The anterior midcingulate cortex might be a neuronal substrate for the ideomotor mechanism.

The way the brain controls voluntary movements for normal and pathological subject remains puzzling. In this selective review, we provide unreported harmonies between the anterior midcingulate cortex (aMCC) activities and the ideomotor mechanism postulating that voluntary movements are controlled by the anticipation of the expected perceptual consequences of an action, critically involving bidirectional interplay of a given motor activity and corresponding sensory feedback. Among other evidence, we found that the required asymmetry in the bidirectional interplay between a given motor command and its expected sensory effect could rely on the specific activity of aMCC neurons when observing errors and successes. We confirm this hypothesis by presenting a pathological perspective, studying obsessive-compulsive and other related disorders in which hyperactivated and uniform aMCC activities should lead to a circular-reflex process that results in persistent ideas and repeated actions. By evaluating normal and pathological data, we propose considering the aMCC at a central position within the cerebral network involved in the ideomotor mechanism.