Cingulate-mediated depressive symptoms in neurologic disease and therapeutics

Patricio Riva-Posse, Paul E. Holtzheimer, Helen S. Mayberg

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

9 Scopus citations


The depressive syndrome includes a number of symptoms that are clinically diverse. Research in the past decades has consistently demonstrated that the cingulate cortex plays an essential role in these manifestations. With anatomic studies initially showing volumetric changes, followed by the insights that functional imaging and physiology contributed to neuroscience and psychiatry, the distinct areas of the cingulate subdivisions were seen to have unique contributions. The subcallosal cingulate, with its functional responsivity to mood states and to antidepressant therapies, has been identified as a central node within the mood regulation network. In this chapter, detailed descriptions of the anatomic and functional changes that are seen in depression will be discussed. Finally, a focus on the development of deep brain stimulation in the subcallosal cingulate area will be used to emphasize the conceptualization of a network model with the cingulate as a hub, where engagement of remote areas of the depression network is needed to treat depression.

Original languageEnglish
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Number of pages9
StatePublished - 2019

Publication series

NameHandbook of Clinical Neurology
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152


  • Cingulate cortex
  • Deep brain stimulation
  • Depression
  • Neuromodulation
  • Subcallosal cingulate
  • Treatment-resistant depression


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