We've all been there. You sit down after a hard day in the lab and open a bottle of wine to relax. Offering the first glass to a friend, you watch in horror as their first sip turns into a facial grimace of disgust — the wine has corked. Without even tasting your own glass, you consign the offending liquor to the bin and pull another from your wine rack. In a sense, that is the purpose of the readily recognizable facial expression of disgust — to prevent you from experiencing unpleasantness, such as food or drink that has turned and may be harmful to your health. But what is the neural basis of your reaction to recognition of disgust in others?

Functional neuroimaging studies have shown that facial expressions of disgust involve a range of brain areas. However, just two areas are consistently identified by these studies — the insula and the putamen. These results are consistent with data from patients with Huntington's disease who are impaired at the recognition of disgust from the facial expression of others, and have damage to the striatal regions (which include the putamen) and insula. However, these patients have damage to other brain systems, and the functional neuroimaging data provide correlational rather than causal evidence for the role of these structures.

Andrew Calder and colleagues now report the first analysis of a patient (NK) with selective and specific damage to the insula and putamen on various aspects of the processing of disgust and other emotions. Patient NK demonstrated a largely selective deficit in the recognition of disgust from facial expressions of others, non-verbal emotional sounds, and emotional prosody. Moreover NK was less disgusted than controls when presented with disgust-provoking scenarios.

These data support the idea that the neural substrates of emotional experience are recruited during the recognition of the expression of emotion by others and indicate that an insular-striatal network may be involved in disgust across all sensory modalities.