The role of the dorsal anterior insula in

ecstatic sensation revealed by direct

electrical brain stimulation F.
Bartolomei & S. Lagarde & D. Scavarda
& R. Carron & C.G. Bénar & F. Picard
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Accepted Manuscript

The role of the dorsal anterior insula in ecstatic sensation revealed by direct electrical
brain stimulation

F. Bartolomei, S. Lagarde, D. Scavarda, R. Carron, C.G. Bénar, F. Picard

PII: S1935-861X(19)30230-X
DOI: https://doi.org/10.1016/j.brs.2019.06.005
Reference: BRS 1488

To appear in: Brain Stimulation

Received Date: 16 February 2019

Revised Date: 13 May 2019
Accepted Date: 3 June 2019

Please cite this article as: Bartolomei F, Lagarde S, Scavarda D, Carron R, Bénar C, Picard F, The role
of the dorsal anterior insula in ecstatic sensation revealed by direct electrical brain stimulation, Brain
Stimulation, https://doi.org/10.1016/j.brs.2019.06.005.

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to
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 1
ACCEPTED MANUSCRIPT
The role of the dorsal anterior insula in ecstatic sensation revealed by direct
electrical brain stimulation

F. Bartolomei 1,2, S Lagarde1,2, D. Scavarda1,3, R Carron1,4, CG Bénar1, F. Picard5

PT
1. Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France

2. APHM, Timone Hospital, Clinical Neurophysiology and Epileptology Department,

RI
Marseille, 13005, France

3. Department of Pediatric Neurosurgery, Timone University Hospital, Marseille, France.

SC
4. Department of Functional and Stereotactic Neurosurgery, Timone University Hospital,
Marseille, France.

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5. Department of Neurology, University Hospitals and Medical School of Geneva,
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Geneva, Switzerland

Corresponding Author:
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Prof Fabrice Bartolomei, MD, PhD

Address: Service d’Epileptologie et Rythmologie Cérébrale, CHU Timone - 264 Rue St Pierre
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13005-Marseille, France
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Tel: +33491385833 Fax: +33491385826 Email: Fabrice.bartolomei@ap-hm.fr

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Abstract

Background: An ecstatic phenomenon is an altered state of consciousness with a sense of

“hyper-reality”, and a complete present-moment awareness with a feeling of union with the
Universe. A better understanding of the network mechanisms underlying this fascinating
subjective experience may help to unravel some mysteries of human consciousness. Insula has
been recently proposed to be a key region to elicit these symptoms.

PT
Objective/Hypothesis: We studied functional connectivity changes in several brain areas
during the induction of ecstatic auras by direct electrical stimulation of the dorsal anterior

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insular cortex in patients with refractory focal epilepsy implanted with intracerebral
electrodes (stereotactic-EEG, SEEG) in the context of their pre-surgical evaluation.

SC
Methods: Three patients were selected on the basis of the occurrence of ecstatic symptoms
triggered by direct intracerebral electrical stimulation (ES) of the antero-dorsal part of the

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insula. ES was performed (50 Hz, 1.5-2.1 mA, in a bipolar fashion to each contact in the gray
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matter during a 3 second period) to map functional cortices and trigger habitual seizures.
One stimulation inducing ecstatic changes in each patient was analyzed. Functional
connectivity analysis was performed by measuring interdependencies (nonlinear regression
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analysis based on the h² coefficient) between SEEG signals before and after stimulations.
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Results:
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In all patients, only the stimulation of dorsal anterior insula was able to reproduce an ecstatic
aura. We observed a significant increase of functional connectivity values between several
brain regions in the immediate period following stimulations. The most commonly implicated
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region was the dorsal anterior insula. Out-degrees (a measure intended to identify leading
structures in a network) identified the dorsal anterior insula as the most common leading
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region in the induced networks.

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Conclusion(s): Our findings bring additional support in favor of a major role played by the
dorsal anterior insula in ecstatic experiences.

Highlights

- In 3 patients, only the direct stimulation of the dorsal anterior insula induced ecstatic
phenomenon.
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- Increased functional connectivity in the period post stimulation implicated mostly the
anterior insula

- Outdegrees identified the dorsal anterior insula as the most common leading region.

