The role of the insula in speech and language processing has long been noted [54], while there is now broad clinical and functional imaging evidence for a participation of the left anterior insula in speech motor control [55]. The left insula is notably larger than the right in most humans [56], consistent with a left-hemispheric dominance in language. Mutism has been frequently observed in cases of insular pathology: Transient mutism is found in cases of left inferior motor cortex damage extending to the insula [57,58], whereas lasting mutism appears to be associated with bilateral lesions of the frontal operculum and anterior insula [59][60][61]. Functional magnetic resonance studies have revealed significant blood flow increases at the level of intrasylvian cortex during overt speech in the left anterior insula [62,63], suggesting that the left insula plays a role in the coordination of speech articulation. Because of its role in both affective and speech processing, the insula has been assumed to influence verbal affect [54]. It has been proposed [55] that the insula might fuse linguistic **data** structures with affective-prosodic information on a moment-to-moment basis into a smooth motor innervation pattern during speech production.