Gyrus Cinguli and Its Origin from the Surrounding Neuronal Cortical and Sub- Cortical Structures

The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications

Gheorghe S. Dragoi1*, Petru Razvan Melinte1, Liviu Radu1, Octavian Buda2

______Abstract: The authors made a macro anatomic analysis of the variable landmarks on the medial face of 32 cerebral hemispheres in order to evaluate the identity of gyrus cinguli and its origin from the surrounding neuronal cortical and sub- cortical structures. In the history of knowledge, gyrus cinguli belonged successively to: “the great limbic lobe” (Broca, 1878); rhinencephalon (Turner, 1890); limbic system (Papez, 1937; Mac Lean 1954; Nauta, 1958); “cortical-hippocampus loop” (Miller, 1991). Nowadays the limbic paradigm is abandoned and since 1962 Kuhn has considered the limbic system obsolete. Based on personal observations, the authors bring anatomic arguments to sustain the globalization paradigm for cingular cortex. Knowing the variable landmarks is necessary for reconsidering the identity and origin of gyrus cinguli regarding the surrounding neuronal structures and for understanding the connection derangements in general and forensic psychopathology. Key Words: gyrus cinguli, limbic system, globalization paradigm for gyrus cinguli, passage crease.

n the history of neurosciences, gyrus cinguli mechanism of emotions including hypothalamus Icrossed many stages of knowledge regarding in limbic lobe and consequently achieves the first its identity, its origin from the neuro anatomy subsystems conception of globalization inside telencephalon and and its neurobiological globalization. For a long time, diencephalon neuronal complex. Mac Lean (1954) gyrus cinguli was considered as an anatomic entity with introduces and develops the concept of “limbic system” homogeneous structure. Gerdy (1839) [1] was the first by including the “amygdale” and “septum area” [5]. anatomist that integrated gyrus cinguli in a “ring shaped Based on experimental models, he studied the convolution” that Broca (1878) [2] later called “the mechanism of behavior. Nauta (1958) expands the concept great limbic lobe”; it included gyrus cinguli and gyrus of “limbic system” by describing the mesencephalon parahippocampalis. That new structure was bound to limbic areas [6]. olfaction sense. In that respect, Turner (1890) introduced He considered the habenular nuclei from the term Rhinencephalon [3]. Limbic lobe was considered mesencephalon as passing bridges from prosencephalon as part of rhinencephalon (olfaction brain) that is actually to mesencephalon. Thus, a new stage of globalization an ancestral structure achieving its complete development appeared as the “prosencephalon-mesencephalon system” in reptiles. was imposed. Miller (1991) expands the connections of Papez (1937) noticed that gyrus cinguli is a gyrus cinguli after including prefrontal cortex in a functional functional entity that must be integrated in emotional complex known as “cortex-hippocampus loop” that also neurological circuits [4]. He brings in the neuronal comprised Brodman areas 24 and 32 from gyrus cinguli [7].

1) University of Medicine and Pharmacy of Craiova * Corresponding author: Prof Dr., Member of the Romanian Academy of Medical Sciences, E-mail : [email protected] 2) Assoc. Prof., "Carol Davila" University of Medicine and Pharmacy, Dept. of History of Medicine, (&) National Institute of Legal Medicine, Dept. of Forensic Psychiatry, Bucharest, Romania 55 G.S.Dragoi et al. The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications

