demonstrated a link between the processing of interoceptive and exteroceptive signals as well as visual awareness in the insular cortex. The advantage for visual stimuli which are asynchronous to the heartbeat to enter visual consciousness may indicate a role for the anterior insula in the suppression of the sensory consequences of cardiac signals. Here, we present data from the detailed investigation of two patients with insular lesions (as well as four patients with non-insular lesions and healthy age matched controls) indicating that a lesion of the anterior insular cortex, but not of other regions, abolished this cardio-visual suppression effect. The present data provide causal evidence for the role of the anterior insula in the integration of internal interoceptive and external sensory signals for visual awareness.

Original languageEnglish
Pages (from-to)87-95
Number of pages9
StatePublished - Apr 2018

Bibliographical note

Funding Information:
O.B. is supported by the Bertarelli Foundation , the Swiss National Science Foundation , and the European Science Foundation . R.S was supported by the National Center of Competence in Research, NCCR) “SYNAPSY–The Synaptic Bases of Mental Diseases” financed by the Swiss National Science Foundation (no. 51AU40_125759 ) & an Israel Science Foundation grant. ( 1169/17 ). N.F. is an École Polytechnique Fédérale de Lausanne Fellow co-funded by a Marie Skłodowska-Curie fellowship and was also supported by the European Union Human Brain Project.

Publisher Copyright:
© 2018


  • Anterior insula
  • Brain-damaged patients
  • Cardio-visual interaction
  • Heartbeat
  • Interoception
  • Visual awareness


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