PT
Introduction

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The epileptic “aura” is a subjective phenomenon that sometimes precedes the visible clinical
features of a seizure and that is related to the beginning of seizures in the brain. A few patients

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with epilepsy experience a type of aura referred to as “ecstatic”. Ecstatic epileptic auras
consist of a sensation of “hyper-reality”. The patients use terms such as “clarity”, “evidence”,

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“certainty”, “understanding”, “insight”, “enlightenment” or “epiphany”. Dostoevsky gave a
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famous description of such seizures, that he experienced himself and in which he reached a
wonderful state of clarity and bliss [1]. The phenomenological detail of the ecstatic aura
includes three important points: bliss (“the immense joy that feels me is above physical
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sensations”[2]), a sense of certainty (“things suddenly seemed self-evident”[3]), and a sense

of timelessness or a sense of being in an eternal now (“These moments are without beginning
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and without end”[2]). The feeling of certainty during ecstatic auras and a frequent feeling of
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oneness with the Universe are sometimes interpreted as mystical or religious by some
individuals, depending on their previous religious beliefs, and may change their life forever.
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The suspected location of the ecstatic ictal symptoms was the temporal lobe until recently,
however evidence has converged more recently pointing to an involvement of the dorsal
anterior insula probably within a larger neural network [2, 4, 5]. We could support this
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hypothesis of insular involvement by the finding of a first patient in whom the direct
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stimulation of the antero-dorsal part of the insula induced her ecstatic auras [6]. In the present
report, we studied functional connectivity changes in several brain areas during the induction
of ecstatic auras by electrical stimulation of the dorsal anterior insula in 3 patients having
intracerebral electrodes for presurgical evaluation. Physiological functions in the brain require
the functional interactions between multiple distinct neural networks. The measure of
statistical interdependencies between signals of brain activity is an estimation of functional
interactions and is referred to as ‘functional connectivity”[7]. The underlying assumption is
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that such correlations reflect, at least in part, functional interactions between different brain
areas.

Materials and methods

Selection of patients

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Subjects were 3 patients (P1, P2 and P3) (Table 1) with drug-resistant focal epilepsy,
candidate to surgical treatment. They were studied in the Epilepsy Unit of the Timone

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Hospital, Marseille, France. For all these patients, intracerebral recordings with stereotactic
EEG (SEEG) were performed in the context of their pre-surgical evaluation. These three

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patients were selected in the period 2011-2017 because they reported during intracerebral
stimulation the occurrence of ecstatic symptoms defined by seizures with the feeling of (1)
intense positive emotion (bliss), (2) enhanced physical well-being, and (3) heightened self-

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awareness or heightened perception of the external world (clarity) [2]. These feelings were
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similar to those reported during their spontaneous auras. Patients with only vague pleasant
phenomenon, with orgasmic/sexual feeling or with associated perceptual hallucinations
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(feeling of a presence, auditory hallucinations…) were not selected. Patients signed informed
consent, and the study was approved by the Institutional Review board (IRB00003888) of
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INSERM. Patient data are summarized in Table 1.

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SEEG recordings and electrical stimulation

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SEEG recordings were made thanks to intracerebral electrodes with multiple contacts (10-15
contacts) as previously described [8]. The electrodes were positioned in each patient based
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upon hypotheses about the localization of the epileptogenic zone, formulated from available
noninvasive information. Each patient had a comprehensive evaluation including detailed
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history, neurological examination, neuropsychological testing, high resolution magnetic

resonance imaging (MRI), and video-electroencephalography (EEG) recording of seizures
before SEEG. Signals were recorded on a 256-channels Natus™ system. They were sampled
at 1024 Hz. In total, 3 stimulations in 3 different patients, were selected for this study. Electric
stimulation was produced by a regulated neurostimulator designed for safe diagnostic
stimulation of the human brain (Inomed®). High frequency stimulation at 50 Hz (pulse
duration 1 millisecond, intensity 0.5-2 mA) was applied in a bipolar fashion to each of the
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pairs of contacts in the gray matter during a 3-5 seconds period. During stimulation, patient
was sitting in bed and was asked to read or count.

One stimulation inducing ecstatic changes in each patient was analyzed (table 1). In each
patient we studied the interdependencies between bipolar SEEG signals (i.e., difference of
contiguous contacts).

SEEG analysis: estimation of functional connectivity changes

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Functional connectivity is defined as the statistical dependencies between two
neurophysiological responses. In our case, these functional connectivity measures are

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directed, in the sense that we assessed nonlinear correlations as a function of time lag between
electrodes.

