The involvement of the insular cortex in predicting drinking outcomes adds to the growing literature indicating that this region, an integrator of the body-brain connection, may be related to the motivation to use substances (Paulus & Stewart, 2014; Verdejo-Garcia et al., 2012), especially in the context of approach or avoidance behaviors. Potentially pertinent to LR processing, the insula influences the nucleus accumbens and striatum downstream, with possible impacts regarding reward-related behaviors and craving (Cho et al., 2012; Goldstein et al., 2009). The frontal systems are important in cognitive effort (Corbetta & Shulman, 2002) and affective modulation of stress (Miller & Cohen, 2001), two processes that may be vital to alcohol effects and recovery from their influences (Franken, 2003).
