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The Anterior Cingulate Cortex as an Integrative Hub: Mechanisms Underlying Pain and Anxiety Comorbidity - PubMed

5 hours ago
  • #Pain and Anxiety Comorbidity
  • #Anterior Cingulate Cortex
  • #Neuromodulation
  • Chronic pain and anxiety disorders are highly comorbid, forming a vicious cycle.
  • The anterior cingulate cortex (ACC) dysfunction is proposed as the core neural substrate for this comorbidity.
  • Macro-level neuroimaging shows abnormal ACC activation, disrupted connectivity, and structural degeneration in comorbid individuals.
  • Therapeutic neuromodulation targeting the ACC can alleviate both pain and anxiety symptoms.
  • Micro-level mechanisms include LTP of excitatory synapses, disrupted inhibition, neuroimmune interactions, and epigenetic changes in the ACC.
  • Circuit-level dysfunction involves the ACC's interaction with amygdala, thalamus, periaqueductal gray, and prefrontal cortex.
  • Emerging therapies target glutamate/GABA imbalance, immunomodulation, epigenetics, and precision neuromodulation in the ACC.
  • Future research should integrate multilevel methods to uncover ACC pathophysiology for better treatments.