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Definition of the period of interest

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For each stimulation we chose two periods of analysis. The background period was a period
of 15 s immediately preceding the stimulation and is referred here as PreS (“pre stimulation”).
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The second period was a 10 s period immediately following the stimulation artifact and
referred as PoS (post stimulation). All the analyses were performed with bipolar derivation
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(subtraction of consecutive channels). During stimulation, the bipolar contacts are

disconnected and cannot be studied for connectivity analysis. Thus we have taken two
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adjacent contacts representative of the stimulated region.

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Signals were filtered in Anywave software [9] (software available at http://meg.univ-

amu.fr/wiki/AnyWave), with Butterworth filters of order 4. We used only a 1Hz high pass
filter in all the analyses.
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Estimation of functional connectivity using Non-linear correlation (h²)

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Signals were analyzed with the AnyWave software [9], which computes a nonlinear
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regression analysis based on the h² coefficient[10] . In summary, a piecewise linear regression

is performed between each pair of signals, testing all the shifts of one signal relative to the
other within a maximum lag. The h² is the coefficient of determination which measures the
goodness of fit of the nonlinear regression - equivalent to the R-squared used in linear
regression. The h² is bounded between 0 (no correlation) and 1 (maximal correlation) and -
contrary to the R-squared - is not symmetric [11]. We used a sliding window of 3 seconds
with an overlap of 2 seconds, and a maximum delay between signals of 100 ms. For each pair
of signals (X,Y), we retained the maximal value across delays and across directions (X to Y
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or Y to X). This value corresponded to a delay between signals, which was used to define the
direction of the link. We thus obtained functional connectivity graphs, with each channel
representing a node of the graph, and h2 values the strength of the link between two
nodes[12].

Connectivity graphs were obtained for the three stimulations (one for each patient) between
bipolar signals derived from the grey matter of 7 regions. We computed all pair-wise

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interactions from 7 regions (42 connections), and for each connectivity pair, we took the
maximum (resulting in a final number of 21 interactions). For clinical reasons, the sampling

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of the brain could be variable from one patient to the other. Therefore we selected a common
set of regions (amygdala, hippocampus, temporal neocortex, dorsal anterior insular cortex,

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orbitofrontal cortex, dorsolateral prefrontal cortex (DLPFC)) and another neocortical region
that was variable from one patient to the other (see Fig 2 for the electrodes placement on 3D
mesh of the MRI in the three patients).

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Graph measures
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We summarized the connectivity graphs with a graph measures, the node degrees. This
entailed thresholding the graphs, and then counting the number of significant links between a
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given node and the rest of the graph. This has the advantage of removing the links with low
connectivity. The threshold was set empirically to 0.2. In order to study the influence of the
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choice of threshold on the results, we also estimated the degrees using thresholds at 0.1 and
0.3. Overall the results are very similar (see Figure in supplementary material) and in the
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following, only results at a threshold of 0.2 will be reported.

Thresholding resulted in binary graphs (a link is 0 or 1), with each node corresponding to a
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channel, and a direction given by the delay. In other words, we assembled an asymmetric and
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directed adjacency matrix, based upon our measures of directed functional connectivity. Then,
in each time window and for each channel, we counted the number of links with an h² value
above the threshold, only for the outgoing links (OUT measure, corresponding to "out
degrees" in graph theory), ingoing links (IN measure), and for all links independently of the
directionality (TOT measure, with TOT=IN+OUT). High values of out-degrees OUT were
considered to be indicative of the driving (i.e., source) regions [12].(see also supplementary
material for more details)

Graph comparison
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For each link, the h2 values were compared between PoS and PreS conditions. The test for a
difference was performed across time windows (i.e., within subject) to compare two sets of
functional connectivity measures for a given pairs of electrodes (one for PreS, one for PoS).
We also compared the degrees for each given region. For both comparisons, we used a
Wilcoxon non-parametric paired test with Bonferroni correction for multiple comparisons.

