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Distinct Subdivisions of the Cingulo-Insular Region and Their Role in Modulating the Cardiac
Yingxuan Li1,2, Na Clara Pan1,2, Cuiping Xu3,4
1Department of Neurology (Y.L., N.C.P., Y.W.), Xuanwu Hospital, Beijing, China.
The anterior cingulate gyrus promotes parasympathetic activity, while the posterior insula enhances sympathetic activity, revealing distinct roles in cardio-autonomic balance. These findings offer insights into neurological disorders affecting heart function.
Area of Science:
- Neuroscience
- Cardiology
- Autonomic Nervous System Research
Background:
- The cingulo-insular region is vital for regulating heart activity.
- Specific roles of its subdivisions in sympathetic-parasympathetic balance are not well understood.
Purpose of the Study:
- To investigate the distinct contributions of cingulo-insular subdivisions to cardio-autonomic balance modulation.
- To clarify the neural mechanisms underlying heart rate regulation.
Main Methods:
- Prospective observational study involving patients with drug-resistant epilepsy undergoing stereo-electroencephalography (SEEG) and electrical cortical stimulation.
- Synchronous SEEG and ECG recording during stimulation of the cingulo-insular region.
- Heart rate variability and R-R interval analyses to assess cardiac autonomic balance; correlation of SEEG phase-amplitude coupling with heart rate variability.
Main Results:
- Stimulation of the anterior cingulate gyrus (ACG) enhanced parasympathetic activity, with left ACG increasing pNN50 and right ACG increasing SDNN and SD2.
- Stimulation of the posterior insula (PI) reduced parasympathetic activity; left PI decreased the SD1/SD2 ratio, and right PI decreased high-frequency power and approximate entropy.
- ACG stimulation correlated with increased local phase-amplitude coupling strength.
Conclusions:
- The anterior cingulate gyrus is associated with cardio-parasympathetic dominance.
- The posterior insula is linked to cardio-sympathetic dominance.
- Findings enhance understanding of neural modulation of cardio-autonomic balance, with potential implications for treating autonomic dysfunction in neurological disorders.
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