What role does insula and anterior cingulate cortex play in internal arousal

The insula and the anterior cingulate cortex (ACC) play pivotal roles in interpreting and managing internal arousal. The ACC is responsible for integrating information about what's happening inside your body and even on the surface, like pain or discomfort. It's a key player in processing the signals related to internal states like heart rate and breathing 1.

The insula, on the other hand, interprets both internal and external signals, assessing whether bodily sensations correspond to what's happening around you. For example, if you're experiencing heavy breathing while running uphill, the insula gauges this as a normal response given the context. Together, the insula and ACC engage in a neural conversation, constantly assessing and interpreting internal physiological states against external conditions. This helps determine if the sensations you experience make sense in your current environment, influencing your emotional and physical responses 1.

Additionally, the anterior mid-cingulate cortex, which is part of the broader cingulate cortex, is involved in reward processing and is connected to various systems, including autonomic and immune functions. It plays a significant role in regulating motivation, effort, and emotional responses, linking internal states to behaviors like willpower and tenacity 2.