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Results

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SC
The clinical responses obtained in the three patients are summarized in Table 1. The seizure
onset zone spared the insula in the three patients, but the insula was involved during the
seizure spread. Patient 1 has already been reported in a previous study[6]. Patients 2 and 3

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also reported typical ecstatic sensations during their habitual seizures.
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In all the three cases, the stimulated contacts were located in the antero-dorsal part of the
insular cortex (two right side, one left side, Fig 1). The stimulations ranged from 1.6 to 2.1
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mA (50 Hz, 1ms pulse width, 3-5 sec) and were not followed by any after-discharge. The
patients were asked what they felt immediately after the stimulation ended. In two subjects a
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directed interview focusing on the ecstatic phenomenon was performed. In all three cases, it
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was not possible to precisely detect the timing of occurrence within or after the stimulation
period but the ecstatic feeling lasted a few seconds. In the three patients, the other
stimulations (particularly in the mesial temporal lobe) failed to trigger such phenomenon.
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Figure 2A shows the functional connectivity graphs superposed on a 3D rendering of the

cortex, with each bipolar channel representing a node of the graph. Links represents the
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strengths of h2 values between pairs of nodes with a significative change (p <0.001190 for
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multiple comparison) between post stimulation (PoS) and pre stimulation (PreS) periods,
during ecstatic symptoms induced by stimulation. These stimulations induced a significant
increase of functional connectivity values between different regions, particularly between
amygdala and hippocampus, dorsal anterior insula and prefrontal cortex, amygdala and
orbitofrontal cortex, amygdala and dorsal anterior insula in P1; between dorsal anterior insula
and orbitofrontal cortex, dorsal anterior insula and DLPFC, dorsal anterior insula and
temporal neocortex, dorsal anterior insula and amygdala in P2; between dorsal anterior insula
and amygdala, amygdala and DLPFC, amygdala and dorsolateral prefrontal cortex in P3.
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Figure 2B presents the differences in mean total degree (number of significant links,
independently of the direction of the links) between PreS and PoS periods. The following
regions increased significantly their degree values: P1: amygdala, hippocampus, dorsal
anterior insula, orbitofrontal cortex, dorsolateral prefrontal cortex; P2: dorsal anterior insula;
P3: amygdala, dorsal anterior insula, premotor cortex, dorsolateral prefrontal cortex.

Thus, variable changes in functional connectivity occurred after stimulation, but the most

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commonly implicated region in the three patients was the dorsal anterior insula. Out-degrees
were estimated with a 0.2 threshold, in the PoS period. This measure is a mean of identifying

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leading structures in a network. The Fig 3A shows the out-degree values (colored spheres).
For P1, two regions presented the highest values, the dorsal anterior insula and the frontal

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lobe. In P2 and P3 the highest value was observed in the insular cortex. The out-degree values
pooled from the three stimulations are shown in the Fig 3B showing that the insula was the

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structure with the largest changes in the three patients.
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Discussion

We report here the induction of ecstatic auras by electrical stimulation of the dorsal anterior
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insula in 3 patients with refractory focal epilepsy. To our knowledge, these are the only
descriptions of true ecstatic auras induced by brain electrical stimulation in the literature. In
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our 3 patients, no other stimulated areas than the dorsal anterior insula could induce such
symptoms. We demonstrated that, at the time of the induction of the ecstatic symptoms, the
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insula was the most active region, playing a leading role among different areas forming an
hyperactive network. Importantly, the analysis was performed in the few seconds following
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the stimulation, thus avoiding the bias related to the stimulation artifact.

The anterior insula has been recognized as a major component of the salience network, in
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association with the dorsal anterior cingulate cortex. The anterior insula activates in cases of
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behaviorally-relevant new external or internal stimuli [13, 14]. The insula also integrates the
interoceptive signals, i.e. stimuli coming from the inside of the body. It processes the
physiological body state, contextualized by exteroceptive (environmental) signals. In the
context of predictive coding in the brain, the insula continuously produces (top down)
interoceptive predictions and generates prediction errors when the real signals arrive, allowing
to update the next predictions. This process of interoception participates in the generation of
emotions, feelings and probably the sense of self [13, 14]. The neurocognitive hypothesis in
ecstatic seizures is that an aberrant epileptic activity affecting a network which includes the
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anterior insula could prevent it from reaching the minimal level of differentiation and
complexity necessary to encode predictions and/or prediction errors related to interoception
and emotions. This would mimic a perfect match between interoceptive predictions and the
incoming interoceptive signals, leading to a sense of certainty [3, 5]. Such a state was
described as the ”ultimate stable state”, which Mumford suggested occurred when the top-
down cortical signals would perfectly predict representations at lower cortical levels[15]. This

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would be the state of a perfect prediction of the world that the brain is trying to achieve, in
order to avoid surprise and minimize energy expenditure.

