Anterior Cingulate Cortex
Abstract
The Anterior Cingulate Cortex (ACC) plays a central role in judgment, decision-making, emotional processing, and behavioral control in the human brain. This system helps individuals perform daily tasks, make appropriate decisions, and inhibit maladaptive behaviors. People with Bulimia Nervosa (BN) often exhibit impaired control over food intake, characterized by episodes of binge eating, which may be linked to deficits in ACC-mediated error monitoring and self-regulation.
Keywords: judgment, decision-making, emotion, behavioral control, Anterior Cingulate Cortex, Bulimia Nervosa
Anterior Cingulate Cortex Defined
The ACC, located between the limbic system and the prefrontal cortex, integrates emotional and cognitive processes. The limbic system mediates emotional and behavioral responses essential for survival, such as feeding, reproduction, and fight-or-flight reactions (The Limbic System, 2019). The prefrontal cortex governs planning, goal-directed actions, and moral reasoning (SoP et al., 2021). By linking these regions, the ACC coordinates physical and psychological responses, making it critical for behavior regulation. Dysregulation of ACC neural circuits may contribute to the impulsive behaviors observed in BN.
ACC Functions
The ACC influences decision-making, judgment, emotional assessment, and learning from emotions, earning the label of an “executive” region in the brain. Anatomically, it is divided into subgenual (sACC) and pregenual (pACC) regions, while the dorsal ACC includes the middle cingulate cortex (MCC) with anterior (aMCC) and posterior (pMCC) subdivisions (Stevens et al., 2011).
Emotionally, the sACC responds to sadness, the pACC to happiness, and the MCC to pain. The ACC also processes reward-related signals, with the sACC responding to expected rewards and the pMCC involved in fear and action selection. Its interplay with the amygdala underlies self-regulatory behaviors, including both enhancement and suppression of actions.
ACC and Bulimia Nervosa
Individuals with BN often demonstrate impaired decision-making regarding food. Impulsive binge-eating episodes, often preceded by periods of fasting, may result from ACC dysfunction. Neural studies indicate that women with BN fail to engage ACC circuits appropriately: they show increased ACC activation during errors, whereas healthy individuals activate ACC during correct decisions (Marsh et al., n.d.).
Emotional responses processed by the ACC may exacerbate uncontrolled eating. While the ACC functions as an error-monitoring system, dysregulation from emotional cues or long-term psychological stress can impair self-control. In modern societies, constant cues promoting binge eating further challenge the ACC’s regulatory capacity (Peñas-Lledí, Loeb, Martin, & Fan, 2007).
Conclusion
The ACC is a pivotal brain region for behavioral and emotional regulation. Impairments in ACC function can lead to impulsive behaviors and poor decision-making, including binge-eating episodes in BN. Future research is needed to clarify the neural pathways linking ACC dysfunction and BN, providing a deeper understanding of the disorder and potential therapeutic targets.
Resources
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Marsh R;Steinglass JE;Gerber AJ;Graziano O'Leary K;Wang Z;Murphy D;Walsh BT;PetersonBS;. (n.d.). Deficient activity in the neural systems that mediate self-regulatory control in bulimia nervosa. Retrieved March 12, 2021, from https://pubmed.ncbi.nlm.nih.gov/19124688/
Peñas-Lledí, E., Loeb, K., Martin, L., & Fan, J. (2007). Anterior cingulate activity in BULIMIA nervosa: A fMRI case study. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 12(4). doi:10.1007/bf03327599
So P., Usamah, Dahlitz, M., Kelly, M., . . . Markyangfa. (2021, February 27). Prefrontal cortex.Retrieved March 12, 2021, from https://www.thescienceofpsychotherapy.com/prefrontal-cortex
Stevens, F., Hurley, R., Taber, K., Hayman, L., Dr., Bouwens, J. (2011, April 01). Anterior cingulate Cortex: Unique role in cognition and emotion. Retrieved March 12, 2021, from https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.23.2.jnp121