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Anterior Cingulate Gyrus (ACG)

top down active view
Top down active view		 Left side active view
Left side active view		 Underside active view
Underside active view
ACG Functions ACG Problems Some Conditions Affecting the ACG

Brain’s gear shifter
Cognitive flexibility
Cooperation See options   
Go from idea to idea
Go with the flow
Error detection

Gets stuck, Trouble shifting
Inflexible , worries
Holds grudges, oppositional
Obsesses
Compulsions
Argumentative
Excessive error detection

OCD Anxiety disorders
Addictions   
Eating Disorders
PTSD   

PMS
Chronic pain
Oppositional Defiant

Area 25     ““ mood states, activates GI system
Area 24v ““ emotional attention, communicates with limbic system
Area 24g (genu) — attention to cold cognition
Area 24d ““ activated in nearly all cognitive tasks, focus to detail
Area 24d more posterior ““ error detection
Middle Cingulate ““ response to pain, also insular cortex
Posterior Cingulate ““ visual memory, visual attention, response to pain, posterior part has access to hippocampus and memory circuit

ACG Treatments

Supplements 5-HTP/St. John’s Wort
Biofeedback to calm AC activity
Cognitive/behavioral strategies
Intense aerobic exercise
Relationship counseling, anger management
Lower protein/complex carbs diet
    ACG Meds

SSRIs (Paxil, Zoloft, Celexa, Prozac, Luvox)
Effexor, use XR prep and start slowly
Atypical antipsychotics in refractory cases
St. John’s Wort may help

Increased activity anterior cingulate gyrus and prefrontal cortex is often associated with problems shifting attention which may be clinically manifested by cognitive inflexibility, obsessive thoughts, compulsive behaviors, excessive worrying, argumentativeness, oppositional behavior or "getting stuck" on certain thoughts or actions.   We have seen a strong association with this finding and obsessive-compulsive disorders, oppositional defiant disorders, eating disorders, addictive disorders, anxiety disorders, Tourette’s syndrome and chronic pain (especially when combined with increased basal ganglia activity).   If clinically indicated, hyperactivity in this part of the brain may be helped by anti-obsessive antidepressants that increase serotonin.   Certain forms of behavior modification techniques have also been found to help lessen activity in this part of the brain.   When this area is low in activity it is often associated with low motivation and verbal expression.   When there is an off centered cingulate (goes off to one side) it may be in response to a brain injury.   Clinical correlation is always needed.  

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