Our aim is to conduct a systemic review of electrical cortical stimulation (ECS) studies to functionally parcellate the cingulate gyrus (CG).

The CG is a brain structure located above the corpus collosum. It’s recognized as a part of the limbic system and it plays many important roles, but its complete functional capacity is yet to be fully understood. In recent years, emerging evidence from imaging modalities, supported by findings from ECS helped us understand it better. To our knowledge, there is no systematic review on the cingulate function studied by ECS. 

We conducted a systematic search using PubMed for studies which investigated the CG by using ECS. We identified 29 studies that met our inclusion criteria. We then evaluated the ECS responses across the cingulate subregions and summarized the reported findings. Statistical analysis was performed by using SPSS version 26.0. 

We included 29 studies (total 887 patients, mean age was 31.8 ± 9.8 years). The responses elicited from the CG were as follows: simple motor (7 studies, 24.1%), complex motor (10 studies, %34.4), gelastic without mirth (4 studies, 13.7%), gelastic with mirth (1 study, 3.4%), somatosensory (9 studies, 31%), autonomic (6 studies, 20.7%), psychic (8 studies, 27.6%), and vestibular (2 studies, 6.9%). The former two studies also reported visual and speech responses. Despite some overlapping, the ECS results show that the anterior cingulate cortex (ACC) is responsible for the majority of emotional, motor and autonomic responses, while the majority of complex motor behaviors are controlled by the middle cingulate cortex (MCC), and the posterior cingulate cortex (PCC) is the principle regulator of visual responses in addition to being involved in a variety of other responses.

our results will provide a segmental mapping of the functional properties of the CG and will aid in improving the precision of epilepsy surgical resections.