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There are two circumstances in which this sense of certainty and consequent bliss as
experienced in ecstatic auras occurs. First, the “Aha!” moment or “eureka” moment (also

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known as insight) is an experience of sudden understanding of a previously incomprehensible
problem or concept, accompanied by joy or satisfaction. A recent study showed a specific
activation of the dorsal anterior insula at an eureka moment of bug detection in computer code

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[16]. A previous study on insight solutions also showed an early bilateral insular activation
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[17]. Secondly, a peaceful and blissful state similar to the ecstatic state can be reached
sometimes by meditation, in particular in the subjective experience of Samadhi during deep
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meditation or as the ultimate goal of yoga. Jamieson [18] postulated that the non-reactivity to
the contents of awareness in mindfulness practices leads to a heightened level of match
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between interoceptive predictions and the real felt state of the body[18]. Mindfulness training
was reported to induce an increased connection strength of the right insula in all its
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connections [19]. A larger gyrification within the right antero-dorsal insula was also reported
in meditators [20], as well as in increased grey matter volume in the left or right insula, or in
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the right fronto-insular cortex in a study on a yoga meditation practice[21].

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Our findings bring additional support in favor of a major role played by the dorsal anterior
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insula in the feeling of certainty, accompanied by a feeling of bliss and a sense of

timelessness, as observed in ecstatic seizures. The fact that the stimulation of a certain part of
the brain is able to induce the complex cognitive state observed in ecstatic auras is extremely
interesting. The fact that we have shown an increased functional connectivity of the insula
seems to exclude an inhibition of other regions by the abnormal activation of the insula, and
favor the above-mentioned hypothesis of a hindrance to the generation of interoceptive
prediction errors because of a supra-optimal level of activity inappropriate for this complex
cognitive function. We must however recognize that these ecstatic phenomena have only been
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induced in patients with ecstatic epilepsy up to now, and that it is possible that epilepsy
changes the excitability and wiring of the regions.

Legends of Table and Figures

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Table 1. Patients’ data and stimulation parameters inducing the ecstatic symptom in
each patient.

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Abbreviations: M, male; F, female; N: normal; FCD: focal cortical dysplasia; OFC:
orbitofrontal cortex; ES: epigastric sensation; R: right; L: left; TLE: temporal lobe epilepsy;

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FLE: frontal lobe epilepsy; ATL: anterior temporal lobectomy; Ant insula: anterior insula.

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Figure 1: Anatomical localization of the contacts in the dorsal anterior insula stimulated
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during ecstatic phenomenon.

A: Localization of the contacts inducing an ecstatic aura in the operculo-insular region in the
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3 patients (P1, P2 and P3), in blue. The red dots correspond to other implanted electrodes.
Localisation was performed using in-house Gardel software [22]. B: SEEG traces and an
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example of insular stimulation in patient 3. Note the absence of after discharges. Intracerebral
electrodes are implanted under stereotactic conditions in Talairach’s reference frame.
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Electrodes are identified by letter (A, etc..) and the recordings leads are numbered from 1 to
15, low numbers corresponding to the deepest structures
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Figure 2. Intracerebral EEG functional connectivity changes in the three patients (P1,
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P2, P3)

A: Functional connectivity graphs are illustrated on a 3D mesh of the MRI with the position
of electrodes. Only the significant changes are indicated for the post stimulation period (PoS)
relative to the pre stimulation period (PreS). Color scale indicated the p values of the Z-
scores. B: for each bipolar channel the degrees are indicated between the two conditions (pre
stimulation (PreS) and post stimulation (PoS)).* indicated significant interactions (*p<0.05,
**p<0.01 after Bonferroni corrections).
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Bipolar channels selected for connectivity analysis:

P1: patient 1 (right side): A1-2: Amygdala; B1-2: Anterior hippocampus; I1-2: Insula (middle
part); OF3-4: Dorsal insula/Operculum; OR1-2: Orbitofrontal cortex; A9-10: Middle temporal
gyrus; OR9-10: Dorsolateral prefrontal cortex.

P2: patient 2 (left side): A’1-2: Amygdala; B’2-3: Hippocampus, IM’1-2: ventral Insula ;
OF’1-2: dorsal Insula OR’1-2: Orbitofrontal cortex; B’9-10: Middle temporal gyrus; OR’10-

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11: Dorsolateral prefrontal cortex.