The assimilation of “limbic system” to rhinencephalon is difficult to accept because some anosmia animals have structures belonging to limbic system and orbital frontal cortex that is not included in rhinencephalon is an important olfaction center with synapses inside thalamus. Those arguments justify why some authors separated the olfaction system from limbic system (Rauber Kopsch, 1987) [8]; Niuwenhuys et al., 1988 [9]. Nowadays the limbic paradigm was abandoned and we witness a conceptual change determined by neurobiological research. Kuhn (1962) considers that the limbic concept belongs to the past and proposes to change it based on the progress registered by imagistic sciences [10]. We consider that in order to fundament the concept of cortex cinguli globalization, it is imposed to also reconsider the classic methods for the study of neuronal structures and especially the macroanatomic dissection techniques. The reevaluation of gyrus cinguli relations to the surrounding neuronal structures during ontogenetic dynamics is imposed. Many problems of structural and functional anatomy wait for their answer: 1. What is and what still represents “lobus Pierre Nicolas Gerdy (1797-1856) limbicus” from anatomic and topographic point of view as it is named in International Nomina Anatomica [11]? 2. Can gyrus cinguli of limbic lobe be considered as a neuronal structure that connects frontal, parietal and temporal lobes? 3. Are there anatomic landmarks on the medial face of cerebral hemispheres that allow for rigorous tracing of gyrus cinguli borders? 4. What are the determining factors of genesis and modeling of the landmarks present on the medial face of cerebral hemispheres? 5. What is the neuroanatomical explanation for “passage creases” between gyrus cinguli and frontal, parietal and temporal lobes? 6. What are the neurobiological consequences of the anatomic changes undergone by hemispheric vesicles during ontogenesis? 7. What is the criterion that stands for the paradigm of gyrus cinguli globalization? Our research proposes itself to know the passage neuronal structures from gyrus cinguli to the lobes from the medial side of cerebral hemisphere. The results of those observations are imperiously needed for the evaluation of neuronal connection paths and stand at the base of globalization concept involving gyrus cinguli. We considered as objectives the macro anatomic analysis of location and relations of gyrus cinguli and of space distribution of “passage creases” towards the adjacent areas. Equally, we studied the morphogenesis of medial cerebral hemispheres landmarks as location Pierre Paul Broca (1824-1880) of gyrus cinguli.

