Von Economo neurons: clinical and evolutionary perspectives.

Von Economo neurons (VENs) are projection neurons located in layer V of the anterior cingulate and frontoinsular cortex that are increasingly attracting the interest of the scientific community as many studies point to their involvement in neuropsychiatric conditions. In this review we provide a critical appraisal of both historic and recent literature on VENs that highlights the importance of clinicopathological studies in areas of research where animal models are not available. Current data suggest that VENs represent a specialized neuronal type with a characteristic morphology that evolved only in a restricted number of species most likely from a population of pyramidal neurons present in ancestral mammals in the context of specific adaptive pressures. VENs, which evolved among primates only in the hominoid lineage, are particularly vulnerable in neuropsychiatric conditions characterized by deficits in social skills and emotional function. Moreover, recent evidence on the neurochemical profile, morphologic features, and laminar and regional distribution of VENs suggests that this intriguing neuronal population could be critically involved in autonomic regulation.