Human lesion studies of ventromedial prefrontal cortex

Personality and Cognitive Functions in Violent Offenders - Implications of Character Maturity?

Previous research has suggested that personality and cognitive functions are essential in the emergence of persistent aggressive antisocial behaviors and that character maturity could be an important protective factor against these behaviors. The aims of this study were (1) to determine associations between personality traits, intellectual ability, and executive function in young male violent offenders, and (2) to investigate differences in intellectual ability and executive function between groups of violent offenders with low, medium, and high character maturity. A cohort of 148 male violent offenders (18–25 years of age) participated in this study. The Temperament and Character Inventory was used as a self-report measure of personality traits, and cognitive functions were measured with the Wechsler Adult Intelligence Scale – Third Edition and the Cambridge Neuropsychological Test Automated Battery. Intellectual ability was negatively correlated to the temperament dimension Harm Avoidance and the character dimension Self-Transcendence, and positively correlated to the character dimensions Self-Directedness and Cooperativeness and the temperament dimension Novelty Seeking. Visual sustained attention correlated positively to the temperament dimension Persistence and negatively to the temperament dimension Harm Avoidance. Spatial working memory correlated negatively to the character dimension Cooperativeness. Character maturity, however, did not affect intellectual and executive functions to a statistically significant degree. Our findings indicate that offender personality characteristics such as optimism, responsibility, empathy, curiosity, and industry that would seem more favorable to positive intervention outcomes are related to better cognitive functioning. Possible implications are that interventions in offender populations could be more effective if tailored to participants’ personality dimensions and cognitive proficiencies, rather than offered as “one size fits all.”

Why we need nonhuman primates to study the role of ventromedial prefrontal cortex in the regulation of threat- and reward-elicited responses

The ventromedial prefrontal cortex (vmPFC) is consistently implicated in the cognitive and emotional symptoms of many psychiatric disorders, but the causal mechanisms of its involvement remain unknown. In part, this is because of the poor characterization of the disorders and their symptoms, and the focus of experimental studies in animals on subcortical (rather than cortical) dysregulation. Moreover, even in those experimental studies that have focused on the vmPFC, the preferred animal model for such research has been the rodent, in which there are marked differences in the organization of this region to that seen in humans, and thus the extent of functional homology is unclear. There is also a paucity of well-defined behavioral paradigms suitable for translating disorder-relevant findings across species. With these considerations in mind, we discuss the value of nonhuman primates (NHPs) in bridging the translational gap between human and rodent studies. We focus on recent investigations into the involvement in reward and threat processing of 2 major regions of the vmPFC, areas 25 and 32 in NHPs and their anatomical homologs, the infralimbic and prelimbic cortex, in rodents. We highlight potential similarities, but also differences between species, and consider them in light of the extent to which anatomical homology reflects functional homology, the expansion of the PFC in human and NHPs, and most importantly how they can guide future studies to improve the translatability of findings from preclinical animal studies into the clinic.

Behavioral defects associated with amygdala and cortical dysfunction in mice with seeded α-synuclein inclusions

Parkinson’s disease (PD) is defined by motor symptoms such as tremor at rest, bradykinesia, postural instability, and stiffness. In addition to the classical motor defects that define PD, up to 80% of patients experience cognitive changes and psychiatric disturbances, referred to as PD dementia (PDD). Pathologically, PD is characterized by loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) and intracellular inclusions, called Lewy bodies and Lewy neurites, composed mostly of α-synuclein. Much of PD research has focused on the role of α-synuclein aggregates in degeneration of SNpc dopamine neurons because of the impact of loss of striatal dopamine on the classical motor phenotypes. However, abundant Lewy pathology is also found in other brain regions including the cortex and limbic brain regions such as the amygdala, which may contribute to non-motor phenotypes. Little is known about the consequences of α-synuclein inclusions in these brain regions, or in neuronal subtypes other than dopamine neurons. This project expands knowledge on how α-synuclein inclusions disrupt behavior, specifically non-motor symptoms of synucleinopathies. We show that bilateral injections of fibrils into the striatum results in robust bilateral α-synuclein inclusion formation in the cortex and amygdala. Inclusions in the amygdala and prefrontal cortex primarily localize to excitatory neurons, but unbiased stereology shows no significant loss of neurons in the amygdala or cortex. Fibril injected mice show defects in a social dominance behavioral task and fear conditioning, tasks that are associated with prefrontal cortex and amygdala function. Together, these observations suggest that seeded α-synuclein inclusion formation impairs behaviors associated with cortical and amygdala function, without causing cell loss, in brain areas that may play important roles in the complex cognitive features of PDD