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Materials and methods callosum. From here it continues at the periphery of gyrus cinguli (Fig. 1 ; 2). The study of landmarks variability on the Its posterior part has an ascending curve medial face of cerebral hemispheres and the analysis trajectory and surrounds lobules paracentralis on its o gyrus cinguli relations was achieved on 32 cerebral inferior and posterior margins at an almost 90 degrees hemispheres obtained from 16 brains. The analysis of angle. It then climbs vertically, sometimes discreetly landmarks morphogenesis was carried out on 12 fetus – oblique towards posterior to the superior margin of 6 of them being fixed in 10% formaldehyde solution and cerebral hemisphere, 8-9 cm posterior from the central having their cephalic extremities sectioned at different groove extremity (Rolando). In this part, sulcus cinguli successive planes. is deep and crenelated. It is crossed, preferably at its The study of the development from direction change points, by “passage creases” from lisencephalon to gyrencephalon was achieved on 8 gyrus cinguli to lobus frontalis, lobules paracentralis brains extracted from skulls and then fixed 5% saline and precuneus (Fig.1; 2 ). In one case, we met a small formaldehyde solution. The relations of anterior notch oriented posteriorly, started from the second cerebral artery branches were evaluated both on fetus curve of sulcus cinguli where it becomes ascendant and encephalon (6 cases) and on adult brains (4 cases). communicates with sulcus subparietalis (Fig. 1 F). The macroanatomic imagery was performed with a digital camera Canon EOS Mark II equipped 2. Analysis of gyrus cinguli location and with macro ultrasonic lens EF 100 mm, F/2,8. Images relations processing was possible using Professional Digital When examining the medial face of cerebral Photo Software and Adobe Photoshop CS4. hemispheres we identified gyrus cinguli as a prominent cortical structure that cross the space between corpus Results callosum and frontal, parietal and temporal lobes (Fig. 1). In some hemispheres we noticed the The knowledge of variable landmarks on the continuity of gyrus cinguli to precuneus creating an medial face of cerebral hemispheres is necessary for image compared to a “rooster ridge” (Fig. 1 A; C-F). the reevaluation of identity and origin of gyrus cinguli Analyzing the gyrus cinguli trajectory we observed regarding the adjacent neuronal structures. The analysis its formation in front of rostrum corpus callosum as a of the landmarks was achieved by establishing the narrow portion bound to subcallosal gyrus (Fig. 1). Then distribution of the grooves between gyri, the location and it has an arched trajectory that surrounds successively: relations of gyrus cinguli with the surrounding lobes by genu corpus callosum, truncus corporis callosum and means of “passage creases” during ontogenesis dynamics. splenium corpori callosum where it continues to gyrus parahippocampalis through ithmus gyri cinguli that is A. Macroanatomic analysis of gyrus cinguli actually a real “passage crease”. In many cases, the gyrus location and relations cinguli surface is crossed by superficial grooves parallel The analysis of location and relations of gyrus cinguli is to the general direction of the gyrus and we sometimes