How Deep Brain Stimulation of the Nucleus Accumbens Affects the Cingulate Gyrus and Vice Versa

Abstract

The nucleus accumbens (NA) and the cingulate gyrus (CG) are two vital limbic brain structures. They have attracted attention as deep brain stimulation (DBS) targets in the treatment of common refractory psychiatric illness. The primary purpose of this article was to review the current knowledge regarding the way that NA DBS affects the CG and vice versa. Methodologically, a thorough literature review was performed. According to the current literature, NA DBS modulates the function of several brain areas including the CG cortex. It specifically causes activation in the ipsilateral CG cortex and voltage-dependent reduction of its blood oxygenation. It also reverses anterior mid-CG cortex dysfunction and decreases metabolism in the subgenual CG. Moreover, NA DBS that induces mirth inhibits the function of the anterior CG cortex and enhances effective connectivity from anterior CG to the ventral striatum. On the other hand, although it is highly probable that CG DBS affects the NA, the exact nature of its effects remains unclear. Despite the increasing interest in psychiatric DBS, the available data on how NA DBS affects the CG and vice versa are restricted. This conclusion probably reflects the high complexity of the limbic circuits and necessitates further research.

Efficacy and safety of deep brain stimulation for treatment-refractory anorexia nervosa: a systematic review and meta-analysis

“…This is in line with the concept of connectomic DBS, where different implementation targets all relate to similar pathophysiologically relevant white matter tracts [ 40 ]. Moreover, these effects may be shared with other psychiatric disorders, where similar targets resulted in transdiagnostic beneficial effects [ 34 , 41 ].…”

Positive Emotions from Brain Injury: The Emergence of Mirth and Happiness

“…The regions associated with the experience of mirth include the VS/NA as well as connections from the anterior cingulate gyrus (ACG), posterior insula, and frontal (left>right) lobe [25][26][27][28]. Deep brain stimulation of the VS/NA induces mirth and enhances effective connectivity from the ACG to the VS [25,26]. As well as promoting surprise, electrical stimulation of the rostral pregenual ACG can also elicit laughter with mirth [27,29,30].…”