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Anterior Cingulate Cortex Damage: Symptoms and Treatments

doctor in white lab coat holding computer-generated brain to illustrate anterio cingulate cortex dysfunction

Damage to the anterior cingulate cortex can cause a number of cognitive, emotional, and even physical side effects.

These include symptoms such as:

  • Poor decision-making and judgment
  • Endocrine and autonomic dysfunction
  • Impaired empathy and emotional function

In this article, you will learn the basic functions of the cingulate cortex plus how to recover from damage to it.

Anterior Cingulate Cortex Function

The anterior cingulate cortex (ACC) is found near the front of the brain and wraps around the head of the corpus callosum. It connects to a number of other brain regions and therefore has a variety of functions.

For example, the ACC 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 express certain emotions, e.g. laughing when you are happy, etc…

The anterior cingulate cortex is also involved in pain perception and regulating endocrine responses. Finally, there are parts of the ACC that play a role in cognitive functions such as decision-making and social skills.

Since the anterior cingulate cortex plays a role in such a wide range of functions, damage can lead to a diverse array of symptoms.

Symptoms of Anterior Cingulate Cortex Dysfunction

Symptoms of cingulate cortex damage can be divided into three groups: cognitive deficits, emotional symptoms, and physical symptoms.

We’ll explore the most common of these symptoms in the sections below.

Flat Affect

woman with expressionless face because she has flat affect after anterior cingulate cortex damage

The anterior cingulate cortex has many important functions, but it is mainly responsible for overall affect.

The term “affect” refers to emotional expressiveness. In other words, it describes how our face and voice reflect how we feel. Therefore, the anterior cingulate cortex helps translate emotions into physical expressions.

It can do this because many of its neural connections are linked to the limbic system, the source of emotions. Therefore, if the anterior cingulate cortex suffers damage, a person will have trouble expressing their feelings.

Psychologists call this lack of emotion after brain injury “flat affect” because the person’s voice often has a flat, almost robotic sound.

Lack of Empathy

The cingulate cortex also connects with the amygdala, the main part of the brain responsible for emotions.

These two areas work together to pair emotions with memory and sensory information. This helps a person develop empathy, because they can imagine what someone in a certain stressful situation might feel.

If the anterior cingulate cortex becomes damaged, however, the patient will struggle to associate certain actions with emotions such as fear or sadness. This can lead to anti-social behavior, because the person does not realize that their actions can hurt others or cause them distress.

Autonomic Dysfunction

woman sweating and having a panic attack in living room

In addition, the anterior cingulate cortex collaborates with the hypothalamus to regulate hormone release. Specifically, it helps coordinate autonomic functions to occur when we experience emotions such as fear or anger.

Some of these functions include:

  • Heart rate
  • Respiratory rate
  • Blood pressure

Therefore, when a brain injury damages the anterior cingulate cortex, autonomic dysfunction can occur.

Poor Decision Making

Finally, the anterior cingulate assists in the decision-making process. It does this by detecting errors and monitoring negative responses. This allows us to correct our behavior and avoid harmful situations.

Without this skill, a person’s judgment will be severely impaired, and they will continue putting themselves in danger.

This is one of the main reasons that TBI patients often display poor decision-making skills. It is not their fault, their brain has quite literally lost its ability to learn from mistakes.

Treating Anterior Cingulate Cortex Damage

doctor discussing treatment options for anterior cingulate cortex damage with patient

Since many of the problems that anterior cingulate cortex damage causes are cognitive issues, a psychotherapist will be the best person to help you find treatment.

Some possible treatments that a therapist might recommend include:

  • Cognitive-behavioral therapy (CBT). CBT helps people better understand their behavior and develop positive strategies to avoid harmful actions. Can be especially helpful for patients who struggle with poor decision making or lack of empathy.
  • Speech therapy. For people who struggle with flat affect, a speech therapist can help you relearn how to display emotions. For example, they can teach you how to control the pitch and tone of your voice again.
  • Medications. There are no specific drugs to treat anterior cingulate cortex damage. But there are medications that can treat the most difficult symptoms. For example, ADHD drugs such as Ritalin can help reduce impulsive behavior.

If your injury has caused autonomic dysfunction, talk to an endocrinologist about your symptoms.

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 symptoms.

The symptoms listed in this article are just a small sample of what can happen after an injury to the ACC. Fortunately, many of these side effects can be treated with the right approach.

We hope this article helps you better understand the effects of anterior cingulate cortex damage and how to overcome them.

Featured image: ©iStock/Rawpixel

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