Elsevier

Biological Psychiatry

Volume 69, Issue 4, 15 February 2011, Pages 301-308
Biological Psychiatry

Review
The Subcallosal Cingulate Gyrus in the Context of Major Depression

https://doi.org/10.1016/j.biopsych.2010.09.034Get rights and content

The subcallosal cingulate gyrus (SCG), including Brodmann area 25 and parts of 24 and 32, is the portion of the cingulum that lies ventral to the corpus callosum. It constitutes an important node in a network that includes cortical structures, the limbic system, thalamus, hypothalamus, and brainstem nuclei. Imaging studies have shown abnormal SCG metabolic activity in patients with depression, a pattern that is reversed by various antidepressant therapies. The involvement of the SCG in mechanisms of depression and its emerging potential role as a surgical target for deep brain stimulation has focused recent interest in this area. We review anatomic and histologic attributes of the SCG and the morphologic and imaging changes observed in depression. Particular attention is given to the regional and downstream structures that could be influenced by the application of deep brain stimulation in this region.

Section snippets

The Cingulate Gyrus

The cingulate gyrus is an arch-shaped convolution in the medial surface of the cerebral hemisphere. It lies in close relation to the corpus callosum, from which it is separated by the callosal fissure (11). It commences below the rostrum, curves around anterior to the genu, extends along the dorsal surface of the body, and finally turns ventrally behind the splenium, where it is connected by a narrow isthmus with the hippocampal gyrus (11). It is separated from the medial part of the superior

Projections to and from the Subcallosal Cingulum

In nonhuman primates, studies on SCG projections have mainly characterized afferents and efferents to and from BA25 (Figure 1). BA32 projections have been predominantly studied in regions anterior and dorsal to the SCG (e.g., prelimbic BA32). Because the prelimbic BA32 in nonhuman primates has been suggested to be homologous to the subgenual BA32 in humans, afferent and efferent projections to and from this region are reported later in the article (26). SCG BA24 projections in nonhuman primates

Subcallosal Cingulum and Depression

When healthy subjects are asked to rehearse autobiographic sad scripts or are depleted of tryptophan, cerebral blood flow increases in the SCG (Figure 2) (9, 55, 56, 57, 58). In patients with depression, imaging studies have often shown an increased SCG activity (4, 59, 60, 61). This has been sometimes reported in association with a reduced activity in BA 46/9 (8, 9, 10). A decrease in SCG activity has been observed after treatment with a variety of interventions, including antidepressants,

Summary and Future Perspectives

Imaging studies in patients with depression have shown an increased SCG activity that may be reversed by several antidepressants therapies. As a result, the SCG has been suggested as an important structure in the pathophysiology of depression. Although still investigational, the use of DBS as a therapy for major depression offers a unique opportunity to gain further insight on the physiology of the SCG and its involvement in mechanisms of the disease. As an example, some centers conduct

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