Anterior Cingulate Cortex

The AIC+ ACC core control network serves as a flexible central processing unit that underlies fluid intelligence and the speed of mental processing, as well as a mental resource that enables heightened awareness and percept identification in the presence of degraded sensory input.

Craig argues that the AIC and ACC together constitute the brain's core control network, underpinning fluid intelligence, awareness, and network-level guidance of behavior.

Craig, A.D. Bud, How Do You Feel? An Interoceptive Moment with Your Neurobiological Self, 2014thesis

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the AIC and ACC to control network operations in the brain. Functional imaging studies of error responses, task switching, and perceptual decision making suggest that the AIC and ACC bilaterally serve as a 'core control network' that guides brain function by engaging and dise

Craig synthesizes functional imaging evidence to establish that the AIC and ACC bilaterally form a core control network regulating error processing, task switching, and perceptual decision-making.

Craig, A.D. Bud, How Do You Feel? An Interoceptive Moment with Your Neurobiological Self, 2014thesis

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An extraordinary morphological characteristic of the anterior insular cortex (AIC) and the anterior cingulate cortex (ACC) in hominoid primates is the unique concentration of clusters of large spindle-shaped neurons among the pyramidal neurons in layer 5, called von Economo neurons (VENs)

Craig proposes that VENs concentrated in both the AIC and ACC are the morphological substrate for fast, integrated emotional representations and may explain their consistent co-activation.

Craig, A. D., How Do You Feel — Now? The Anterior Insula and Human Awareness, 2009thesis

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Almost all recent imaging studies of emotion report joint activation of the AIC and the ACC in subjects experiencing emotional feelings, including maternal and romantic love, anger, fear, sadness, happiness, sexual arousal, disgust, aversion, unfairness, inequity, indignation, uncertainty, disbelief, social exclusion, trust, empathy

Craig documents the pervasive co-activation of the AIC and ACC across the full spectrum of human emotional states, establishing their joint centrality to emotional awareness.

Craig, A. D., How Do You Feel — Now? The Anterior Insula and Human Awareness, 2009thesis

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the AI plays a more prominent role in detection of salient stimuli, whereas the ACC plays a more prominent role in modulating responses in the sensory, motor, and association cortices.

Menon articulates a functional division of labor within the salience network, assigning the ACC a primary role in top-down response modulation while the insula handles bottom-up salience detection.

Menon, Vinod, Saliency, switching, attention and control: a network model of insula function, 2010thesis

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whereas the rostral ACC (comprising both sub- and pregenual ACC) is important for emotional processing, the dorsal or mid-cingulate cortex is thought to implement cognitive control and emotion regulation. However, there is also considerable overlap between the 'cognitive' division of the ACC and the mid-cingulate area that processes pain and fear.

Paulus maps the cytoarchitectural and functional subdivisions of the ACC, identifying the rostral-emotional and dorsal-cognitive distinction while emphasizing their overlapping roles in pain, fear, and appraisal.

Paulus, Martin P., Treatment approaches for interoceptive dysfunctions in drug addiction, 2013thesis

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Their demonstration that the AIC+ACC core control network is a main functional microstate provides strong corroboration for the present interoceptive integration model.

Craig interprets microstate imaging data as confirming that the AIC+ACC network operates as a primary functional state in the brain, supporting his interoceptive integration theory.

Craig, A.D. Bud, How Do You Feel? An Interoceptive Moment with Your Neurobiological Self, 2014thesis

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a region of the ventrolateral prefrontal cortex (the anterior insular cortex (AIC)) and a region of the medial prefrontal cortex (the anterior cingulate cortex (ACC)) are co-active in so many behaviours, because such widely separated regions in the cortex generally have distinct roles.

Craig frames the anatomical mystery of AIC-ACC co-activation — two spatially distant regions consistently active together — as requiring a novel theoretical account of their functional coupling.

Craig, A. D., How Do You Feel — Now? The Anterior Insula and Human Awareness, 2009supporting

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how does the SN, identified by resting-state fMRI, modulate other core networks involved in cognitive information processing? One approach here is to examine how the salience network and its two major cortical nodes, the insula and the anterior cingulate cortex, influence other core networks

Menon positions the ACC as one of two principal cortical nodes of the salience network, whose function is to modulate interactions between the central executive and default-mode networks.

Menon, Vinod, Saliency, switching, attention and control: a network model of insula function, 2010supporting

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the AI and ACC form the core of a SN that facilitates the detection of important environmental stimuli. Although salience filters likely exist at multiple levels of ascending pathways that bring sensory stimuli into the neocortex, what makes the SN special is that it triggers a cascade of cognitive control signals

Menon concludes that the AI-ACC salience network is distinctive not merely for detecting stimuli but for triggering cascades of cognitive control that determine how salient information is subsequently processed.

Menon, Vinod, Saliency, switching, attention and control: a network model of insula function, 2010supporting

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Stimulants also made task-related deactivations in the ventral anterior cingulate cortex and posterior cingulate cortex significantly more prominent in youths with ADHD, producing levels similar to those in healthy comparison subjects

Peterson demonstrates that psychostimulants normalize deficient default-mode suppression in the ventral ACC of youth with ADHD, linking ACC dysfunction to ADHD pathophysiology and its pharmacological remediation.

