Physiological responses to brain stimulation during limbic surgery: further evidence of anterior cingulate modulation of autonomic arousal.
BACKGROUND
In view of conflicting neuroimaging results regarding autonomic-specific activity within the anterior cingulate cortex (ACC), we investigated autonomic responses to direct brain stimulation during stereotactic limbic surgery.


METHODS
Skin conductance activity and accelerative heart rate responses to multi-voltage stimulation of the ACC (n = 7) and paralimbic subcaudate (n = 5) regions were recorded during bilateral anterior cingulotomy and bilateral subcaudate tractotomy (in patients that had previously received an adequate lesion in the ACC), respectively.


RESULTS
Stimulations in both groups were accompanied by increased autonomic arousal. Skin conductance activity was significantly increased during ACC stimulations compared with paralimbic targets at 2 V (2.34 +/- .68 [score in microSiemens +/- SE] vs. .34 +/- .09, p = .013) and 3 V (3.52 +/- .86 vs. 1.12 +/- .37, p = .036), exhibiting a strong "voltage-response" relationship between stimulus magnitude and response amplitude (difference from 1 to 3 V = 1.15 +/- .90 vs. 3.52 +/- .86, p = .041). Heart rate response was less indicative of between-group differences.


CONCLUSIONS
This is the first study of its kind aiming at seeking novel insights into the mechanisms responsible for central autonomic modulation. It supports a concept that interregional interactions account for the coordination of autonomic arousal.
Gentil
André Felix
AF
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. afgentil@gmail.com
Eskandar
Emad N
EN
Marci
Carl David
CD
Evans
Karleyton Conroy
KC
Dougherty
Darin Dean
DD
D000328:Adult; D001143:Arousal / Q000502:physiology*; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001931:Brain Mapping; D003865:Major Depressive Disorder / Q000601:surgery; D004558:Electric Stimulation / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006179:Gyrus Cinguli / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000601:surgery; D011612:Psychosurgery / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult