Impairments of attention after cingulotomy

Background: Outcome studies have generally not indicated significant cognit ive disturbances after cingulotomy. There is now considerable evidence that the cingulate may play an important role in emotional behavior and attenti on. Objective: To characterize impairments of attention associated with bil ateral lesions of the anterior cingulate cortex produced by cingulotomy. Me thods: Twelve patients who underwent cingulotomy for treatment of intractab le pain were administered tests of attention, executive functions, response intention and production, and a broad range of other neurocognitive functi ons before surgery and again 3 and 12 months after surgery. Data from this within-subjects repeated-measures design were analyzed by multivariate anal ysis of variance procedures. Results: After cingulotomy, patients initially had executive and attentional impairments. By 12 months, these had resolve d into more circumscribed deficits, with greatest impairments on tasks requ iring intention and spontaneous response production, and milder impairments of focused and sustained attention. Other aspects of attention and other c ognitive functions were generally unaffected. Conclusion: The anterior cing ulate cortex modulates response intention and focused attention.