Exploration Deficits Under Ecological Conditions as a Marker of Apathy in Frontotemporal Dementia

Apathy is one of the six clinical criteria for the behavioral variant of frontotemporal dementia (bvFTD), and it is almost universal in this disease. Although its consequences in everyday life are debilitating, its underlying mechanisms are poorly known, its assessment is biased by subjectivity and its care management is very limited. In this context, we have developed "ECOCAPTURE," a method aimed at providing quantifiable and objective signature(s) of apathy in order to assess it and identify its precise underlying mechanisms. ECOCAPTURE consists of the observation and recording of the patient's behavior when the participant is being submitted to a multiple-phase scenario reproducing a brief real-life situation. It is performed in a functional exploration platform transformed into a fully furnished waiting room equipped with a video and sensor-based data acquisition system. This multimodal method allowed video-based behavior analyses according to predefined behavioral categories (exploration behavior, sustained activities or inactivity) and actigraphy analyses from a 3D accelerometer. The data obtained were also correlated with behavioral/cognitive tests and scales assessing global cognitive efficiency, apathy, cognitive disinhibition, frontal syndrome, depression and anxiety. Here, bvFTD patients (n = 14) were compared to healthy participants (n = 14) during the very first minutes of the scenario, when the participants discovered the room and were encouraged to explore it. We showed that, in the context of facing a new environment, healthy participants first explored it and then engaged in sustained activities. By contrast, bvFTD patients were mostly inactive and eventually explored this new place, but in a more irregular and less efficient mode than normal subjects. This exploration deficit was correlated with apathy, disinhibition and cognitive and behavioral dysexecutive syndromes. These findings led us to discuss the presumed underlying mechanisms responsible for the exploration deficit (an inability to self-initiate actions, to integrate reward valuation and to inhibit involuntary behavior). Altogether, these results pave the way for simple and objective assessment of behavioral changes that represents a critical step for the evaluation of disease progression and efficacy of treatment in bvFTD.

Ventromedial prefrontal cortex contributes to performance success by controlling reward-driven arousal representation in amygdala

When preparing for a challenging task, potential rewards can cause physiological arousal that may impair performance. In this case, it is important to control reward-driven arousal while preparing for task execution. We recently examined neural representations of physiological arousal and potential reward magnitude during preparation, and found that performance failure was explained by relatively increased reward representation in the left caudate nucleus and arousal representation in the right amygdala (Watanabe, et al., 2019). Here we examine how prefrontal cortex influences the amygdala and caudate to control reward-driven arousal. Ventromedial prefrontal cortex (VMPFC) exhibited activity that was negatively correlated with trial-wise physiological arousal change, which identified this region as a potential modulator of amygdala and caudate. Next we tested the VMPFC - amygdala - caudate effective network using dynamic causal modeling (Friston et al., 2003). Post-hoc Bayesian model selection (Friston and Penny, 2011) identified a model that best fit data, in which amygdala activation was suppressively controlled by the VMPFC only in success trials. Furthermore, fixed connectivity strength from VMPFC to amygdala explained individual task performance. These findings highlight the role of effective connectivity from VMPFC to amygdala in order to control arousal during preparation for successful performance.

Specializations for reward-guided decision-making in the primate ventral prefrontal cortex

The estimated values of choices, and therefore decision-making based on those values, are influenced by both the chance that the chosen items or goods can be obtained (availability) and their current worth (desirability) as well as by the ability to link the estimated values to choices (a process sometimes called credit assignment). In primates, the prefrontal cortex (PFC) has been thought to contribute to each of these processes; however, causal relationships between particular subdivisions of the PFC and specific functions have been difficult to establish. Recent lesion-based research studies have defined the roles of two different parts of the primate PFC - the orbitofrontal cortex (OFC) and the ventral lateral frontal cortex (VLFC) - and their subdivisions in evaluating each of these factors and in mediating credit assignment during reward-based decision-making.

Behaviour outcomes in children with epilepsy 1 year after surgical resection of the ventromedial prefrontal cortex

Early damage to the ventromedial prefrontal cortex (VM) has been associated with impaired behavioural functioning in children without epilepsy, yet behaviour in children with epilepsy and VM lesions has not been investigated. The primary aim of this study was to examine behavioural outcomes in children with epilepsy emanating from the VM preoperatively and one year after epilepsy surgery compared to the general population and matched epilepsy controls. Behavioural outcomes were defined as comprising both problems and competencies (i.e. social, school and co-curricular performance). A secondary aim was to examine whether seizure outcome, number of antiepileptic drugs (AEDs), or age at surgery related to behavioural outcomes. Ratings on the Child Behavior Checklist were examined preoperatively and 1 year after surgery for 20 children with epilepsy who had undergone surgical resection of the VM (N = 10) or temporal lobe (TL, N = 10). VM and TL groups were comparable on Full Scale IQ (40-101), age of seizure onset (0.5-9.0 years), age at surgery (3.1-16.9 years), seizure laterality (5 left in each group), age at assessments, sex (3 female in VM group, 2 female in TL group) and seizure outcome (7 seizure free in VM group, 6 seizure free in TL group). The VM group had significantly elevated behaviour problems (i.e. withdrawn, thought, social and attention problems) and reduced competencies (i.e. social and school) compared to the general population before and after surgery. VM and TL cases did not differ on any behaviour problem scales pre or postoperatively and neither group showed significant change in functioning over time; however, VM patients had significantly lower total competence than TL patients postoperatively. A significant seizure outcome × time interaction was observed: children who were seizure free following surgery (collapsed across surgical site) showed an improvement in total behaviour problems and aggression at 1 year follow-up, whereas children with ongoing seizures showed a deterioration in these domains. In conclusion, VM lesions in children with epilepsy are associated with behavioural problems but their profile does not differ from that of children with temporal lobe epilepsy. These results are consistent with the concept that seizures arise from epileptogenic networks that may affect multiple cortical areas, even when onset is in a focal site.

Lesion Studies in Contemporary Neuroscience

Studies of humans with focal brain damage and non-human animals with experimentally induced brain lesions have provided pivotal insights into the neural basis of behavior. As the repertoire of neural manipulation and recording techniques expands, the utility of studying permanent brain lesions bears re-examination. Studies on the effects of permanent lesions provide vital data about brain function that are distinct from those of reversible manipulations. Focusing on work carried out in humans and nonhuman primates, we address the inferential strengths and limitations of lesion studies, recent methodological developments, the integration of this approach with other methods, and the clinical and ecological relevance of this research. We argue that lesion studies are essential to the rigorous assessment of neuroscience theories.

A Focus on the Functions of Area 25

Subcallosal area 25 is one of the least understood regions of the anterior cingulate cortex, but activity in this area is emerging as a crucial correlate of mood and affective disorder symptomatology. The cortical and subcortical connectivity of area 25 suggests it may act as an interface between the bioregulatory and emotional states that are aberrant in disorders such as depression. However, evidence for such a role is limited because of uncertainty over the functional homologue of area 25 in rodents, which hinders cross-species translation. This emphasizes the need for causal manipulations in monkeys in which area 25, and the prefrontal and cingulate regions in which it is embedded, resemble those of humans more than rodents. In this review, we consider physiological and behavioral evidence from non-pathological and pathological studies in humans and from manipulations of area 25 in monkeys and its putative homologue, the infralimbic cortex (IL), in rodents. We highlight the similarities between area 25 function in monkeys and IL function in rodents with respect to the regulation of reward-driven responses, but also the apparent inconsistencies in the regulation of threat responses, not only between the rodent and monkey literatures, but also within the rodent literature. Overall, we provide evidence for a causal role of area 25 in both the enhanced negative affect and decreased positive affect that is characteristic of affective disorders, and the cardiovascular and endocrine perturbations that accompany these mood changes. We end with a brief consideration of how future studies should be tailored to best translate these findings into the clinic.

Self-related processing and future thinking: Distinct contributions of ventromedial prefrontal cortex and the medial temporal lobes

Episodic future thinking depends on a core network of regions that involves, in addition to the medial temporal lobes (MTL), the ventromedial prefrontal cortex (vmPFC). Neuroimaging studies suggest that vmPFC is particularly involved when future thinking requires consideration of self-relevant information, but lesion evidence for a special role of vmPFC in constructing self-relevant scenarios is limited. To clarify the involvement of vmPFC in future thinking, eight patients with vmPFC lesions were asked to imagine future events pertaining to the self or to another person, and their performance was contrasted with that of eight patients with MTL lesions. Patients with vmPFC lesions were no more detailed in their description of future events pertaining to the self than of events pertaining to another person. In contrast, like controls, patients with MTL lesions showed a self-benefit, despite impoverished performance overall. These findings accord with evidence from neuroimaging studies and elucidate the distinct contributions of vmPFC and MTL to future thinking.

Effective connectivity within the ventromedial prefrontal cortex-hippocampus-amygdala network during the elaboration of emotional autobiographical memories

Autobiographical memories (AMs) are often colored by emotions experienced during an event or those arising following further appraisals. However, how affective components of memories affect the brain-wide network recruited during the recollection of AMs remains largely unknown. Here, we examined effective connectivity during the elaboration of AMs - when retrieved episodic details are integrated to form a vivid construct - in the network composed by ventromedial prefrontal cortex (vmPFC), hippocampus and amygdala, three key regions associated with memory and affective processes. Functional MRI data was collected while volunteers recollected personal events of different types of valence and emotional intensity. Using dynamic causal modeling, we characterized the connections within the triadic network, and examined how they were modulated by the emotional intensity experienced during an event, and the valence of the affect evoked when recollecting the associated memory. Results primarily indicated the existence of a vmPFC to hippocampus effective connectivity during memory elaboration. Furthermore, the strength of the connectivity increased when participants relived memories of highly emotionally arousing events or that elicited stronger positive affect. These results indicate that the vmPFC drives hippocampal activity during memory elaboration, and plays a critical role in shaping affective responses that emanate from AMs.

The emerging neuroscience of appetitive and drug cue extinction in humans

Fear extinction has been extensively studied in both humans and non-human animals, and this work has contributed greatly to our understanding and treatment of anxiety disorders. Yet other psychopathologies like addiction might be associated with impairments selectively in extinction of non-fear based, appetitive and drug cue associations, and these processes have been underexplored in clinical translational neuroscience. Important questions regarding similarities and differences in the neurobiological mechanisms underlying aversive and appetitive extinction remain unanswered, particularly those pertaining to cross-species evidence for the role of the ventromedial prefrontal cortex and, to some extent, the striatum. Here, we aim to draw attention to the paucity of studies investigating non-fear based extinction in humans, summarize emerging findings from the available literature, and highlight important directions for future research. We argue that closing these gaps in our understanding could help inform the development of more targeted, and perhaps more durable, forms of extinction-based treatments for addiction and related psychopathologies characterized by abnormally persistent appetitive and drug cue associations.

Abnormal topological organization of structural covariance networks in amyotrophic lateral sclerosis

Neuroimaging studies of patients with amyotrophic lateral sclerosis (ALS) have shown widespread alterations in structure, function, and connectivity in both motor and non-motor brain regions, suggesting multi-systemic neurobiological abnormalities that might impact large-scale brain networks. Here, we examined the alterations in the topological organization of structural covariance networks of ALS patients (N = 60) compared with normal controls (N = 60). We found that structural covariance networks of ALS patients showed a consistent rearrangement towards a regularized architecture evidenced by increased path length, clustering coefficient, small-world index, and modularity, as well as decreased global efficiency, suggesting inefficient global integration and increased local segregation. Locally, ALS patients showed decreased nodal degree and betweenness in the gyrus rectus and/or Heschl's gyrus, and increased betweenness in the supplementary motor area, triangular part of the inferior frontal gyrus, supramarginal gyrus and posterior cingulate cortex. In addition, we identified a different number and distribution of hubs in ALS patients, showing more frontal and subcortical hubs than in normal controls. In conclusion, we reveal abnormal topological organization of structural covariance networks in ALS patients, and provide network-level evidence for the concept that ALS is a multisystem disorder with a cerebral involvement extending beyond the motor areas.

Face cells in orbitofrontal cortex represent social categories

Perceiving social and emotional information from faces is a critical primate skill. For this purpose, primates evolved dedicated cortical architecture, especially in occipitotemporal areas, utilizing face-selective cells. Less understood face-selective neurons are present in the orbitofrontal cortex (OFC) and are our object of study. We examined 179 face-selective cells in the lateral sulcus of the OFC by characterizing their responses to a rich set of photographs of conspecific faces varying in age, gender, and facial expression. Principal component analysis and unsupervised cluster analysis of stimulus space both revealed that face cells encode face dimensions for social categories and emotions. Categories represented strongly were facial expressions (grin and threat versus lip smack), juvenile, and female monkeys. Cluster analyses of a control population of nearby cells lacking face selectivity did not categorize face stimuli in a meaningful way, suggesting that only face-selective cells directly support face categorization in OFC. Time course analyses of face cell activity from stimulus onset showed that faces were discriminated from nonfaces early, followed by within-face categorization for social and emotion content (i.e., young and facial expression). Face cells revealed no response to acoustic stimuli such as vocalizations and were poorly modulated by vocalizations added to faces. Neuronal responses remained stable when paired with positive or negative reinforcement, implying that face cells encode social information but not learned reward value associated to faces. Overall, our results shed light on a substantial role of the OFC in the characterizations of facial information bearing on social and emotional behavior.

Process-Specific Alliances (PSAs) in Cognitive Neuroscience

Most cognitive neuroscience theories have focused on the functions of individual brain regions, but cognitive abilities depend also on functional interactions among multiple regions. Many recent studies on these interactions have examined large-scale, resting-state networks, but these networks are difficult to link to theories about specific cognitive processes. Cognitive theories are easier to link to the mini-networks we call process specific alliances (PSAs). A PSA is a small team of brain regions that rapidly assemble to mediate a cognitive process in response to task demands but quickly disassemble when the process is no longer needed. We compare PSAs to resting-state networks and to other connectivity-based, task-related networks, and we characterize the advantages and disadvantages of each type of network.

Ventromedial Prefrontal Cortex Is Critical for Helping Others Who Are Suffering

Neurological patients with damage to the ventromedial prefrontal cortex (vmPFC) are reported to display reduced empathy toward others in their daily lives in clinical case studies. However, the empathic behavior of patients with damage to the vmPFC has not been measured experimentally in response to an empathy-eliciting event. This is important because characterizing the degree to which patients with damage to the vmPFC have lower empathic behavior will allow for the development of targeted interventions to improve patients’ social skills and in turn will help family members to better understand their impairments so they can provide appropriate supports. For the first time, we induced empathy using an ecologically-valid empathy induction in neurological patients with damage to the vmPFC and measured their empathic emotional responses and behavior in real time. Eight neurological patients with focal damage to the vmPFC were compared to demographically-matched brain-damaged and healthy comparison participants. Patients with damage to the vmPFC gave less money in the empathy condition to a person who was suffering (a confederate) than comparison participants. This provides the first direct experimental evidence that the vmPFC is critical for empathic behavior toward individuals who are suffering.

The effects of acute foot shock stress on empathy levels in rats

Empathy defined as the ability to understand and the share the feelings, thoughts, and attitudes of another, is an important skill in survival and reproduction. Among many factors that affect empathy include psychological stress, anxiety states. The aim of this study was to investigate the impact of acute psychological stress on empathic behavior and its association with oxytocin and vasopressin levels in amygdala and prefrontal cortex. Rats were subjected to 0.2 mA (low) and 1.6 mA (high) intensity of foot shock stress for duration of 20 min. Empathic behavior was found to be improved as a response to low intensity stress, but not to high intensity stress. As a response to lower intensity stress, vasopressin was increased in prefrontal cortex and amygdala; oxytocin was increased in only prefrontal cortex, and corticosterone levels increased in general. Anxiety indicators did not change in low intensity stress group yet; high intensity stress group demonstrated a lesser degree of anxiety response. High intensity stress group stayed unexpectedly more active in middle area of elevated plus maze test equipment, which may support impaired executive decision making abilities in the setting of high anxiety states. Further research is needed to investigate gender effects, the role of dopaminergic system and other stress related pathways in acute stress.

Damage to the ventromedial prefrontal cortex is associated with impairments in both spontaneous and deliberative moral judgments

Implicit moral evaluations-spontaneous, unintentional judgments about the moral status of actions or persons-are thought to play a pivotal role in moral experience, suggesting a need for research to model these moral evaluations in clinical populations. Prior research reveals that the ventromedial prefrontal cortex (vmPFC) is a critical area underpinning affect and morality, and patients with vmPFC lesions show abnormalities in moral judgment and moral behavior. We use indirect measurement and multinomial modeling to understand differences in implicit moral evaluations among patients with vmPFC lesions. Our model quantifies multiple processes of moral judgment: implicit moral evaluations in response to distracting moral transgressions (Unintentional Judgment), accurate moral judgments about target actions (Intentional Judgment), and a directional tendency to judge actions as morally wrong (Response Bias). Compared to individuals with non-vmPFC brain damage and neurologically healthy comparisons, patients with vmPFC lesions showed a dual deficit in processes of moral judgment. First, patients with vmPFC lesions showed reduced Unintentional Judgment about moral transgressions, but not about non-moral negative affective distracters. Second, patients with vmPFC lesions showed reduced Intentional Judgment about target actions. These findings highlight the utility of a formal modeling approach in moral psychology, revealing a dual deficit in multiple component processes of moral judgment among patients with vmPFC lesions.