Function of the Human Cingulate Cortex: A Brainnetome Atlas-Based Study via Cortical Electrical Stimulation in Patients With Epilepsy.

OBJECTIVE: This study aimed to systematically map the functional organization of the cingulate gyrus using cortical electrical stimulation (CES) guided by the Brainnetome Atlas. METHODS: We retrospectively analyzed CES data from 234 patients with drug-resistant epilepsy who underwent stereoelectroencephalography (SEEG) implantation in the cingulate cortex. A total of 1141 stimulation sites across seven cingulate subregions (A23d, A24rv, A32p, A23v, A24cd, A23c, A32sg) were examined. Responses were categorized into somatosensory, motor, autonomic, vestibular, visual, emotional, memory, and pain-related phenomena. RESULTS: Key findings included: (1) Somatosensory responses (n = 99) were widely distributed, with motor responses localized to middle-posterior subregions (A23c/A24rv/A24cd); (2) Autonomic (n = 58) and emotional (n = 15) responses showed broad distribution, with ventral MCC (A24rv) as an affective hub; (3) Pain responses (n = 30) involved both anterior (affective) and posterior (spatial) subregions; (4) Memory deficits (n = 8) specifically localized to posterior cingulate (A23d); (5) Visual (n = 13) and vestibular (n = 51) responses clustered in posterior and middle-posterior regions, respectively. CONCLUSION: This study provides a systematic functional mapping of the cingulate gyrus using the Brainnetome Atlas, demonstrating its integrated role in diverse neurological functions. The findings advance understanding of cingulate pathophysiology and have implications for surgical planning in epilepsy.