Damage to the anterior cingulate cortex can cause different cognitive, emotional, and even physical effects. For example, someone with damage to the anterior cingulate cortex may sustain cognitive effects such as poor decision-making skills or they may develop emotional effects such as impaired empathy.
In this article, you will learn the basic functions of the anterior cingulate cortex, what happens when cingulate cortex damage occurs, and how the recovery process works.
Anterior Cingulate Cortex Function
The anterior cingulate cortex is located near the front of the brain and wraps around the head of the corpus callosum. It connects to other brain regions and therefore has a variety of functions.
For example, the anterior cingulate cortex connects to limbic structures such as the amygdala and hypothalamus. This means the cingulate cortex is involved in several emotional functions, such as:
- Assigning emotions to certain stimuli
- Connecting facial expressions to the correct emotion
- Making vocalizations to express certain emotions (e.g., laughing when you are happy)
The anterior cingulate cortex is also involved in pain perception and regulating endocrine responses. Finally, there are parts of the anterior cingulate cortex that play a role in cognitive functions such as decision-making, attention, and memory.
Since the anterior cingulate cortex plays a role in such a wide range of functions, damage to this area of the brain can lead to a diverse array of secondary effects.
Secondary Effects of Anterior Cingulate Cortex Damage
The effects of cingulate cortex damage can be divided into three groups: cognitive, emotional, and physical. Not all individuals will experience all three. It depends on the severity and location of the damage.
Here are the most common effects that can occur after anterior cingulate cortex damage:
Autonomic Dysfunction
The anterior cingulate cortex collaborates with the hypothalamus to regulate hormone release. When we experience emotions such as fear or anger, the hypothalamus and anterior cingulate cortex work together to coordinate autonomic functions, or involuntary physiologic processes, such as blood pressure.
When the anterior cingulate cortex becomes damaged, it may result in autonomic dysfunction. This means that the autonomic nervous system cannot function properly, which can affect involuntary bodily functions such as heart rate, blood pressure, and digestion, among many others.
Flat Affect
The anterior cingulate cortex also plays a strong role in overall affect, or emotional expressiveness. This area of the brain helps translate emotion into physical expression. It can do this because many of its neural connections are linked to the limbic system, the source of emotions.
Therefore, after anterior cingulate cortex damage, a person may have trouble expressing their feelings. This can result in a lack of emotion, formally known as “flat affect” because the individual’s voice often develops a flat, emotionless tone.
Lack of Empathy
Empathy is a skill regulated in part by both the anterior cingulate cortex and the amygdala, a part of the brain that contributes to emotional information processing. These two areas of the brain work together to pair emotions with memory and sensory information, which helps a person develop empathy. This process allows an individual to imagine what someone else in a stressful situation might feel.
After damage to the anterior cingulate cortex, however, it can lead to a lack of empathy. The individual may struggle to associate certain actions with emotions such as fear or sadness. This can lead to socially inappropriate behavior because the person does not realize that their actions can hurt others or cause them distress.
Panic Disorder
A person’s cognitive and emotional response to stimuli is also regulated in part by the anterior cingulate cortex. When this area of the brain becomes damaged, it can contribute to panic disorder. This is a type of anxiety disorder that involves sudden attacks of panic or fear.
Poor Decision Making
The decision-making process is assisted by the anterior cingulate cortex. It allows us to assess the risks and payoffs of our actions so that we can make dynamic decisions. It also allows us to respond to potentially harmful stimuli. Without this skill, a person’s judgment can be impaired and, in severe cases, the person may put themselves into dangerous situations.
A common misunderstanding of individuals with traumatic brain injury occurs when survivors with impaired decision-making skills are judged as careless. However, it’s often not the person’s fault. When a brain injury affects the areas of the brain responsible for decision-making, such as the anterior cingulate cortex, it can impair the brain’s ability to learn from mistakes.
Impaired Attention
In situations involving high conflict, distracting stimuli, and error processing, the anterior cingulate cortex plays an active role. It enables a person to shift their attention in order to respond to stimuli. After the anterior cingulate cortex sustains damage, survivors may develop attention deficits such as the inability to maintain attention when distractions are present.
Executive Dysfunction
Executive dysfunction is an umbrella term for a condition involving a wide array of cognitive, emotional, and behavioral changes. Executive dysfunction may include, but is not limited to:
- Impaired memory
- Lack of motivation
- Loss of cognitive flexibility
- Impulsivity
- Impaired attention
Studies have shown that executive dysfunction may occur after damage to the anterior cingulate cortex. This further illustrates how the anterior cingulate cortex plays a strong role in many different cognitive functions.
Treating Anterior Cingulate Cortex Damage
When damage to the anterior cingulate cortex causes physical effects such as autonomic dysfunction, the individual must work closely with their doctor and/or endocrinologist to monitor and manage symptoms. They may need to administer a variety of treatments depending on the symptoms, such as prescribing medication to stabilize blood pressure.
Furthermore, many of the effects of anterior cingulate cortex damage are cognitive and emotional. In this case, a psychotherapist, occupational therapist, and/or speech therapist are great resources for identifying the best treatment plan.
Some possible treatments that a therapist might recommend for survivors with anterior cingulate cortex damage include:
- Cognitive-behavioral therapy. This type of psychotherapy helps people better understand their behavior and develop positive strategies to avoid harmful actions. It can be especially helpful for patients who struggle with poor decision-making or lack of empathy.
- Speech therapy. A speech therapist can help individuals who struggle with flat affect relearn how to display emotions. For example, they can teach survivors how to control the pitch and tone of their voice again.
- Medications. There are no drugs to treat anterior cingulate cortex damage specifically, but there are medications that can treat some symptoms. For example, some doctors may prescribe ADHD medications such as Adderall to help address executive dysfunction or impaired memory after brain injury.
Furthermore, therapists can often help individuals improve some of the cognitive effects of anterior cingulate cortex damage by providing cognitive rehab exercises. For example, if decision-making has become impaired, a therapist can prescribe exercises that require decision-makings skills.
As these exercises are practice on a consistent basis, it helps stimulate adaptive changes in the brain through neuroplasticity. The brain becomes most efficient with the tasks that it is presented with most frequently. Therefore, by practicing the cognitive skills that are impaired, the survivor can maximize their chances of improving those skills.
Understanding Anterior Cingulate Cortex Damage
The anterior cingulate cortex plays a crucial role in many functions. As a result, damage to it can cause a wide range of problems such as autonomic dysfunction, executive dysfunction, flat affect, and more.
Fortunately, many of these impairments can be treated with the right approach, such as cognitive rehabilitation with an occupational or speech therapist. We hope this article helps you better understand the effects of anterior cingulate cortex damage and how to overcome them.
The post Anterior Cingulate Cortex Damage: Understanding the Secondary Effects & Recovery Process appeared first on Flint Rehab.
