Brain Advance Access originally published online on June 23, 2003
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Brain, Vol. 126, No. 10, 2139-2152,
October 2003
© 2003 Guarantors of Brain
doi: 10.1093/brain/awg216
Human cingulate cortex and autonomic control: converging neuroimaging and clinical evidence
1 Wellcome Department of Imaging Neuroscience, Institute of Neurology, 2 Autonomic Unit and 3 Department of Neuropsychology, National Hospital for Neurology and Neurosurgery and Institute of Neurology, 4 Institute of Cognitive Neuroscience, University College London, 5 Neurovascular Medicine Unit, St Mary’s Hospital, Imperial College, London, UK and 6 Cognitive Neuroscience Sector, SISSA, International School for Advanced Studies, Trieste, Italy.
Correspondence to: Hugo D. Critchley, Wellcome Department of Imaging Neuroscience, Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, UK E-mail: h.critchley{at}fil.ion.ucl.ac.uk
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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