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. 2021 Apr 16;15:625490. doi: 10.3389/fnins.2021.625490

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Copyright © 2021 Harricharan, McKinnon and Lanius.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Sensory transmission in PTSD. The insula is a key node for creating an interoceptive inference based on the convergence of exteroceptive and interoceptive sensory information from the brainstem. However, among traumatized individuals, there is decreased insula subregion connectivity with the prefrontal cortex, which suggests a decreased capacity to evaluate the contextual meaning underlying incoming sensory information. Instead, individuals with PTSD show increased connectivity with limbic and brainstem structures involved in hyperemotionality and hypervigilance, which may evoke survival-based defensive behaviors. SC/PAG (Superior Colliculus/Periaqueductal Gray), VN (Vestibular Nuclei), LC (Locus Coeruleus), Post Ins (Posterior Insula), Ant Ins (Anterior Insula), dlPFC (Dorsolateral Prefrontal Cortex).