Key result
Insular cortex acts as central hub regulating cardiovascular and immune function via autonomic networks.
The insular cortex plays a pivotal role in the brain-heart-immune axis, suggesting that vagally mediated neuromodulation could improve cardiovascular dysregulation.
Whereas the brain-heart axis is an emerging field in neuropsychocardiology, a central autonomic network including the insular cortex (Ic) regulates the cardiovascular system via the intrinsic cardiac nervous system. Cardiac interoception, represented in Ic, has been studied in cardiovascular diseases and inflammation. Therefore, it is important to investigate how interoception is related to cardiovascular disease in terms of its prevention and treatment. To examine the role of the Ic in cardiovascular and immune regulation, we focus on converging evidence from human stroke cohorts, lesion-symptom mapping studies, and experimental models that implicate the Ic as a causal hub within the brain-heart-immune axis. In particular, Ic plays a pivotal role in processing interoception as well as immunoception, and based on this information, Ic regulates cardiovascular and immune systems via efferent autonomic networks. Furthermore, vagally mediated neuromodulation is likely to influence interoception and immunoception and plays a pivotal role in improving cardiovascular dysregulation.
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Nagai et al. (2026) conducted a review in Cardiovascular disease. Insular cortex function was evaluated. The insular cortex acts as a causal hub within the brain-heart-immune axis, processing interoception and immunoception to regulate cardiovascular and immune systems via efferent autonomic networks.
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