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Cingulate infarction: A neuropsychological and neuroimaging study.

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  • 1Ege University, Medical School Hospital, Neurology Department, İzmir, Turkey.

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|May 16, 2019
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Isolated cingulate cortex infarcts are rare, impacting executive functions or spatial memory. Anterior cingulate cortex (ACC) lesions affect executive functions, while posterior cingulate cortex (PCC) lesions cause disorientation and emotional changes.

Keywords:
AttentionCingulate gyrusEmotionIschemic strokeMemoryPericallosal artery

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Area of Science:

  • Neuroscience
  • Neurology
  • Stroke Research

Background:

  • Ischemic lesions rarely affect the cingulate cortex (CC) in isolation.
  • This rarity limits lesion/behavioral change correlational analysis in humans.

Purpose of the Study:

  • To determine clinical, neuropsychological, and neuroimaging features of isolated cingulate infarcts.
  • To investigate the functional differentiation between anterior and posterior cingulate cortex.

Main Methods:

  • Retrospective analysis of 7 patients with acute isolated cingulate infarcts confirmed by MRI.
  • Inclusion criteria: first-ever ischemic stroke patients from a registry (2012-2018).

Main Results:

  • Seven patients (0.01%) presented with isolated cingulate infarcts.
  • Anterior cingulate cortex (ACC) infarction (4 patients) was associated with apathy, mutism, executive dysfunction, and memory deficits.
  • Posterior cingulate cortex (PCC) infarction (3 patients) led to topographic disorientation, visual memory deficits, and affective-behavioral changes.

Conclusions:

  • Anterior and posterior cingulate cortices are functionally distinct.
  • ACC infarcts impact executive functions and memory; PCC infarcts affect spatial orientation and emotional processing.
  • Variations in cingulate arterial supply or embolism may explain infarct patterns.