Anterior cingulate cortex and cognitive control: Neuropsychological and electrophysiological findings in two patients with lesions to dorsomedial prefrontal cortex

• Published in: Brain and cognition Vol. 80; no. 2; pp. 237 - 249
• Main Authors: Løvstad, M., Funderud, I., Meling, T., Krämer, U.M., Voytek, B., Due-Tønnessen, P., Endestad, T., Lindgren, M., Knight, R.T., Solbakk, A.K.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2012; Elsevier
• Subjects: Adult; Anterior cingulate cortex; Attention; Attention - physiology; Behavioral psychophysiology; Biological and medical sciences; Brain; Brain Neoplasms - pathology; Brain Neoplasms - physiopathology; Brain Neoplasms - psychology; Cognition - physiology; Cognition. Intelligence; Cognitive control; Cognitive Measurement; Electrophysiology; Event-related potentials; Evoked Potentials - physiology; Executive function; Executive Function - physiology; Fundamental and applied biological sciences. Psychology; Glioma - pathology; Glioma - physiopathology; Glioma - psychology; Gyrus Cinguli - pathology; Gyrus Cinguli - physiopathology; Humans; Inhibition; Learning; Male; Memory; Miscellaneous; Neurological Impairments; Neurological Organization; Neuropsychological Tests; Neuropsychology; Novelty P3; Patients; Perception Tests; Prefrontal cortex; Prefrontal Cortex - pathology; Prefrontal Cortex - physiopathology; Psychological Testing; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psykologi; Reaction Time - physiology; Samhällsvetenskap; Social Sciences; Novelty P3; Event-related potentials; Executive function; Prefrontal cortex; Anterior cingulate cortex; Cognitive control; Human; Nervous system diseases; Central nervous system; Electrophysiology; Cognition; Experimental study; Encephalon; Cerebral disorder; Cingulate cortex; Central nervous system disease; Event evoked potential
• ISSN: 0278-2626; 1090-2147; 1090-2147
• DOI: 10.1016/j.bandc.2012.07.008

► A case study with two unilateral lesions including anterior cingulate cortex (ACC) is presented. ► Neuropsychologically, both patients had memory impairment while Stroop performance was normal. ► Both patients had a diminished Novelty P3 Event Related Potential (ERP) in a Novelty Oddball task. ► Both patients had an Error-Related Negativity (ERN) ERP-component in a Stop-Signal task. ► The study suggests ACC involvement in cognition that is not restricted to error monitoring. Whereas neuroimaging studies of healthy subjects have demonstrated an association between the anterior cingulate cortex (ACC) and cognitive control functions, including response monitoring and error detection, lesion studies are sparse and have produced mixed results. Due to largely normal behavioral test results in two patients with medial prefrontal lesions, a hypothesis has been advanced claiming that the ACC is not involved in cognitive operations. In the current study, two comparably rare patients with unilateral lesions to dorsal medial prefrontal cortex (MPFC) encompassing the ACC were assessed with neuropsychological tests as well as Event-Related Potentials in two experimental paradigms known to engage prefrontal cortex (PFC). These included an auditory Novelty Oddball task and a visual Stop-signal task. Both patients performed normally on the Stroop test but showed reduced performance on tests of learning and memory. Moreover, altered attentional control was reflected in a diminished Novelty P3, whereas the posterior P3b to target stimuli was present in both patients. The error-related negativity, which has been hypothesized to be generated in the ACC, was present in both patients, but alterations of inhibitory behavior were observed. Although interpretative caution is generally called for in single case studies, and the fact that the lesions extended outside the ACC, the findings nevertheless suggest a role for MPFC in cognitive control that is not restricted to error monitoring.