Abstract Details

Title Mapping the Insular Cortex for Cardiac Responses in Humans

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-001

Objective We used electrical stimulation of the insular cortex in non-epileptic patients to delineate how different insular subregions influence cardiac rhythm.

Background The location and function of cortico-cardiac regulation by the insular cortex remain unclear in humans.

Design/Methods ECG were obtained from 4 subjects (3 females, 67.7 ± 15.8 years) enrolled in a chronic pain DBS trial. Longitudinal insular depth electrodes (10 contacts, 5mm spacing) were implanted bilaterally. Bi-polar stimulations (50Hz, bi-phasic, 250µs PD, 2-8mA) were delivered in 10-30s trains. Insular sub-regions were defined by side ((L)eft/(R)ight, i.e. L/R) and by the central sulcus ((A)nterior/(P)osterior). The mean ± one standard deviation of the pre-stimulation (~30s) R-R intervals (RRI) was used to identify RRI responses. RMSSD was calculated to measure heart rate variability (HRV).

Results Ninety-eight stimulations were delivered to the LA (23), RA (23), LP (32), and RP (20) insular subregions. Stimulus-evoked sensory symptoms were observed in all subjects, confined to the posterior insula. Forty-eight of these stimulations evoked RRI responses, evenly split between increased and decreased RRI. Overall, increased and decreased RRI were associated with the anterior-posterior axis of the insula cortex (χ²(1) = 4.148, p = 0.042). A greater proportion of decreased RRI was found in the posterior insula compared to the anterior insula (two-proportion Z test, 17/21 vs. 7/27, p = 0.00016). The RP insular subregion tended to elicit more decreased than increased RRI compared to chance (8/10, one-proportion Z test, p = 0.058). Furthermore, no significant changes in HRV were found across all four insular subregions (Wilcoxon rank sum test, p > 0.05).

Conclusions Preliminary results suggest a role for the insular cortex in cardiac rhythm. Stimulation of the right posterior insula likely increases heart rate, expanding our understanding of human insular cortex. More subjects are needed to further validate findings in the current study.

Authors/Disclosures
Shuqi Ye PRESENTER	Ms. Ye has nothing to disclose.
Mark S. Quigg, MD (UVA Neurology)	Dr. Quigg has received personal compensation for serving as an employee of Natus. Dr. Quigg has received personal compensation for serving as an employee of Neurocrine. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerebral Therapeutics. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cerebral Therapeutics. Dr. Quigg has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Finnigen and Harrison. Dr. Quigg has received research support from NIH. Dr. Quigg has received publishing royalties from a publication relating to health care.
Dan Wang, PhD	Miss Wang has nothing to disclose.
Xiaohan Zhang, MD	No disclosure on file
Whitney Carter, BS (research assistant	Mrs. Carter has nothing to disclose.
Patrick Finan, PhD	An immediate family member of Dr. Finan has received personal compensation for serving as an employee of Canopy Growth Corporation. An immediate family member of Dr. Finan has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Charlotte's Web. Dr. Finan has stock in Meta. Dr. Finan has stock in Google. Dr. Finan has stock in Amazon. Dr. Finan has stock in Visa. Dr. Finan has stock in M&T Bank. Dr. Finan has stock in PNC Bank. Dr. Finan has stock in Danaher Corp. Dr. Finan has stock in IBM. The institution of Dr. Finan has received research support from NIH. Dr. Finan has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH.
Shayan Moosa, MD	Dr. Moosa has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for RebrAIn.
William S. Elias, MD	No disclosure on file
Chang-Chia Liu, PhD	Prof. Liu has nothing to disclose.

��ɫ��

��ɫ��