Initial Evidence of a Failure to Activate Right Anterior Insula During Affective Set Shifting in Posttraumatic Stress Disorder
Open accessAbstract
Objective: Interoception is the sense of one’s internal physiological, sensory, and emotional status. Extensive evidence supports a link between interoception and subjective experience. An altered ability to monitor or modulate interoception as it relates to subjective experience may provide a mechanistic explanation for the development of some forms of psychiatric illness. Methods: We investigated which neural networks are activated when anticipating a change in affective (and thus interoceptive) state, which we term “affective set-shifting,” in 15 women with posttraumatic stress disorder (PTSD) related to intimate partner violence, and in 15 nontraumatized healthy volunteers. Results: Although both groups activated the dorsolateral prefrontal cortex during affective set shifting, the PTSD group showed significantly less activation in the right anterior insula than did the controls. Conclusions: These findings may suggest that although individuals with PTSD are cognitively aware of the impending shift in interoceptive state, they fail to appropriately activate neural circuitry involved in modulating interoceptive responses. AI = anterior insula; BA = Brodmann Areas; BOLD = blood oxygenation level dependent; CPT = continuous performance task; DLPFC = dorsal lateral prefrontal cortex; fMRI = function magnetic resonance imaging; IFG = inferior frontal gyrus; IPV = intimate partner violence; NTC = nontraumatized control; PTSD = posttraumatic stress disorder; ROI = region of interest; RT = reaction times (RTs).
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The insula has been identified previously as a key neural correlate for individuals with PTSD.
“Critically, the insula has been identified previously as a key neural correlate for individuals with PTSD (Simmons et al., 2009; Bruce et al., 2013; Nicholson et al., 2016; Harricharan et al., 2019b).”
From How Processing of Sensory Information From the Internal and External Worlds Shape the Perception and Engagement With the World in the Aftermath of Trauma: Implications for PTSD (2021) · cites this paper as Simmons et al., 2009
Women with PTSD show decreased activation of the insula in response to shifts in interoceptive responses.
“For instance, women with PTSD show decreased activation of the insula in response to shifts in interceptive responses (Simmons et al, 2009)”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as Simmons et al, 2009
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- Authors
- Simmons, A., Strigo, I. A., Matthews, S. C., Paulus, M. P., & Stein, M. B.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Simmons, Alan
- Venue
- Psychosomatic Medicine
- Published
- 2009-05
- Volume
- 71
- Issue
- 4
- Pages
- 373-377
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC2888032
- OpenAlex
- W2063898170
- Cited by
- 64
- References
- 29
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 1 · 2013: 5 · 2012: 2
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH-64122, MH 65413, K24MH064122, R01MH065413)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- post-traumatic stress disorder, interoception, anterior insula, intimate partner violence, dorsolateral prefrontal cortex, neural circuits, subjective experience, emotion regulation
- MeSH terms
- Adult, Affect, Anxiety Disorders, Brain Mapping, Cerebral Cortex, Cerebrovascular Circulation, Female, Humans, Learning, Magnetic Resonance Imaging, Photic Stimulation, Reaction Time, Self Concept, Stress Disorders, Post-Traumatic
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