Function of the Human Cingulate Cortex: A Brainnetome Atlas‐Based Study via Cortical Electrical Stimulation in Patients With Epilepsy

TL;DR

This study maps the functions of the human cingulate cortex using brain stimulation in epilepsy patients, revealing distinct roles in sensory, emotional, and memory processes.

Contribution

The study provides a detailed functional atlas of the cingulate cortex using the Brainnetome Atlas and cortical electrical stimulation.

Findings

Somatosensory responses were widespread, while motor responses were localized to middle-posterior subregions.

Autonomic and emotional responses were broadly distributed, with A24rv as an affective hub.

Pain responses involved both anterior and posterior subregions, indicating dual affective and spatial roles.

Abstract

This study aimed to systematically map the functional organization of the cingulate gyrus using cortical electrical stimulation (CES) guided by the Brainnetome Atlas.

We retrospectively analyzed CES data from 234 patients with drug‐resistant epilepsy who underwent stereoelectroencephalography (SEEG) implantation in the cingulate cortex. A total of 1141 stimulation sites across seven cingulate subregions (A23d, A24rv, A32p, A23v, A24cd, A23c, A32sg) were examined. Responses were categorized into somatosensory, motor, autonomic, vestibular, visual, emotional, memory, and pain‐related phenomena.

Key findings included: (1) Somatosensory responses (n = 99) were widely distributed, with motor responses localized to middle‐posterior subregions (A23c/A24rv/A24cd); (2) Autonomic (n = 58) and emotional (n = 15) responses showed broad distribution, with ventral MCC (A24rv) as an affective hub; (3) Pain responses (n = 30) involved both anterior (affective) and posterior (spatial) subregions; (4) Memory deficits (n = 8) specifically localized to posterior cingulate (A23d); (5) Visual (n = 13) and vestibular (n = 51) responses clustered in posterior and middle‐posterior regions, respectively.

This study provides a systematic functional mapping of the cingulate gyrus using the Brainnetome Atlas, demonstrating its integrated role in diverse neurological functions. The findings advance understanding of cingulate pathophysiology and have implications for surgical planning in epilepsy.

This study provides a systematic functional mapping of the human cingulate cortex using cortical electrical stimulation guided by the Brainnetome Atlas. Key findings include distinct functional specializations across seven cingulate subregions. The results demonstrate the cingulate gyrus's integrated role in diverse neurological processes, offering insights for epilepsy surgery planning.

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