Is anterior cingulate cortex necessary for cognitive control?

Functional neuroimaging studies in normal humans suggest that dorsal anterior cingulate cortex (dACC) plays an important role in cognitive control. This brain area is reliably activated when tasks require the ongoing adjustment of the allocation of attention. The dACC has come to occupy a central role in theories of attention and cognitive control, which hold that dACC either monitors response conflict, signalling the need for adjustments in cognitive processes, or directly mediates such adjustments. However, functional imaging results cannot establish that a brain area is necessary for a particular cognitive process. This requires evidence from loss-of-function studies. Here we assessed cognitive control in four human subjects with damage to dACC and 12 age- and education-matched control subjects using several measures drawn from the functional imaging literature. All four subjects with dACC damage showed normal adjustments in performance following manipulation of response conflict in both Stroop and go-no go tasks. Furthermore, damage to the dACC did not impair the phenomenon of post-error slowing, nor alter the ability to adjust performance in response to explicit speed or accuracy instructions. Thus, cognitive control, as assessed by four different measures in two different tasks, appears to be intact in these subjects, arguing against a necessary role for dACC in this process.