tightly bound to the heterogeneous space distribution of identified transverse or stellate notches determined by grooves that participate to the landmarks of medial face the relation to the blood vessels. The inferior face of of cerebral hemispheres. gyrus cinguli is in contact with arteria pericallosa and 1. Analysis of the distribution of grooves on the Lancisi nerves (Fig. 6). medial side of cerebral hemispheres An important number of grooves is present B. Macroanatomic analysis of “passage and limit compartments on the medial side of cerebral creases” space distribution hemispheres: sulcus cinguli, sulcus corpori callosi, “Passage creases” are well visible on the medial sulcus subparietalis, sulcus parietooccipitalis, sulcus face of cerebral hemispheres after leptomeninges paracentralis, sulcus calcarinus and sulcus intralimbic removal. They act like continuity bridges between gyrus (Fig. 1 A-H). We had particular attention for sulcus cinguli and the gyri from the adjacent lobes: cinguli- cinguli. frontal; cinguli-parietal; cinguli-temporal (Fig. 3). We identified sulcus cinguli as a curve, line We identified three “passage creases” between space that separates gyrus cinguli from the following gyrus cinguli and frontal lobe and we named them surrounding structures: gyrus frontalis medialis, lobules according to their topographic location: inferior paracentralis and precuneus (Fig. 1A; C–E). One can cinguli-frontal, anterior cinguli-frontal and posterior easily notice its S italic shape trajectory that gives cinguli-frontal. “The inferior cinguli-frontal passage” almost straight intermediate branches. The origin of unites the anterior and inferior origin of gyrus cinguli to sulcus cinguli is under the rostrum and knee of corpus the inferior part of medial frontal gyrus. “The anterior

57 G.S.Dragoi et al. The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications

case I case II 5 6 7 13 3 8 9 2 1 S 12 4 S G G

A B case III case IV 5 6 10 5 6 10 3 9 3 7 9 7 8 8 2 11 2 4 1 S S G G 1 C D case V case VI 5 6 3 7 10 5 6 10 9 3 8 9 4 2 4 8 2 S 1 G S 1 G E F case VII case VIII 5 3 6 10 9 2 11 S 4 8 G 1 S G G H Figure 1. The variable position of cerebral grooves and the variable relations of gyrus cinguli to the adjacent structures on the medialFigure side of left1. Thecerebral variable hemisphere. position 1. Lobulus of occipitalis. cerebral 2. groovesSulcus parietooccipitalis. and the variable 3. Precuneus. relations 4. Sulcus subparietalis. 5. Sulcus cinguli – ramus marginalis. 6. Lobulus paracentralis. 7. Sulcus cinguli. 8. Gyrus cinguli. 9. Gyrusof gyrusfrontalis medialis.cinguli 10.to Sulcus the paracentralis.adjacent 11.structures Sulcus intralimbicus. on the 12.medial A. Pericallosa. side 13.of A.left Callosomarginalis. cerebral S=SPLENIUM;hemisphere. G=GENU. 1. Lobulus Macrophotos occipitalis. by Canon 2. Sulcus EOS Mark parietooccipitalis. II Digital Camera. 3. MacroPrecuneu Ultrasonics. 4. S Lens,ulcus EF subparietalis. 100 mm, F/2,8. 58 5. Sulcus cinguli – ramus marginalis. 6. Lobulus paracentralis. 7. Sulcus cinguli. 8. Gyrus cinguli. 9. Gyrus frontalis medialis. 10. Sulcus paracentralis. 11. Sulcus intralimbicus. 12. A. Pericallosa. 13. A. Callosomarginalis. S=SPLENIUM; G=GENU. Macrophotos by Canon EOS Mark II Digital Camera. Macro Ultrasonic Lens, EF 100 mm, F/2,8.

