The Cardioinhibitory Responses of the Right Posterior Insular Cortex in an Epileptic Patient
Bibliographic record
Abstract
BACKGROUND: The insular cortex (IC) has long been implicated in the central regulation of the autonomic nervous system but its precise role remains to be determined. We studied the role of IC in cardiovascular control using a multimodality approach consisting of isometric handgrip exercises, functional magnetic resonance imaging (fMRI) activation during handgrip exercises, and direct electrical stimulations of the posterior right IC in a single patient. METHOD: A 24-year-old patient had medically intractable epilepsy secondary to a small ganglioglioma in the right posterior IC. His cardiovascular responses to 30 and 70% maximum voluntary contraction (MVC) handgrip exercises were recorded in the lab and during fMRI and compared to those of 10 healthy control subjects. He subsequently underwent stereo-electroencephalography with depth electrodes in the right posterior IC and further study of the cardiovascular responses to electrical stimulation at rest and during MVC handgrip exercises. RESULT: fMRI data showed nearly absent activation in the right IC relative to healthy subjects. At rest, electrical stimulation of the right posterior inferior IC but not the superior IC suppressed heart rate (HR) by 3 beats per minute. During exercise, the HR response to isometric handgrip contraction was weakened when the right posterior inferior IC was simultaneously stimulated. CONCLUSION: This study shows that, in this patient, the right posterior inferior IC is an important cardioinhibitory center and interference with this region alters the cardiac response to handgrip exercise. Further investigations are required to examine the cardiovascular control of the IC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".