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The cingulate cortex has been implicated in a wide range of overlapping cognitive, affective, skeletomotor, and visceromotor functions. In this chapter, we focus on the role of the anterior and midcingulate cortex (ACC and MCC) in facilitating a person's ability to recognize and understand his or her own emotions. Here, we illustrate how this ability-often referred to as "emotional awareness" (EA)-may require integration across each of the aforementioned functions. To appropriately situate the role of the cingulate in EA, we first summarize a number of studies that have highlighted ACC/MCC engagement in the context of emotion. We then describe prominent domain-general views of the ACC (in interaction with MCC), which together suggest that it may serve as a hub within a high-level visceromotor control system. This high-level system functions to predict and mobilize the required metabolic resources in a given situation via the integration of multimodal information available from both sensory cortices and memory. Based on this work, we show that EA can be seen as an important consequence of this integrative process and how it can help to explain the adaptive nature of such advanced emotional capacities. We close by briefly considering the potential clinical relevance of understanding ACC/MCC function and its specific role in emotion and awareness., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The vagal (high frequency [HF]) component of heart rate variability (HRV) predicts survival in post-myocardial infarction patients and is considered to reflect vagal antagonism of sympathetic influences. Previous studies of the neural correlates of vagal tone involved mental stress tasks that included cognitive and emotional elements. To differentiate the neural substrates of vagal tone due to emotion, we correlated HF-HRV with measures of regional cerebral blood flow (rCBF) derived from positron emission tomography (PET) and (15)O-water in 12 healthy women during different emotional states. Happiness, sadness, disgust and three neutral conditions were each induced by film clips and recall of personal experiences (12 conditions). Inter-beat intervals derived from electrocardiographic recordings during the 60-second scans were spectrally-analyzed, generating 12 separate measures of HF-HRV in each subject. The six emotion and six neutral conditions were grouped together and contrasted. We observed substantial overlap between emotion-specific rCBF and the correlation between emotion-specific rCBF and HF-HRV, particularly in the medial prefrontal cortex. Emotion-specific rCBF also correlated with HF-HRV in the caudate nucleus, periacqueductal gray and left mid-insula. We also observed that the elements of cognitive control inherent in this experiment (that involved focusing on the target mental state) had definable neural substrates that correlated with HF-HRV and to a large extent differed from the emotion-specific correlates of HF-HRV. No statistically significant asymmetries were observed. Our findings are consistent with the view that the medial visceromotor network is a final common pathway by which emotional and cognitive functions recruit autonomic support.

Facial electromyography (EMG) was recorded from left and right zygomatic and corrugator muscle regions in response to reflective questions and during voluntary facial expressions. Both muscle regions showed consistent responses to five emotions (happiness, excitement, neutral, sadness, and fear) evoked in the involuntary condition (i.e. reflective questions) and four emotional facial expressions (happiness, excitement, sadness, and fear) self-generated in the voluntary condition. Lateralized responses were found for the zygomatic muscle in the involuntary condition: positive emotion questions elicited relatively greater right muscle activity than left muscle activity, while negative emotion questions elicited relatively greater left muscle activity than right muscle activity. Lateralized responses were found for the corrugator muscle in the voluntary condition, but were not significantly related to type of emotional expression. Sex differences indicating greater lateralization for females were found in some of the measures. The results are consistent with the hypothesized specialization of the left and right cerebral hemispheres for the mediation of positive and negative emotions, respectively. [ABSTRACT FROM AUTHOR]