Bilateral cingulotomy
Neuroimaging also uncovered different sub-regions in the anterior cingulate cortex itself based on their function. These studies showed that the caudal part of the anterior cingulate cortex plays a more important function in cognitive activities that involve attention, salience, interference and response competition. These results combined with electrophysiological investigation of the function of neurons in the anterior cingulate cortex have provided insights that can be used in the improvement of cingulotomy performed on patients treated for OCD. The basis behind this idea is the fact that a variation of certain tasks, Emotional Stroop tasks (ES), which have been particularly identified as exerting effects in OCD patients activate neurons in the more rostral part of the anterior cingulate cortex. Thus, theoretically if bilateral cingulotomy is performed in such patient in the rostral anterior cingulate cortex, better results should be obtained.
Anterior cingulate cortex
The ACC registers physical pain as shown in functional MRI studies that showed an increase in signal intensity, typically in the posterior part of area 24 of the ACC, that was correlated with pain intensity. When this pain-related activation was accompanied by attention-demanding cognitive tasks (verbal fluency), the attention-demanding tasks increased signal intensity in a region of the ACC anterior and/or superior to the pain-related activation region. The ACC is the cortical area that has been most frequently linked to the experience of pain. It appears to be involved in the emotional reaction to pain rather than to the perception of pain itself.