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11 10 6 E F Figure 2. Cerebral cortex landmarks continue from the medial to the superior-lateral face of left cerebral hemisphere. 1. Passage occipitotemporal.Figure 2. Cerebral 2. Passage cuneo-cinguli.cortex landmarks 3. Passage cingulotemporal.continue from 4. Passage the cinguloparietal medial to theposterior. superior 5. Passage- cinguloparietal anterior. 6. Lobulus paracentralis. 7. Passage cingulofrontal posterior. 8. Passage cingulofrontal anterior. 9. Sulcuslateral cinguli. face 10.of Sulcusleft cerebral supraorbitalis hemisphere (Broca). 11. Passage. 1. Passage cingulofrontal occipitotemporal. inferior. 12. Passage2. Passage parieto-frontal. cuneo-cinguli. 13. Sulcus 3. centralisPassage (Rolando). cingulotemporal. Macrophotos 4. by Passage Canon cinguloparietaEOS Mark II Digitall posterior. Camera, 5. Macro Passage Ultrasonic cingulo Lens,parietal EF 100 anterior. mm, F/ 6.2,8. Lobulus paracentralis. 7. Passage cingulofrontal posterior. 8. Passage cingulofrontal anterior. 9. Sulcus59 cinguli. 10. Sulcus supraorbitalis (Broca). 11. Passage cingulofrontal inferior. 12. Passage parieto- frontal. 13. Sulcus centralis (Rolando). Macrophotos by Canon EOS Mark II Digital Camera, Macro Ultrasonic Lens, EF 100 mm, F/ 2,8.

G.S.Dragoi et al. The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications

A B C Z

Area 30. Retrosplenial Cingulate Cortex Area 31. Dorsal Posterior Cingulate Area 23. Ventral Posterior (RSC). Passage cingulotemporal. Localed Cortex ( d PCC ). Passage Cingulate Cortex ( v PCC ). Passage in the isthmus of cingulated gyrus. cinguloparietal dorsal. Thalamic inputs cinguloparietal ventral. Connections Visuospatial orientation. Memory acces. from anterior thalamic nuclei. with insula. Visuospatial processing, Retrosplenial amnesia Visuospatial processing memory and attention.

dorsal z PCC / ACC Z caudal rostral Z Z area 24 (vACC) area 23 (vPCC) ventral area 31 (dPCC) area 32 (dACC)

