The possible role of the insula in the epilepsy and the gambling disorder of Fyodor Dostoyevsky

Dalma Tény, Csilla Gyimesi, Norbert Kovács, Tamás Tényi, József Janszky

Research output: Contribution to journalArticle

4 Citations (Scopus)


Background: The retrospective diagnosis of Fyodor Mikhailovich Dostoyevsky's (1821-1881) neurological and psychiatric disease proves to be particularly interesting. Recent neurobiological data suggest a solution to the questions regarding the writer's retrospective diagnosis, claiming the insular cortex to be the origin of the rare ecstatic seizures. Regarding Dostoyevsky's pathological gambling, this hypothesis is consistent with another finding from recent neuroscience, namely that the malfunction of the insula could be an important underlying pathology in gambling disorder. Case study: Literary and scientific overview (1928-2015) on the subjects of Dostoyevsky's epilepsy and gambling disorder. Discussion and conclusion: Taking Dostoyevsky's neurological (ecstatic seizures) and psychiatric (pathological gambling) disease and the crossroads into consideration, these two disciplines make regarding the underlying pathology, we would like to suggest a speculative theory that these two disorders have a common insular pathomechanism, namely, the malfunctioning of the risk prediction-risk prediction error coding system. Furthermore, based on Dostoyevsky's case, regarding gambling disorder in general, we would like to hypothesize that the three common gambling related cognitive distortions (near miss effect, gambler's fallacy, and the illusion of control) can be all attributed to the impairment of the anterior insular risk prediction-risk prediction error coding system.

Original languageEnglish
Pages (from-to)542-547
Number of pages6
JournalJournal of behavioral addictions
Issue number3
Publication statusPublished - Sep 2016


  • Ecstatic seizure
  • Gambling disorder
  • Gambling-related cognitive distortions
  • Illness of Dostoyevsky
  • Risk prediction-risk prediction error coding system

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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