Insular routing to orbitofrontal cortex enables breathing awareness.

Authors

Joshua Y Assi, Stephan Bickel, Harly E Greenberg, Ashesh D Mehta, Thomas Similowski, José L Herrero

Published in

Science advances. Volume 12. Issue 31. Pages eaeb3326. Jul 31, 2026. Epub Jul 29, 2026.

Abstract

How does the human brain detect and respond to disruptions in breathing? While animal studies have advanced our understanding of respiratory control, breathing distress in humans remains difficult to treat. It often arises not only from pulmonary lesions or brainstem dysfunction but also from how higher brain regions interpret breathing signals shaped by emotion and experience. We recorded intracranial cortical activity in neurosurgical patients during an interoceptive task involving transient breathing challenges. Conscious detection of these disruptions was predicted by early responses in the anterior insula, which routed signals to orbitofrontal and premotor cortices for appraisal and compensation. These cortical regions preferentially encoded inspiratory effort or airflow, revealing signal-specific processing that echoes functional segregation in brainstem centers. The present findings identify a dynamic insular-frontal circuit for sensing and adapting to respiratory challenges, offering insight into the neural basis of breathing awareness and its disruption in disease.

PMID:
42525758
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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