Trauma-related intrusive memories (TR-IMs) are a significant challenge in treating post-traumatic sequelae. This study investigated the neural mechanisms of TR-IMs' unique phenomenological properties in 84 trauma-exposed adults using ecological momentary assessments (EMAs) and resting-state fMRI. Emotional intensity was inversely associated with anterior hippocampal (aHPC)-default mode network (DMN) co-activation. Sensory features correlated with HPC-sensory cortex and ventral attention network co-activation, while reliving was linked to persistent pHPC-visual cortex co-activation. Importantly, no associations were found with conventional symptom measures, highlighting the value of EMAs. These findings offer insights into the neural basis of TR-IMs, crucial for developing individualized treatments.

Kevin J. Clancy, Quentin Devignes, Boyu Ren, Yara Pollmann, Sienna R. Nielsen, Kristin Howell, Poornima Kumar, Emily L. Belleau, Isabelle M. Rosso