Peterson, Bradley S., An fMRI Study of the Effects of Psychostimulants on Default-Mode Processing During Stroop Task Performance in Youths With ADHD, 2009supporting

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methylphenidate decreases blood flow to the ventral anterior cingulate cortex, posterior cingulate cortex, and inferior parietal cortex in adults with ADHD in direct proportion to improved performance on cognitive tasks, which has been attributed to an improved efficiency of neural processing

Peterson reports that methylphenidate-induced reductions in ventral ACC blood flow correlate with cognitive performance gains in ADHD, interpreted as enhanced neural efficiency rather than simple suppression.

Peterson, Bradley S., An fMRI Study of the Effects of Psychostimulants on Default-Mode Processing During Stroop Task Performance in Youths With ADHD, 2009supporting

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Coactivation in the ACC is captured with current methods in most, but not all, conditions. No other region of the brain is activated during all feelings and all tasks.

Craig establishes the near-universal co-activation of the ACC with the AIC across all feeling states and tasks, while acknowledging that current methods do not always capture ACC engagement.

Craig, A.D. Bud, How Do You Feel? An Interoceptive Moment with Your Neurobiological Self, 2014supporting

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exercise helps to optimize complex goal-directed behaviors, which may train the ACC to compute more appropriate value signals. Meditative approaches highlight the influence of pre-existing belief systems on the evaluation of conditioned stimuli

Paulus argues that exercise and meditation can reshape ACC-mediated value computation, offering therapeutic leverage on interoceptive dysfunction in addiction.

Paulus, Martin P., Treatment approaches for interoceptive dysfunctions in drug addiction, 2013supporting

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the right fronto-insular cortex together with the anterior cingulate cortex plays a causal role in switching between the frontal control network and the default mode network

Paulus situates the ACC within a causal network-switching mechanism alongside the right fronto-insular cortex, implicating this circuit in addiction-relevant cognitive control.

Paulus, Martin P., Interoception and drug addiction, 2013supporting

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the right fronto-insular cortex together with the anterior cingulate cortex plays a causal role in switching between the frontal control network and the default mode network (Sridharan et al., 2008) and is involved in switching during a variety of perceptual, memory, and problem solving tasks

Paulus reiterates the causal role of the ACC and right fronto-insular cortex in network switching across multiple cognitive domains, reinforcing this circuit's centrality to goal-directed behavior in addiction.

Paulus, Martin P., Interoception and drug addiction, 2014supporting

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cues that are associated with drugs and elements of non-drug addictions produce activation of the prefrontal cortex, including the dorsolateral prefrontal cortex, anterior cingulate gyrus, and medial orbitofrontal cortex.

Koob documents imaging evidence that cue-induced craving activates the anterior cingulate gyrus as part of a prefrontal circuit, integrating the ACC into the neurocircuitry of addiction.

Koob, George F., Neurobiology of addiction: a neurocircuitry analysis, 2016supporting

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AIC—anterior insular cortex ACC—anterior cingulate cortex ANOVA—analysis of variance; a statistical test across several variables ANS—autonomic nervous system

Craig's abbreviation list formally pairs the ACC with the AIC as co-equal structural referents throughout his interoceptive integration framework.

Craig, A.D. (Bud), How Do You Feel? An Interoceptive Moment with Your Neurobiological Self, 2015aside

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decreased activation in anterior cingulate cortex and supplementary motor area. Relative to placebo, increased activation is shown with acute stimulant medication in right inferior prefrontal cortex extending deep into the insula and bordering superior temporal lobe

Rubia's meta-analysis finds that stimulant medication in ADHD produces decreased ACC activation alongside increased right inferior frontal activation, suggesting a rebalancing of the error-monitoring and inhibitory control circuitry.

Rubia, Katya, Effects of Stimulants on Brain Function in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysissupporting

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it remains to be determined exactly which connections of the neural substrates underlying interoceptive processing (e.g., insular and anterior cingulate cortex) are critical in driving drug-related urges

Paulus identifies the ACC alongside the insula as a key but incompletely understood substrate of interoceptive processing whose connectivity patterns drive drug craving.

Paulus, Martin P., The role of interoception and alliesthesia in addiction, 2009supporting

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the interoceptive pathways from the brain stem make their first connections in the center of the brain with the hypothalamus and thalamus. These structures lie within what is called the limbic system, which also includes the amygdala, hippocampus, and cingulate cortex.

Fogel situates the cingulate cortex within the interoceptive pathway as a limbic relay structure, providing anatomical context for the ACC's role in embodied self-awareness.

Fogel, Alan, Body Sense: The Science and Practice of Embodied Self-Awareness, 2009aside

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ACC – cerebellar vermis 0.00001074 n.s. ACC – L Cerebellum 0.00005420 n.s. ACC – R Cerebellum 0.00000064 n.s.

Rubia's connectivity data show baseline ACC-cerebellar coupling in ADHD that is not significantly normalized by methylphenidate, indicating the limits of pharmacological modulation of this circuit.

Rubia, Katya, Methylphenidate normalises activation and functional connectivity deficits in attention and motivation networks in medication-naïve children with ADHD during a rewarded continuous performance task, 2009aside

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