Abstract
The insular cortex, hidden within the lateral sulcus of the human brain, participates in a range of cognitive, affective, and sensory functions. Autism spectrum disorder (ASD), a neurodevelopmental condition affecting all of these functional domains, has increasingly been linked with atypical activation and connectivity of the insular cortices. Here we review the latest research linking atypical insular function to a range of behaviors characteristic of ASD, with an emphasis on neuroimaging findings in the domains of social cognition and executive function. We summarize some of the recent work linking the insula to interventions in autism, including oxytocin-based pharmacological treatments and music therapy. We suggest that future directions likely to yield significant insights into insular pathology in ASD include the analysis of the dynamics of this brain region. We also conclude that more basic research is necessary on the use of oxytocin pharmacotherapy, and larger studies addressing participant heterogeneity are needed on the use of music therapy in ASD. Long-term studies are needed to ascertain sustained effects of these interventions.
•Insular dysfunction in autism may underlie a range of symptoms of the disorder.•Atypical functional activation and connectivity of the insula in autism is widely documented.•Oxytocin treatment may alter insula function in autism.•Music therapy may also influence insula function to improve symptoms.