area 30 (RSC) [Type a quote from area 25 (sACC) the document X Y or the summary of an interesting point. You can position the text box D E F anywhere in the document. Use the Text Box Tools tab to Area 25. Subgenual Anterior Area 24. Ventral Anterior Area 32. Dorsal Anterior Cingulate Cingulate Cortex ( s ACC ). Passage Cingulate Cortex ( v PCC ). Passage Cortex ( d ACC ). Passaage change the Cingulofrontal inferior. Talamic cingulofrontal posterior. Cingulofrontal anterior. formatting of projections . Information relevant for Talamocortical projections. Talamocortical projections. olfaction and autonomic reglation. Cingulofrontal connections Information for olfaction. the pull Figure 3. Location of Brodmann cortical areas on the space sectors of gyrus cinguli. A. Retrosplenial Cingulate Cortex (RSC) B. quote text Dorsal posteriorFigur Cingulatee 3 Cortex. Location (d PCC). of C. BrodmannVentral Posterior cortical Cingulate areas Cortex (von PCC). the D.space Subgenual sectors anterior of Cingulate box.] Cortex (sACC). E. Ventral anterior Cingulate Cortex (v ACC ). F. Dorsal Anterior Cingulate Cortex (dACC). Macrophotos by Canon gyrusEOS Mark cinguli. II Digital A. Camera,Retrosplenial Macro UltrasonicCingulate Lens, Cortex EF 100mm,(RSC) B.F/2,8 Dorsal posterior Cingulate Cortex (d PCC). C. Ventral Posterior Cingulate Cortex (v PCC). D. Subgenual anterior Cingulate 60 Cortex (sACC). E. Ventral anterior Cingulate Cortex ((v ACC ). F. Dorsal Anterior Cingulate Cortex (dACC). Macrophotos by Canon EOS Mark II Digital Camera, Macro Ultrasonic Lens, EF 100mm, F/2,8

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7 7 4 8 G H Figure 4. Horizontal sections through fetus head. One can notice the simultaneous presence of cerebral cortex landmarks on the faces of cerebral hemispheres. 1. Lobus temporalis. 2. Lobus insularis. 3. Lobus frontalis. 4. Fissura longitudinalis cerebri. 5. ForamenFigur einterventricularis. 4. Horizontal 6. Ventriculus sections lateralis. through 7. Cornu fetusfrontale (Ventriculus head. One lateralis) can 8. noticeCornu temorale the (Ventriculussimultaneous lateralis). presence Macrophotos of by cerebralCanon EOS cortexMark II. Digital landmarks Camera, Macroon theUltrasonic faces Lens ofEF 100, cerebral F /2,8. hemispheres. 1. Lobus temporalis. 2. Lobus insularis. 3. Lobus frontalis. 4. Fissura longitudinalis61 cerebri. 5. Foramen interventricularis. 6. Ventriculus lateralis. 7. Cornu frontale (Ventriculus lateralis) 8. Cornu temorale (Ventriculus lateralis). Macrophotos by Canon EOS Mark II. Digital Camera, Macro Ultrasonic Lens EF 100, F /2,8.

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6 9 12 5 8 1 2 4 10 11 1 3 3 G H Figure 5. Evolution from lisencephalon to gyrencephalon explained by genesis and evolution of cortical grooves and gyri. 1.Lobus frontalis.2.FossaFigure 5. Evolution lateralis cerebri.3. from Lobus lisencephalon temporalis 4.Lobus to occipitalis.gyrencephalon 5. Gyrus Cinguli. explained 6. Lobulus by paracentralis.genesis 7. Sulcus cinguli. 8. Gyrus frontalis medialis. 9. Sulcus centralis. 10. Sulcus lateralis. 11. Sulcus parietooccipitalis. 12.and Precuneus. evolution Macrophotos of cortical by Canon grooves EOS andMark gyri. II Digital 1.Lobus Camera. frontalis.2.Fossa Macro Ultrasonic lateralis Lens cerebri.3.EF 100mm, Lobus F/2,8. temporalis 4.Lobus occipitalis. 5. Gyrus Cinguli. 6. Lobulus paracentralis. 7. Sulcus cinguli. 8. Gyrus 62 frontalis medialis. 9. Sulcus centralis. 10. Sulcus lateralis. 11. Sulcus parietooccipitalis. 12. Precuneus. Macrophotos by Canon EOS Mark II Digital Camera. Macro Ultrasonic Lens EF 100mm, F/2,8.

