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Case Reports
. 2013 Dec 18;80(6):1359-67.
doi: 10.1016/j.neuron.2013.10.057. Epub 2013 Dec 5.

The will to persevere induced by electrical stimulation of the human cingulate gyrus

Josef Parvizi  1 , Vinitha Rangarajan  2 , William R Shirer  3 , Nikita Desai  2 , Michael D Greicius  3
Affiliations
Case Reports

The will to persevere induced by electrical stimulation of the human cingulate gyrus

Josef Parvizi et al. Neuron. .

Abstract

Anterior cingulate cortex (ACC) is known to be involved in functions such as emotion, pain, and cognitive control. While studies in humans and nonhuman mammals have advanced our understanding of ACC function, the subjective correlates of ACC activity have remained largely unexplored. In the current study, we show that electrical charge delivery in the anterior midcingulate cortex (aMCC) elicits autonomic changes and the expectation of an imminent challenge coupled with a determined attitude to overcome it. Seed-based, resting-state connectivity analysis revealed that the site of stimulation in both patients was at the core of a large-scale distributed network linking aMCC to the frontoinsular and frontopolar as well as some subcortical regions. This report provides compelling, first-person accounts of electrical stimulation of this brain network and suggests its possible involvement in psychopathological conditions that are characterized by a reduced capacity to endure psychological or physical distress.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1. Anatomical Location of the Intracranial Electrodes and Electroencephalographic Activity
In P1 (A) and P2 (B) electrical stimulation was bipolar between contacts 1 and 2. As noted in the magnetic resonance images (MRIs) and the electroencephalographic (EEG) traces, contacts 1 and 2 in P1 and contact 1 in P2 were clearly in the gray matter. Because the EBS was performed in a bipolar manner (i.e., between electrode contacts 1 and 2), we attribute the results of the EBS to the engagement of the aMCC gray matter and its white matter connections with other brain regions. Note the decrement of EEG activity between sites 2–3 compared to the activity recorded between sites 1 and 2. The MNI coordinates of the EBS targets were as follows: P1 (electrode 1=; 2.00, 26.00, 26.00; electrode 2=8.00, 26.00, 26.00) and P2 (electrode 1=10.00, 18.00, 26.00; electrode 2=16.00, 20.00, 26.00). Note that the right side of the image corresponds to the right side of the brain. One second (1s) EEG time scale shown. Sites of stimulation in the subgenual and retrosplenial regions are shown as controls sites 1 or 2 (C1 and C2 – blue filled circles). Besides these cingulate control regions, sites immediately adjacent to the aMCC were also stimulated as control sites (see Table 1). Stimulation of these control sites did not elicit similar cognitive and emotional effects as the stimulation of the aMCC sites.
Figure 2
Figure 2. Functional Connectivity Analyses of the Stimulation Sites Identify the EBS Target Sites as Part of the Emotional Salience Network
Panels A and B show the functional connectivity network derived by seeding a small region-of-interest (ROI) centered between electrodes 1 and 2 in patients P1 and P2, respectively. The ROI is indicated in blue for P1 and purple for P2. These results are presented in standard MNI space with the right side of the image corresponding to the right side of the brain. A goodness-of-fit analysis, comparing the networks in A and B to a set of 14 previously characterized networks, found that each patient’s network best matched the “emotional salience” network. Panel C shows the location of the electrodes in P1 and P2 overlaid onto the standard emotional salience network derived from a group of normal human subjects (Shirer et al., 2012b).
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