P3: patient 3 (right side): TP1-2: Mesial part of the temporal pole; A1-2: Amygdala; A9-10:

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Middle temporal gyrus; OR1-2: Orbitofrontal cortex; OR10-11: Dorsolateral prefrontal
cortex; PM9-10: Premotor cortex; OF 4-5: dorsal anterior Insula.

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Figure 3: Estimation of the leading regions in the network. A: Spheres on each contact
represent out-degree values according to the values indicated in the colour scale. B: Mean
across time windows of total degree values pooled from the three stimulations (in the three
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patients). MTL: mesial temporal lobe, OFC: orbito-frontal cortex; TNcx: temporal neocortex.
Other: corresponds to different electrodes in the different patients. Highest values are
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observed for dorsal anterior insula versus mesial temporal lobe (p=0.04), dorsal anterior
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insula versus temporal neocortex (p=0.04); orbitofrontal cortex versus temporal neocortex
(p=0.005), dorsal anterior insula versus orbitofrontal cortex (p=0.005) and dorsal anterior
insula versus other cortex (p=0.04) (Wilcoxon test with Bonferoni correction).
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Declaration of Interest:

Authors have no conflict of interest to disclose

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Acknowledgements

The authors thank Samuel Medina and Bruno Colombet for their help with Anywave and

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Gardel software.

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Stimulation inducing
ecstatic symptoms
Spontaneous
sz
Patients subjective Type of Surgery (Engel

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(gender) Age (years) MRI/etiology symptoms epilepsy outcome) Region Frequency Duration Intensity Pulse width
Ecstatic, ES ATL (outcome
P1 (F) 23 N R-TLE Engel III) Ant Insula 50 Hz 3sec 1.6 mA 1 ms

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Ecstatic, ES,
P2 (M) 18 FCD Nausea L-TLE no Ant Insula 50 Hz 3sec 2.1 mA 1ms

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P3 (M) 36 OFC lesion Ecstatic R-FLE awaiting Ant Insula 50Hz 5sec 1.6 mA 1ms

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Highlights

- In 3 patients, only the direct stimulation of the dorsal anterior insula induced ecstatic
phenomenon.
- Increased functional connectivity in the period post stimulation implicated mostly the
anterior insula

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- Out-degrees identified the dorsal anterior insula as the most common leading region.