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9 8 5 9 G 5 H I Figure 6. The contribution of anterior cerebral artery to the genesis of landmarks on the medial face of left cerebral hemisphere. 1.Lobus occipitalis. 2.Lobus temporalis 3.Gyrus Cinguli. 4. Lobus frontalis. 5.Arteria pericallosa. 6.Arteria callosomarginalis. 7. ArteriaFigur cerebrie anterior 6. The (Pars contribution postcommunicalis). of anterior 8.Rami paracentraliscerebral artery (A.cerebri to anterior).the genesis 9. Ramus of landmarksprecunealis (A. cerebrion the anterior). medial Macrophotos face of left by cerebralCanon EOS hemisphere Mark II Digital. 1.Lobus Camera occipitalis.Macrolens Ultrasonic 2.Lobus temporalisLens EF100mm, 3.Gyrus F/2,8. Cinguli. 4. Lobus frontalis. 5.Arteria pericallosa. 6.Arteria callosomarginalis. 7. Arteria cerebri anterior63 (Pars postcommunicalis). 8.Rami paracentralis (A.cerebri anterior). 9. Ramus precunealis (A. cerebri anterior). Macrophotos by Canon EOS Mark II Digital Camera Macrolens Ultrasonic Lens EF100mm, F/2,8.

G.S.Dragoi et al. The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications cinguli-frontal passage” originates at the level of genu oval excavation with its inferior extremity towards the corporis callosum, crosses sulcus cinguli and unites olfaction region. Due to the intense growth of cerebral with medial frontal gyrus. “The posterior cinguli-frontal hemisphere towards anterior, the axis of fossa lateralis passage” is lunate shaped and is located posteriorly cerebri becomes from vertical, oblique posterior and from the anterior cinguli-frontal passage. It unites gyrus inferiorly and the depression deepens (Fig. 5 A, B, G). cinguli to gyrus paracentralis anterior. We noticed the It covers by the growing frontal and temporal presence of two “cinguli-parietal passage creases” that regions hiding the island lobe. was easy to identify and name based on topographic The growth of cerebral cortex is rapid and criterion: ventral and dorsal cinguli-parietal. massive. In a 3 months old fetus we noticed that the “The ventral cinguli-parietal passage” occipital lobe already completely covers diencephalon originates at the level of splenium and truncus corporis (Fig. 5 A). At 5 months it covers the quadrigeminal callosum and makes the connection to the ventral part plate and at 8 months completely covers cerebellum. of precuneus under sulcus subparietalis. “The dorsal On the medial side, cortex creasing determines cinguli-perietal passage” originates ventrally from two folds almost parallel to each other and parallel to sulcus cinguli and unites gyrus cinguli to the dorsal part the superior border of cerebral hemisphere. of precuneus above sulcus subparietalis. “The cinguli-temporal passage” originates D. Analysis of the relations between the behind splenium corpori callosum and unites with gyrus branches of anterior cerebral artery and the landmarks parahippocampalis. This passage was named “isthmus on the medial side of cerebral hemispheres gyri cinguli” in the international anatomic terminology. Dissection of the branches of anterior cerebral artery in pars postcommunicales (Segmentum A2) C. Morphogenetic analysis of the landmarks allowed us to evaluate the vascular relations to corpus on the medial side of cerebral hemispheres callosum, gyrus cinguli and gyri from frontal and When examining the horizontal sections parietal lobes. One can easily observe the existence of through the cephalic extremity of fetus aged between two arterials semi rings: one inferiorly, around corpus 4-8 months old antepartum, allowed us to visualize the callosum and the other one superiorly (Fig. 6). cavity and walls of the lateral ventricles. From pericallosum ring we visualized As the cerebral hemispheres grow from paracentral, precuneus and parietooccipital posterior to superior, we noticed its relation to the brain branches. Callosum-marginal semi ring gives frontal stem and its proximity to the medium sagittal plane. (anteromedial, intermediomedial, posteromedial), The internal face of cerebral hemisphere is plane while cingular and paracentral branches. All the arterial the external one increases its convexity (Fig. 4 A, B). branches occupy the grooves between the neuronal Between the two internal faces of cerebral hemispheres structures. is fissure longitudinalis cerebri where one can find falx cerebri (Fig.4 H). Discussions The cerebral hemisphere walls change during ontogenesis. Initially its thickness and structure are There are many variable criteria that can impose homogeneous without landmarks (Fig. 4 A, B). the globalization paradigm for cortex cinguli: 1. The Analyzing the serried sections through fetus macroanatomic criteria ensures the knowledge of the head one can easily noticed the existence of two parts grooves that border gyrus cinguli from the surrounding in the structure of cerebral hemisphere walls: cerebral gyri; 2. The criteria of Talairach coordinates system cortex that will expand enormously and a basal part that (1988) [12] that allows us to locate different cerebral will form thalamus and corpus striatum (Fig. 4). structures including Brodmann areas; 3. The criteria As the cerebral hemispheres curve around of cell architecture (Brodmann) [13]; 4. The anatomic corpus striatum, the posterior extremity becomes and functional criteria (Papez 1937 [4], Mac Lean 1954 oriented inferiorly. Cerebral cortex has an anterior or [5]); 5. The criteria of ablation experiments (Kluver frontal part and a posterior inferior or temporal part. lobectomy) [14]. We noticed how the frontal part prolongs to anterior In this paper we dealt with the morphologic and the temporal part towards posterior. The central study of the medial side of cerebral hemispheres and part of cerebral hemisphere does not expand as much we visualized and evaluated the location of gyrus as its extremities; in this manner appears a vertical cinguli, its relations and especially its connections to depression limited up, down and posterior by frontal, the adjacent cerebral cortex that belongs to frontal, parietal and temporal cerebral cortex. This depression is parietal and temporal lobes. Gyrus cinguli is involved fossa lateralis cerebri (Sylvius) where there is the island in the determination of the landmarks on the medial lobe (Reil) (Fig. 4; 5 A, B). side of cerebral hemispheres and this fact imposes In the beginning it has the shape of a circular or the reevaluation of the classic anatomy descriptive

