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Abstract
Background The cingulate gyrus (CG), a brain structure above the corpus callosum, is recognised as part of the limbic system and plays numerous vital roles. However, its full functional capacity is yet to be understood. In recent years, emerging evidence from imaging modalities, supported by electrical cortical stimulation (ECS) findings, has improved our understanding. To our knowledge, there is a limited number of systematic reviews of the cingulate function studied by ECS. We aim to parcellate the CG by reviewing ECS studies.
Design/methods We searched PubMed and Embase for studies investigating CG using ECS. A total of 30 studies met the inclusion criteria. We evaluated the ECS responses across the cingulate subregions and summarised the reported findings.
Results We included 30 studies (totalling 887 patients, with a mean age of 31.8±9.8 years). The total number of electrodes implanted within the cingulate was 3028 electrode contacts; positive responses were obtained in 941 (31.1%, median percentages, 32.3%, IQR 22.2%–64.3%). The responses elicited from the CG were as follows. Simple motor (8 studies, 26.7 %), complex motor (10 studies, 33.3%), gelastic with and without mirth (7 studies, 23.3%), somatosensory (9 studies, 30%), autonomic (11 studies, 36.7 %), psychic (8 studies, 26.7%) and vestibular (3 studies, 10%). Visual and speech responses were also reported. Despite some overlap, the results indicate that the anterior cingulate cortex is responsible for most emotional, laughter and autonomic responses, while the middle cingulate cortex controls most complex motor behaviours, and the posterior cingulate cortex (PCC) regulates visual, among various other responses. Consistent null responses have been observed across different regions, emphasising PCC.
Conclusions Our results provide a segmental mapping of the functional properties of CG, helping to improve precision in the surgical planning of epilepsy.
Data availability statement
Data are available on reasonable request. The articles reviewed here are included in public domain.
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Data availability statement
Data are available on reasonable request. The articles reviewed here are included in public domain.
Footnotes
X @raneuron
Contributors RM: drafting the manuscript, appraisal of studies for inclusion, data analysis and synthesis, preliminary figure generation, and protocol registration. AKB: literature review, protocol development, appraisal of studies for inclusion and exclusion, data extraction, database management, Tables. DDS: manuscript revisions and study supervision. RA: study conceptualisation, manuscript revisions, study supervision, appraisal of studies for inclusion/exclusion, figure generation, final data appraisal, database development and computational aspects.RA accepts full resposnsibiliy for the work and/or the conduct of the study, have access to the data, and controlled the deiciosn to publish.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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