[Von Economo neurons and insular cortex - the bridge between soma and psyche].

New research suggests a pivotal role of the anterior insular cortex for the integration of somatic sensation and for intuitive decisions in complex social situations. Functional magnetic resonance imaging (fMRI) has demonstrated a close coupling between the anterior insular cortex and the anterior cingulate gyrus, the only areas with von Economo-neurons. These large spindle cells are exclusively found in species with complex social lifes (apes, cetaceans). Observations in humans showed decreased numbers of von Economo neurons in patients with frontotemporal dementia, or agenesis of the corpus callosum, conditions with impaired theory of mind and interpersonal behaviour. It almost appears as if spindle cells would reach out from the realm of subconscious gut-feelings into the premises of conscious prefrontal planning.