64 Romanian Journal of Legal Medicine Vol. XXI, No 1(2013) and topographic data. The diversity of non-invasive without taking into consideration the functions of research methods for brain study inevitably lead to the those regions. Brodmann [13] described two regions in abandon of macroanatomic dissection that stood at the gyrus cinguli: anterior (ACC) and posterior (PCC). The base of real knowledge of cerebral cortex landmarks. anterior region (ACC) is the frontal part of gyrus cinguli. Analyzing our observations, we stated a great It includes a ventral (vACC) and a dorsal (dACC) area variability of the sulcus cinguli trajectory especially involved in vegetative functions (arterial blood pressure in its ascending or terminal part, known as “ramus regulation and heart rhythm), cognitive, decision and marginalis” in the International Nomina Anatomica. emotion. The anterior cortex of gyrus cinguli was We noticed that this groove can split sending a branch divided anatomically in a dorsal and a ventral part. to precuneus or it can send a posterior branch that The dorsal part (dACC) includes Brodmann continues to sulcus subparietalis. area 32 strongly interconnected to prefrontal cortex On the superior border of cerebral hemisphere, (49/9), parietal cortex (7) and motor areas. It is it engages sometimes in a part of the root of superior associated to the functions of voluntary mental control parietal gyrus. Eberstaller (1899) [15] saw the existence and rational thinking. Based on NEUN criteria (Neuron of three types of gyrus cinguli: 1. Simple groove specific Nuclear binding protein), area 32 was divided (68%) more frequent in the right hemisphere, where in three locations: subgenual (s32), pregenual (p32) and it is straight and continuous except for some short dorsogenual (d32). and transverse “passage creases” that do not alter its The ventral part (vACC) contains area 24 and shape; 2. Double groove (30%) more frequent in the left is connected to amygdaloidal complex, grey matter hemisphere where it is double and consequently so is the around the aqueduct, accubens nucleus, hypothalamus, medial frontal gyrus; 3. Fragmented groove (2%) that is anterior island and orbital frontal cortex. It is involved interrupted by two or more “passage creases”. Poirier in the evaluation of emotional information and is the (1899) [16] considers that the double type groove is site for free will. Equally it intervenes in physiologic much likely to be determined by a new groove – the emotional reactions: horripilate (“chicken skin”), intralimbic groove that tend to split gyrus cinguli in two. vascular changes and pupils’ dilation. The presence of “passage creases” is a macro The stimulation of this region can cause stop of anatomic reality. Regis (1994) [17] tried to map them. breath and inhibition of voluntary motility. Nevertheless, an architectural map based on grooves The posterior region is the parietal temporal and gyri and having a functional signification is far from part of gyrus cinguli. It includes Brodmann areas being admitted. The complexity and the variability of 23, 31 and 30. Area 23 (vPCC) is the ventral part of grooves and gyri only allows for a rough mapping as posterior cingular cortex. It is bound to space vision each area could include numerous functional parts. processing. Area 30 (RSC) is the retro-splenius part of Paul Mac Lean (1990) [18] made the first step posterior cingular cortex. It is involved in space vision for the elaboration of globalization paradigm involving orientation. gyrus cinguli. He stated the “Triune Brain” evolutionary In psychopathology there are some anatomic theory according to which, in humans, there are in fact and functional derangements regarding gyrus cinguli: three inherited brains: 1. The reptilian brain implemented depression, obsession, attention deficit, panic, in the control of reflexes and primitive behavior; 2. neuropathic and functional pain, schizophrenia, The paleomammalian Brain implicated in emotionally Parkinson disease, Alzheimer disease as well as motivated behavior; 3. Neocortex and Neocerebellum posttraumatic stress [20-23]. In posttraumatic stress – The neomammalian Brain – implemented in logic disorder, neural structures of the limbic system are thinking and learning. MacLean (1993) [19] considers involved: corpus amygdaloideum, anterior cingulated the cingular thalamic compartment of the limbic system cortex (ACC) and hippocampus. as specific to mammals as a mediator of behaviors Anterior cingular cortex is responsible for present during games, maternal caring, audio and vocal visceral pain syndrome. Areas 24 and 32 receive communication between mother and child. He draws impulses from amygdale and sometimes from the attention towards the role of education in human hypothalamus. All the ACC areas send their fibers to behavior development and concludes that “a man must the grey matter around the aqueduct while area 25 also be judged after his behavior”. sends to solitary tract nucleus. The clarification of gyrus cinguli cortex subdivisions for integrating the knowledge, emotional Conclusions and motor processes, needs the gathering of all data regarding anatomic cell architecture, connections, 1. Macro anatomic analysis of the medial face of psychological behavior, electrophysiology and lesions. cerebral hemispheres offers the knowledge of the variable The division of gyrus cinguli cortex was done landmark (grooves, gyri) but also of interconnectivity by Brodmann (1909) [13] based on anatomic criteria potential of cerebral cortex by “passage creases” [24].

65 G.S.Dragoi et al. The paradigm of cingulate cortex globalization. Psychopathologic and forensic implications

2. The existence of a great phenotype variability 4. Knowing the development stages from concerning grooves and gyri system stereo distribution lisencephalon to gyrencephalon allows the understanding represents an important obstacle in functional and/or of the interconnection networks between limbic system architectural mapping of cingular cortex. neuronal structures. 3. The diversity of noninvasive imagistic methods 5. Understanding the derangements involving to evaluate the encephalon and the reconsideration of behavior and adaptive processes is dependent on the data obtained after macroscopic dissection open new knowledge of specific connections between prefrontal perspectives for the globalization paradigm of cerebral cortex and anterior subdivisions of cingular cortex. cortex structures.

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