Critchley HD, Mathias CJ, Josephs O, O'Doherty J, Zanini S, Dewar BK et al. Human cingulate cortex and autonomic control: converging neuroimaging and clinical evidence. Brain 126: 2139-2152

Wellcome Department of Imaging Neuroscience, Institute of Neurology, University College London, London WC1N 3BG, UK.
Brain (Impact Factor: 9.2). 11/2003; 126(Pt 10):2139-52. DOI: 10.1093/brain/awg216
Source: PubMed


Human anterior cingulate function has been explained primarily within a cognitive framework. We used functional MRI experiments with simultaneous electrocardiography to examine regional brain activity associated with autonomic cardiovascular control during performance of cognitive and motor tasks. Using indices of heart rate variability, and high- and low-frequency power in the cardiac rhythm, we observed activity in the dorsal anterior cingulate cortex (ACC) related to sympathetic modulation of heart rate that was dissociable from cognitive and motor-related activity. The findings predict that during effortful cognitive and motor behaviour the dorsal ACC supports the generation of associated autonomic states of cardiovascular arousal. We subsequently tested this prediction by studying three patients with focal damage involving the ACC while they performed effortful cognitive and motor tests. Each showed abnormalities in autonomic cardiovascular responses with blunted autonomic arousal to mental stress when compared with 147 normal subjects tested in identical fashion. Thus, converging neuroimaging and clinical findings suggest that ACC function mediates context-driven modulation of bodily arousal states.

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    • "Some previous works on this topic have found that in HC some areas linked to the limbic system including regions of medial temporal lobe, insular lobe and prefrontal cortex (MacLean, 1949, 1952; Catani et al., 2013; Rolls, 2015) are activated during stress (Critchley et al., 2000a,b). Thus, the amygdalo-hippocampal complex, orbitofrontal cortex , anterior cingulum and insula have been shown to be activated by both mental and physical tests, which are useful to evoke an autonomic stress response (Critchley et al., 2003; Williamson et al., 1997; Soufer et al., 1998; Harper et al., 1998). Stressors which require the completion of demanding and uncontrollable cognitive challenges in a context of negative social evaluation, such as the Trier Social Stress Test (TSST) induce increased activity of the medial prefrontal cortex (Kern et al., 2008; Urry et al., 2006), anterior cingulum (which may be of particular importance for generating autonomic cardiovascular responses; Critchley et al., 2000a,b, 2005; Critchley, 2005), insula (which probably works together with anterior cingulum, as both are components of a system underlying self awareness; Medford and Critchley, 2010), and deactivation of the hippocampalamygdala complex (Kern et al., 2008), probably to disinhibit the hypothalamus which commands the HPA and ANS (McEwen and Gianaros, 2010) responses. "
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    • "Additionally, maximal squeeze paradigms can be run without the use of a dynamometer . For example, studies have used a cylinder [11] [12] [13] or a pressure transducer [13] for their hand grip task. In any case, it would seem that maximal squeezes can be done without the feedback component of the dynamometer. "
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    • "involving effort (Critchley et al., 2003), and consciousness more generally (Barrett & Bliss- Moreau, 2009; Craig, 2009; Damasio, 2000; Russell, 2003; Wundt, 1897). "

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