The Insular Cortex, Alzheimer Disease Pathology, and Their Effects on Blood Pressure Variability

Alzheimer Dis Assoc Disord. 2020 Jul-Sep;34(3):282-291. doi: 10.1097/WAD.0000000000000340.


Recent findings indicate that the human cardiovascular system is regulated by a cortical network comprised of the insular cortex (Ic), anterior cingulate gyrus, and amygdala which is necessary for the regulation of the central autonomic network system. Alzheimer disease (AD) affects the Ic at a preclinical stage. The pathology of AD at the Ic is suggested to predispose the cardiovascular system to detrimental changes such as increased blood pressure variability (BPV). In this review article, we focus on the physiology of the Ic in the relationship between the central autonomic network and BPV. We provide a summary of the published evidence regarding the relationship between Ic damage and exaggerated BPV in the context of AD pathology.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / pathology*
  • Autonomic Nervous System* / physiology
  • Autonomic Nervous System* / physiopathology
  • Blood Pressure / physiology*
  • Cerebral Cortex / physiology*
  • Humans
  • Magnetic Resonance Imaging