PMID- 35189456 OWN - NLM STAT- MEDLINE DCOM- 20220519 LR - 20220617 IS - 2213-1582 (Electronic) IS - 2213-1582 (Linking) VI - 34 DP - 2022 TI - Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula. PG - 102964 LID - S2213-1582(22)00029-8 [pii] LID - 10.1016/j.nicl.2022.102964 [doi] LID - 102964 AB - BACKGROUND: One of the core features of posttraumatic stress disorder (PTSD) is re-experiencing trauma. The anterior insula (AI) has been proposed to play a crucial role in these intrusive experiences. However, the dynamic function of the AI in re-experiencing trauma and its putative modulation by effective therapy need to be specified. METHODS: Thirty PTSD patients were enrolled and exposed to traumatic memory reactivation therapy. Resting-state functional magnetic resonance imaging (fMRI) scans were acquired before and after treatment. To explore AI-directed influences over the rest of the brain, we referred to a mixed model using pre-/posttreatment Granger causality analysis seeded on the AI as a within-subject factor and treatment response as a between-subject factor. To further identify correlates of re-experiencing trauma, we investigated how intrusive severity affected (i) causality maps and (ii) the spatial stability of other intrinsic brain networks. RESULTS: We observed changes in AI-directed functional connectivity patterns in PTSD patients. Many within- and between-network causal paths were found to be less influenced by the AI after effective therapy. Insular influences were found to be positively correlated with re-experiencing symptoms, while they were linked with a stronger default mode network (DMN) and more unstable central executive network (CEN) connectivity. CONCLUSION: We showed that directed changes in AI signaling to the DMN and CEN at rest may underlie the degree of re-experiencing symptoms in PTSD. A positive response to treatment further induced changes in network-to-network anticorrelated patterns. Such findings may guide targeted neuromodulation strategies in PTSD patients not suitably improved by conventional treatment. CI - Copyright (c) 2022 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Leroy, Arnaud AU - Leroy A AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France; CHU Lille, Fontan Hospital, General Psychiatry Dpt., 59037 Lille Cedex, France; Centre National de Ressources et Resilience pour les psychotraumatismes (CN2R Lille - Paris), 59000 Lille, France. Electronic address: arnaud.leroy@chu-lille.fr. FAU - Very, Etienne AU - Very E AD - CHU Toulouse, Purpan Hospital, Psychiatry Department, 31059 Toulouse Cedex, France; ToNIC, Toulouse NeuroImaging Center, INSERM U-1214, UPS, France. FAU - Birmes, Philippe AU - Birmes P AD - ToNIC, Toulouse NeuroImaging Center, INSERM U-1214, UPS, France. FAU - Yger, Pierre AU - Yger P AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France; Institut de la Vision, Sorbonne Universite, Inserm S968, CNRS UMR7210, Paris, France. FAU - Szaffarczyk, Sebastien AU - Szaffarczyk S AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France. FAU - Lopes, Renaud AU - Lopes R AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1772), Degenerative & Vascular Cognitive Disorders Team, 59000 Lille, France; Univ Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, US 41 - UMS 2014 - PLBS, 59000 Lille, France. FAU - Outteryck, Olivier AU - Outteryck O AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1772), Degenerative & Vascular Cognitive Disorders Team, 59000 Lille, France; CHU Lille, Department of Neuroradiology, Roger Salengro Hospital, 59037 Lille Cedex, France. FAU - Faure, Cecile AU - Faure C AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France. FAU - Duhem, Stephane AU - Duhem S AD - CHU Lille, Fontan Hospital, General Psychiatry Dpt., 59037 Lille Cedex, France; Centre National de Ressources et Resilience pour les psychotraumatismes (CN2R Lille - Paris), 59000 Lille, France; Universite de Lille, Inserm, CHU Lille, CIC 1403 - Clinical Investigation Center, 59000 Lille, France. FAU - Grandgenevre, Pierre AU - Grandgenevre P AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France; CHU Lille, Fontan Hospital, General Psychiatry Dpt., 59037 Lille Cedex, France. FAU - Warembourg, Frederique AU - Warembourg F AD - CHU Lille, Fontan Hospital, General Psychiatry Dpt., 59037 Lille Cedex, France. FAU - Vaiva, Guillaume AU - Vaiva G AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France; CHU Lille, Fontan Hospital, General Psychiatry Dpt., 59037 Lille Cedex, France; Centre National de Ressources et Resilience pour les psychotraumatismes (CN2R Lille - Paris), 59000 Lille, France. FAU - Jardri, Renaud AU - Jardri R AD - Univ Lille, INSERM, CHU Lille, Lille Neuroscience & Cognition Centre (U-1172), Plasticity & SubjectivitY Team, CURE Platform, 59000 Lille, France; CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Dpt., 59037 Lille Cedex, France. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220210 PL - Netherlands TA - Neuroimage Clin JT - NeuroImage. Clinical JID - 101597070 SB - IM MH - Brain MH - Brain Mapping MH - Humans MH - Insular Cortex MH - Magnetic Resonance Imaging MH - *Stress Disorders, Post-Traumatic/diagnostic imaging/pathology/therapy PMC - PMC8861823 OTO - NOTNLM OT - Directed functional connectivity OT - Granger causality OT - Posttraumatic stress disorder OT - Re-experiencing OT - Salience network OT - Treatment response OT - fMRI COIS- The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2022/02/22 06:00 MHDA- 2022/05/20 06:00 PMCR- 2022/02/10 CRDT- 2022/02/21 20:11 PHST- 2021/09/07 00:00 [received] PHST- 2022/01/27 00:00 [revised] PHST- 2022/02/08 00:00 [accepted] PHST- 2022/02/22 06:00 [pubmed] PHST- 2022/05/20 06:00 [medline] PHST- 2022/02/21 20:11 [entrez] PHST- 2022/02/10 00:00 [pmc-release] AID - S2213-1582(22)00029-8 [pii] AID - 102964 [pii] AID - 10.1016/j.nicl.2022.102964 [doi] PST - ppublish SO - Neuroimage Clin. 2022;34:102964. doi: 10.1016/j.nicl.2022.102964. Epub 2022 Feb 10.