The tenacious brain: How the anterior mid-cingulate contributes to achieving goals

Abstract

Tenacity-persistence in the face of challenge-has received increasing attention, particularly because it contributes to better academic achievement, career opportunities and health outcomes. We review evidence from non-human primate neuroanatomy and structural and functional neuroimaging in humans suggesting that the anterior mid cingulate cortex (aMCC) is an important network hub in the brain that performs the cost/benefit computations necessary for tenacity. Specifically, we propose that its position as a structural and functional hub allows the aMCC to integrate signals from diverse brain systems to predict energy requirements that are needed for attention allocation, encoding of new information, and physical movement, all in the service of goal attainment. We review and integrate research findings from studies of attention, reward, memory, affect, multimodal sensory integration, and motor control to support this hypothesis. We close by discussing the implications of our framework for educational achievement, exercise and eating disorders, successful aging, and neuropsychiatric disorders such as depression and dementia.

Keywords: Anterior mid-cingulate cortex; Energy regulation; Tenacity.

Figure 1.

Neuroanatomy and connectivity of the aMCC. Four Cingulate Regions & Subregions proposed by Vogt (A)(Vogt, 2016) and (B)(Vogt, 2005); Freesurfer cortical parcellation of the aMCC (white arrow) (C) (Desikan et al., 2006); aMCC (black circle) as a member of the brain’s ‘rich club’ hubs (D)(van den Heuvel and Sporns, 2013a); aMCC (black circle, labeled as ‘dACC’ by the authors) as a key region of the multimodal integration network (E)(Sepulcre et al., 2012); aMCC (black circle) sits at the nexus (purple) of two salience subsystems; the dorsal salience subsystem (blue) associated with executive function and the ventral salience subsystem (red) associated with visceroautonomic processing (F)(Touroutoglou et al., 2012); aMCC (black circle) as a key region of the large-scale allostatic/interoceptive system (G)(Kleckner et al., 2017), frontoparietal control system (H)(Vincent et al., 2008), ventral attention system (I)(Fox et al., 2006), and cinguloopercular network (J)(Dosenbach et al., 2007).

Figure 2.

The role of aMCC in tenacious behaviors. Stronger functional connectivity between aMCC (labeled as ‘dACC’ by the authors) and supplementary motor is linked to lower levels of apathy (A) (Bonnelle et al., 2016); stronger functional connectivity between aMCC and ventral striatum is associated with grit (B) (Myers et al., 2016); spontaneous aMCC activity predicts grit (C)(Wang et al., 2017b); greater aMCC (labeled as ‘dACC’ by the authors) activity is associated with higher levels of persistence (D)(Kurniawan et al., 2010); aMCC signal is associated with willingness to exert more effort (E)(Bonnelle et al., 2016); aMCC activity increases during effort magnitude estimation (F)(Scholl et al., 2015); aMCC signal tracks the subjective value of effort exerted (G)(Chong et al., 2017); aMCC stimulation (yellow circle) increases the will to persevere (H)(Parvizi et al., 2013).

Figure 3.

Implications of the aMCC role in tenacity. Compared to healthy controls, patients with depression show reduced regional cerebral blood flow in the aMCC (black circle) during an effortful task (A)(Elliott et al., 1997); apathy scores correlate with altered glucose metabolism in aMCC in early dementia including Alzheimer’s disease, frontotemporal dementia (left, (Schroeter et al., 2011) and Parkinson’s disease (right, labeled as ‘ACC’ by the authors (Huang et al., 2013) (B); aMCC cortical thickness (left, aMCC indicated with white)(Sun et al., 2016) and intrinsic connectivity to anterior insula (right (Zhang et al., 2019)) both predict successful memory performance in superagers and typical older adults (C); aMCC signal increases during effortful memory retrieval in older adults (D)(Dhanjal and Wise, 2014); high exercise intensity is linked to metabolic changes in aMCC (E)(Kemppainen et al., 2005); gray matter volume in frontal regions including the aMCC was increased (blue) for aerobic exercisers relative to nonaerobic controls (F)(Colcombe et al., 2006); obese adolescents show aMCC weaker activation in response to foods compared to lean adolescents (G) (Carnell et al., 2017); transcranial pink noise stimulation of aMCC decreases self-reported desire to eat in women with obesity (H)(Leong et al., 2018); aMCC activity during task increases in individuals who follow the task instructions closely (I)(Mulert et al., 2005); aMCC regional blood flow is associated with faster reaction times in a somatosensory reaction time task (J)(Naito et al., 2000).