A Cross-Sectional and Longitudinal Magnetic Resonance Imaging Study of Cingulate Gyrus Gray Matter Volume Abnormalities in First-Episode Schizophrenia and First-Episode Affective Psychosis

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Abstract
The cingulate gyrus is a cortical area of mixed cytoarchitectonics that links to the limbic system and neocortex.1 The subcomponents of the cingulate gyrus serve a range of functions, including emotional, cognitive and attentional, nociceptive, and motor processing.2-4 Grossly, the anterior cingulate cortex (ACC) is differentiated from the posterior cingulate cortex on the basis of cytoarchitecture, projection patterns, and functions.5-7 For example, the anterior cingulate gyrus is activated by emotional stimuli, whereas the posterior cingulate gyrus is activated by both emotional and nonemotional stimuli and plays an important role in memory access and visuospatial orientation.5,7 Within the ACC, further parcellation can be made on the basis of functional and anatomical studies.8 The rostral area of the ACC (the affective subregion) is connected to the nucleus accumbens, amygdala, insula, hippocampus, and orbitofrontal cortex and assesses the salience of emotional and motivational information regulating emotional responses.8 The caudal (dorsal) area of the ACC (the cognitive subregion) has strong reciprocal interconnections with the lateral prefrontal cortex, parietal cortex, and premotor and supplementary motor areas9 and modulates attention and executive functions, error detection, and working memory.7,10-12 The portion of the ACC located inferior to the genu of the corpus callosum (subgenual subregion) has extensive connections to structures implicated in emotional behavior, mood, and autonomic responses to stressors13 and is the region used for deep-brain stimulation for treatment-resistant depression.14