To be, or not to be, that is the question:
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,

-Shakespeare, Hamlet

On December 5, 2013, Neuron published case study “The Will to Persevere Induced by Electrical Stimulation of the Human Cingulate Gyrus.” Although researchers at Stanford University came across these intriguing results by accident, the implications may prove in the future to be of some consequence. In order to gain knowledge in the neurological source of seizures, study co-author Vinitha Rangarajan explains they were in the process of delivering an electrical charge to the anterior midcingulate cortex region (involved in emotion, pain and cognitive processing) of two persons with epilepsy when the finding occurred. When the charge was delivered, both individuals experienced increase in heart rate, and various sensations in their chest and neck. These physiological sensations were accompanied by a psychological expectation of challenge, and the desire to surmount it.

When, in following, the patients only thought their brains were being stimulated (but were not), they did not experience any of the prior symptoms. This process of assumed stimulation was repeated 5mm away, with the same result – an absence of any or the previous physical or psychological effects. In a press release, lead author Dr. Parvizi explains “Our study pinpoints the precise anatomical coordinates of neuronal populations, and their associated network, that support complex psychological and behavioral states associated with perseverance.” Dissimilarities in this neuronal structure may be tied to innate differences in our capacity to cope and endure amid trying circumstances.

The study highlights dictate:[i]

• Electrical stimulation of the anterior cingulate region performed in two subjects
• A stereotyped set of cognitive and autonomic changes was elicited in both subjects
• This included feeling of anticipated challenge and strong motivation to overcome it
• Site of stimulation in both subjects was a core node of the brain’s salience network

Summary

Anterior cingulate cortex (ACC) is known to be involved in functions such as emotion, pain, and cognitive control. While studies in humans and nonhuman mammals have advanced our understanding of ACC function, the subjective correlates of ACC activity have remained largely unexplored. In the current study, we show that electrical charge delivery in the anterior midcingulate cortex (aMCC) elicits autonomic changes and the expectation of an imminent challenge coupled with a determined attitude to overcome it. Seed-based, resting-state connectivity analysis revealed that the site of stimulation in both patients was at the core of a large-scale distributed network linking aMCC to the frontoinsular and frontopolar as well as some subcortical regions. This report provides compelling, first-person accounts of electrical stimulation of this brain network and suggests its possible involvement in psychopathological conditions that are characterized by a reduced capacity to endure psychological or physical distress.

In brief departure, I am reminded of William James’ thoughts on the notion of the “threshhold.”

Recent psychology has found great use for the word ‘threshold’ as a symbolic designation for the point at which one state of mind passes into another. Thus we speak of the threshold of a man’s consciousness in general, to indicate the amount of noise, pressure, or other outer stimulus which it takes to arouse his attention at all. One with a high threshold will doze through an amount of racket by which one with a low threshold would be immediately waked. Similarly, when one is sensitive to small differences in any order of sensation we say he has a low ‘difference-threshold’- his mind easily steps over it into the consciousness of the differences in question. And just so we might speak of a ‘pain-threshold,’ a ‘fear-threshold,’ a ‘misery-threshold,’ and find it quickly overpassed by the consciousness of some individuals, but lying too high in others to be often reached by their consciousness.[ii]

What is it that allows some individuals to fall off the horse fifty times, only to get back up fifty one? To attend one hundred grueling auditions whilst retaining the hope and inertia to continue showing up? To find love and then betrayal, and yet continue to open one’s heart to the vulnerabilities of emotion? Findings such as these in neuroscience are critical to the understanding of pain, fear, and crisis thresholds, and leave many open pathways for discovery in the realm of physical and psychological resilience.

To be, or not to be, that is the question:
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,
And by opposing end them: to die, to sleep
No more; and by a sleep, to say we end
The Heart-ache, and the thousand Natural shocks
That Flesh is heir to? ‘Tis a consummation
Devoutly to be wished. To die, to sleep,
To sleep, perchance to Dream; Aye, there’s the rub,
For in that sleep of death, what dreams may come,
When we have shuffled off this mortal coil,
Must give us pause.