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To investigate the neuroanatomical structures involved in appetite and weight change, we employed lesion symptom mapping. 358 patients with focal brain lesions and appetite ratings were recruited, as well as 48 patients with pre- and post-lesion weight records. Partial least squares regression identified a significant association between patterns of brain damage and appetite change (model R2 = 0.13, P = 0.006), and the relationship between lesion location and weight change was explored using the proportional subtraction method. The right posterior insula was the peak region associated with both decreased appetite and weight loss, providing new insight into the neural correlates of higher-order appetite regulation and weight management.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag044","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T12:32:23Z","timestamp":1771677143000},"source":"Crossref","is-referenced-by-count":0,"title":["Lesions involving the insula are associated with reduced appetite and weight loss"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2038-4512","authenticated-orcid":false,"given":"Wanzhi","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Institute for Human Neuroscience, Boys Town National Research Hospital , Omaha, NE 68010 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Bruss","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily R","family":"Dappen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5548-1169","authenticated-orcid":false,"given":"Joseph C","family":"Griffis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Pace","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Neisewander","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Manzel","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Tranel","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Department of Neurology, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-9257","authenticated-orcid":false,"given":"Aaron D","family":"Boes","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Department of Pediatrics, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Department of Neurology, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Iowa Neuroscience Institute, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-2964","authenticated-orcid":false,"given":"Nicholas T","family":"Trapp","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Iowa , Iowa City, IA 52242 ,","place":["USA"]},{"name":"Iowa Neuroscience Institute, University of Iowa , Iowa City, IA 52242 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