The decrease in BOLD signal in the AIC is one that is different from previously published results in alcohol addiction. The insula is also a hub of the salience network along with the dACC39. Consistent with the increase in BOLD signal in the dACC, previous literature posits a concurrent increase in BOLD signal in the insula40,41. However, the insula is also a central controller of the autonomic nervous system42 and thus the observed decrease in BOLD signal in the insula could be a biomarker for compromised autonomic system activity in alcoholic patients. This is only a hypothesis, however, as we do not have any measures of heart rate variability or other autonomic system variables that can support this claim.
