Review article
Role of the salience network in cognitive and affective impairments

Network perspective is becoming increasingly popular in the analysis and interpretation of cognitive and affective dysfunctions. To date, neuroimaging studies have identified three core large-scale brain networks, mediating all cognitive functions. These are the default mode network (DMN), the central executive network (CEN), and the salience network (SN). The DMN activity mostly dominates during cognitive leisure and self-monitoring functions. CEN activity is strongest during task engagement and cognitive effort. The salience network plays a crucial role as a dynamic ‘switch’ between the DMN and CEN in accordance with salience and cognitive demand. The salience network relates to activity in the anterior insula and anterior cingulate cortex (ACC). Dysfunctions involving SN activity are associated with a wide range of impairments and non adaptive behavior patterns, both in the cognitive and affective domain. These include depression, insomnia, narcissism (in the case of SN hyperactivity), chronic pain and anxiety, high levels of neuroticism, as well as schizophrenia, epilepsy, autism and neurodegenerative diseases (in the case of SN hypoactivity). In the first part of the paper we present the main principles of the brain network paradigm and contrast it with the more traditional modular approach. Afterwards, we describe the interaction model of the core functional brain networks and present current research linking SN-related dysfunctions with cognitive and affective impairments.