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Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula

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 e...

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Autores principales: Leroy, Arnaud, Very, Etienne, Birmes, Philippe, Yger, Pierre, Szaffarczyk, Sébastien, Lopes, Renaud, Outteryck, Olivier, Faure, Cécile, Duhem, Stéphane, Grandgenèvre, Pierre, Warembourg, Frédérique, Vaiva, Guillaume, Jardri, Renaud
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861823/
https://www.ncbi.nlm.nih.gov/pubmed/35189456
http://dx.doi.org/10.1016/j.nicl.2022.102964
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author Leroy, Arnaud
Very, Etienne
Birmes, Philippe
Yger, Pierre
Szaffarczyk, Sébastien
Lopes, Renaud
Outteryck, Olivier
Faure, Cécile
Duhem, Stéphane
Grandgenèvre, Pierre
Warembourg, Frédérique
Vaiva, Guillaume
Jardri, Renaud
author_facet Leroy, Arnaud
Very, Etienne
Birmes, Philippe
Yger, Pierre
Szaffarczyk, Sébastien
Lopes, Renaud
Outteryck, Olivier
Faure, Cécile
Duhem, Stéphane
Grandgenèvre, Pierre
Warembourg, Frédérique
Vaiva, Guillaume
Jardri, Renaud
author_sort Leroy, Arnaud
collection PubMed
description 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.
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spelling pubmed-88618232022-03-02 Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula Leroy, Arnaud Very, Etienne Birmes, Philippe Yger, Pierre Szaffarczyk, Sébastien Lopes, Renaud Outteryck, Olivier Faure, Cécile Duhem, Stéphane Grandgenèvre, Pierre Warembourg, Frédérique Vaiva, Guillaume Jardri, Renaud Neuroimage Clin Regular Article 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. Elsevier 2022-02-10 /pmc/articles/PMC8861823/ /pubmed/35189456 http://dx.doi.org/10.1016/j.nicl.2022.102964 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Regular Article
Leroy, Arnaud
Very, Etienne
Birmes, Philippe
Yger, Pierre
Szaffarczyk, Sébastien
Lopes, Renaud
Outteryck, Olivier
Faure, Cécile
Duhem, Stéphane
Grandgenèvre, Pierre
Warembourg, Frédérique
Vaiva, Guillaume
Jardri, Renaud
Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title_full Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title_fullStr Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title_full_unstemmed Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title_short Intrusive experiences in posttraumatic stress disorder: Treatment response induces changes in the directed functional connectivity of the anterior insula
title_sort intrusive experiences in posttraumatic stress disorder: treatment response induces changes in the directed functional connectivity of the anterior insula
topic Regular Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861823/
https://www.ncbi.nlm.nih.gov/pubmed/35189456
http://dx.doi.org/10.1016/j.nicl.2022.102964
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