ISSN 2326-7275
International Journal of Anatomy and Physiology | Vol. 15, No. 11, November 2026 | pp. 181–189
DOI: 10.46882/2026/IJAP/001021
Review Article
Title: Neurophysiological Mechanisms and Structural Pathways of Interoceptive Processing in the Human Insular Cortex
Names of Authors: M. L. Hämäläinen¹, C. H. Kim²*
Authors’ Affiliations:
¹ Department of Neuroscience, Aalto University School of Science, Espoo, Finland.
² Department of Physiology, Seoul National University College of Medicine, Seoul, South Korea.
Abstract:
Interoception refers to the physiological process by which the nervous system senses, interprets, and integrates internal visceral signals, providing a foundational baseline for homeostatic regulation and emotional awareness. This review synthesizes current functional neuroimaging, cytoarchitectonic, and electrophysiological literature focused on the human insular cortex as the primary central terminal for interoceptive pathways. Visceral afferents carrying metabolic, cardiovascular, and gastrointestinal data travel via the vagus nerve and spinothalamic tracts to the posterior insula. This region displays a granular cytoarchitecture optimized for primary sensory decoding. From the posterior insula, signals are processed through a functional gradient moving toward the agranular anterior insula. This anterior zone integrates visceral signals with cognitive and environmental inputs. Von Economo neurons, located selectively in the anterior insula, support the rapid transmission of these integrated interoceptive states to the anterior cingulate cortex. Electrophysiological findings highlight the heartbeat-evoked potential (HEP) as a reliable index of cortical interoceptive processing, with fluctuations in HEP amplitude corresponding directly to insular blood-oxygen-level-dependent (BOLD) signals. Understanding these structural and functional pathways provides insight into clinical autonomic imbalance conditions, including anxiety, depression, and somatoform disorders where central interoceptive mapping is altered.
Keywords: Interoception, Insular cortex, Von Economo neurons, Autonomic homeostasis, Heartbeat-evoked potential.
Manuscript Timeline: Received: August 10, 2026; Revised: September 30, 2026; Accepted: October 20, 2026; Published: November 10, 2026.
Citation: Hämäläinen ML, Kim CH. Neurophysiological Mechanisms and Structural Pathways of Interoceptive Processing in the Human Insular Cortex. International Journal of Anatomy and Physiology. 2026; 15(11): 181–189. doi:10.46882/2026/IJAP/001021