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Compared to RW, enhanced functional connectivity was observed between the insula and prefrontal cortex and anterior cingulate cortex, while reduced functional connectivity was observed between the insula and temporal, parietal, and occipital regions following TSD. Moreover, altered insular functional connectivity with the prefrontal cortex, ie superior frontal gyrus and middle frontal gyrus, and inferior temporal gyrus was correlated with PVT performance after TSD. Our results suggest that insular coupling with the prefrontal cortex and