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Cerebral Cortex Advance Access originally published online on May 9, 2008
Cerebral Cortex 2009 19(1):218-223; doi:10.1093/cercor/bhn074
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Published by Oxford University Press 2008.

Involvement of Insula and Cingulate Cortices in Control and Suppression of Natural Urges

Alicja Lerner1, Anto Bagic2, Takashi Hanakawa3, Eilis A. Boudreau4, Fernando Pagan5, Zoltan Mari6, William Bara-Jimenez7, Murat Aksu8, Susumu Sato9, Dennis L. Murphy10 and Mark Hallett1

1 Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA, 2 Department of Neurology, University of Pittsburgh Medical School, Pittsburgh, PA 15213, USA, 3 Department of Cortical Function Disorders, National Center of Neurology and Psychiatry, 187-8502 Tokyo, Japan, 4 Health Science Research and Development Program, Portland VA Medical Center, Portland, OR 97239, USA, 5 Neurology Department, Georgetown University Hospital, Washington, DC 20007, USA, 6 Department of Neurology, Johns Hopkins University, Baltimore, MD 21287, USA, 7 Bethesda Neuroscience Clinic, Bethesda, MD 20885, USA, 8 Medical Faculty Neurology Department, Erciyes University, 38039 Kayseri, Turkey, 9 EEG Section, National Institute of Neurological Disorders and Stroke, 10 Laboratory of Clinical Science, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA

Address correspondence to Dr Alicja Lerner, MD, PhD, Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10, Bethesda, MD 20892, USA. Email: lernera{at}mail.nih.gov.

The physiology of control and suppression of natural urges is not well understood. We used [15O]H2O positron-emission tomography imaging to identify neural circuits involved in suppression of spontaneous blinking as a model of normal urges. Suppression of blinking was associated with prominent activation of bilateral insular-claustrum regions, right more than left; activation was also found in bilateral anterior cingulate cortex (ACC), supplementary motor areas, and the face area of the primary motor cortex bilaterally. These results suggest a central role for the insula possibly together with ACC in suppression of blinking.

Key Words: blinking • insula • PET • suppression • urges • visceral homunculus


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