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Another random document with
no related content on Scribd:
 — « Quelle perte pour moi — pour nous, se reprit-elle avec une
magnanime générosité, et elle ajouta dans un murmure : « pour le
monde entier »… Aux dernières lueurs du crépuscule je pouvais
distinguer la lumière de ses yeux pleins de larmes, de larmes qui ne
voulaient pas couler.
— « J’ai été très heureuse, très fortunée, très fière, continua-t-
elle. Trop fortunée, trop heureuse pendant quelque temps. Et
maintenant je suis malheureuse pour toujours… »
« Elle se leva. Ses cheveux blonds semblaient recueillir, dans un
scintillement doré, tout ce qui restait de clarté dans l’air. Je me levai
à mon tour.
— « Et de tout cela, fit-elle encore, avec désolation, de tout ce
qu’il promettait, de toute sa grandeur, de cette âme généreuses de
ce cœur si noble, il ne reste plus rien — rien qu’un souvenir… Vous
et moi…
— « Nous nous souviendrons toujours de lui !… » fis-je
hâtivement.
— « Non, s’écria-t-elle. Il est impossible que tout soit perdu,
qu’une vie comme la sienne soit sacrifiée sans rien laisser derrière
elle — sinon de la douleur… Vous savez quels étaient ses vastes
projets. Je les connaissais aussi. Peut-être ne comprenais-je pas.
Mais d’autres étaient au courant. Il doit demeurer quelque chose.
Ses paroles au moins ne sont pas mortes !…
— « Ses paroles resteront, dis-je…
— « Et son exemple, murmura-t-elle, comme pour elle-même. On
avait les yeux fixés sur lui. Sa bonté brillait dans toutes ses actions.
Son exemple…
— « C’est vrai, fis-je. Son exemple demeure aussi. Oui, son
exemple, je l’oubliais…
— « Mais non, je n’oublie pas. Je ne puis, je ne puis croire
encore, je ne puis croire que je ne le reverrai plus, que personne ne
le verra plus jamais… »
 « Comme vers une image qui s’éloigne, elle joignit ses mains
pâles et tendit ses bras qui, à contre-jour de l’étroite et pâlissante
lueur de la fenêtre, apparurent tout noirs. Ne plus jamais le revoir !
— Je le revoyais à ce moment bien assez distinctement !… Toute ma
vie, je reverrai ce loquace fantôme, et je la verrai elle-même, ombre
tragique et familière, pareille dans son attitude, à une autre,
également tragique, et ornée de charmes impuissants, qui étendait
ses bras nus, au-dessus du scintillement du fleuve infernal, du fleuve
de ténèbre. Soudain, elle dit, très bas : « Il est mort comme il a
vécu… »
— « Sa mort, fis-je, cependant qu’une sourde irritation montait en
moi, a été de tous points digne de sa vie.
— « Et je n’étais pas auprès de lui, » murmura-t-elle.
« Mon irritation céda à un sentiment de pitié sans bornes.
— « Tout ce qui pouvait être fait… », bredouillai-je.
— « Ah ! J’avais foi en lui plus que quiconque au monde !… Plus
que sa propre mère… Plus que lui-même. Il avait besoin de moi…
Ah ! J’aurais jalousement recueilli le moindre de ses soupirs, ses
moindres paroles, chacun de ses mouvements, chacun de ses
regards. »
« Je sentis une main glacée sur ma poitrine. « Ne l’ai-je pas
fait ?… » dis-je d’une voix étouffée.
— « Pardonnez-moi !… J’ai si longtemps pleuré en silence, en
silence. Vous êtes demeuré avec lui, jusqu’au bout… Je songe à son
isolement… Personne auprès de lui pour le comprendre, comme je
l’aurais compris… Personne pour entendre…
— « Jusqu’au bout, fis-je d’un ton saccadé… J’ai entendu ses
derniers mots… » Je m’arrêtai, saisi.
— « Répétez-les, murmura-t-elle d’un ton accablé. Je veux, je
veux avoir quelque chose avec quoi je puisse vivre… »
« Je fus sur le point de lui crier : « Mais ne les entendez-vous
pas ? » L’obscurité autour de nous ne cessait de les répéter dans un
chuchotement persistant, dans un chuchotement qui semblait
s’enfler de façon menaçante, comme le premier bruissement du vent
qui se lève : « L’horreur ! L’horreur !… »
— « Son dernier mot : que j’en puisse vivre !… » reprit-elle. « Ne
comprenez-vous donc pas que je l’aimais, je l’aimais, je l’aimais ! »
« Je me ressaisis et parlant lentement :
— « Le dernier mot qu’il ait prononcé : ce fut votre nom… »
« Je perçus un léger soupir et mon cœur ensuite cessa de battre,
comme arrêté net par un cri exultant et terrible, un cri d’inconcevable
triomphe et de douleur inexprimable : « Je le savais, j’en étais
sûre !… » Elle savait. Elle était sûre. Je l’entendis sangloter : elle
avait caché son visage dans ses mains. J’eus l’impression que la
maison allait s’écrouler avant que je n’eusse le temps de m’esquiver,
que le ciel allait choir sur ma tête. Mais rien de pareil. Les cieux ne
tombent pas pour si peu. Seraient-ils tombés, je me le demande, si
j’avais rendu à Kurtz la justice qui lui était due ?… N’avait-il pas dit
qu’il ne demandait que justice ? Mais je ne pouvais pas. Je ne
pouvais lui dire. C’eût été trop affreux, décidément trop affreux… »
Marlow s’arrêta et demeura assis à l’écart, indistinct et silencieux,
dans la pose de Bouddha qui médite. Personne, pendant un
moment, ne fit un mouvement. — « Nous avons manqué le premier
flot de la marée », fit l’administrateur tout à coup. Je relevai la tête.
L’horizon était barré par un banc de nuages noirs et cette eau, qui
comme un chemin tranquille mène aux confins de la terre, coulait
sombre sous un ciel chargé, semblait mener vers le cœur même
d’infinies ténèbres.
ACHEVÉ D’IMPRIMER
LE 30 JUILLET 1925
PAR F. PAILLART A
ABBEVILLE (SOMME).
 *** END OF THE PROJECT GUTENBERG EBOOK JEUNESSE,
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