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.
Frontostriatal circuit
Frontostriatal circuits are neural pathways that connect frontal lobe regions with the basal ganglia (striatum) that mediate motor, cognitive, and behavioural functions within the brain. They receive inputs from dopaminergic, serotonergic, noradrenergic, and cholinergic cell groups that modulate information processing. Frontostriatal circuits are part of the executive functions. Executive functions includes following: selection and perception of important information, manipulation of information in working memory, planning and organization, behavioral control, adaptation to changes, and decision making. These circuits are involved in neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease as well as neuropsychiatric disorders including schizophrenia, depression, obsessive compulsive disorder (OCD), and attention-deficit hyperactivity disorder (ADHD).
There are five defined frontostriatal circuits: motor and oculomotor circuits originating in the frontal eye fields are involved in motor functions; while dorsolateral prefrontal, orbital frontal, and anterior cingulate circuits are involved in executive functions, social behavior and motivational states. These five circuits share same anatomical structures. These circuits originate in prefrontal cortex and project to the striatum followed by globus pallidus and substantia nigra and finally to the thalamus. There are also feedback loops from thalamus back to prefrontal cortex completing the closed loop circuits. Also, there are open connections to these circuits integrating information from other areas of the brain.