Stuck in the here and now: Construction of fictitious and future experiences following ventromedial prefrontal damage

Counterfactual thinking induces different neural patterns of memory modification in anxious individuals

Episodic counterfactual thinking (eCFT) is the process of mentally simulating alternate versions of experiences, which confers new phenomenological properties to the original memory and may be a useful therapeutic target for trait anxiety. However, it remains unclear how the neural representations of a memory change during eCFT. We hypothesized that eCFT-induced memory modification is associated with changes to the neural pattern of a memory primarily within the default mode network, moderated by dispositional anxiety levels. We tested this proposal by examining the representational dynamics of eCFT for 39 participants varying in trait anxiety. During eCFT, lateral parietal regions showed progressively more distinct activity patterns, whereas medial frontal neural activity patterns became more similar to those of the original memory. Neural pattern similarity in many default mode network regions was moderated by trait anxiety, where highly anxious individuals exhibited more generalized representations for upward eCFT (better counterfactual outcomes), but more distinct representations for downward eCFT (worse counterfactual outcomes). Our findings illustrate the efficacy of examining eCFT-based memory modification via neural pattern similarity, as well as the intricate interplay between trait anxiety and eCFT generation.

The Interaction of the Dorsolateral and Ventromedial Prefrontal Cortex During Mind Wandering

BACKGROUND AND AIMS

Mind wandering refers to spontaneously occurring, often disruptive thoughts during an ongoing task or resting state. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are two main cortical areas which are involved in this process. This study aimed to explore the interaction of these areas during mind wandering by enhancing specific oscillatory activity of these areas via transcranial alternating current stimulation (tACS) in the theta frequency range.

MATERIAL AND METHODS

Eighteen healthy adults participated in a randomized, single-blinded, crossover study. tACS (1.5 mA, 6 Hz) was applied in five sessions with one week interval via (1) two channels with synchronized stimulation over the left dlPFC and right vmPFC, (2) the same electrode placement with anti-phase stimulation, (3) stimulation over the left dlPFC only, (4) stimulation over right vmPFC only, and (5) sham stimulation. The return electrodes were placed over the contralateral shoulder in all conditions. The sustained attention to response task (SART) with embedded probes about task-unrelated-thoughts and awareness of these thoughts was performed during intervention.

RESULTS

Stimulation did not alter SART performance. Right vmPFC stimulation decreased mind wandering and increased awareness of mind wandering. Left dlPFC stimulation and desynchronized stimulation over the dlPFC and vmPFC increased mind wandering compared to the sham stimulation condition. Synchronized stimulation had no effect on mind wandering, but increased awareness of mind wandering.

CONCLUSION

The results suggest that regional entrainment of the vmPFC decreases mind wandering and increases awareness of mind wandering, whereas regional entrainment of the dlPFC increases mind wandering, but decreases awareness. Under desynchronized stimulation of both areas, the propensity of mind wandering was increased, whereas synchronized stimulation increased the awareness of mind wandering. These results suggest a role of the dlPFC in initiation of mind wandering, whereas the vmPFC downregulates mind wandering, and might exert this function by counteracting respective dlPFC effects via theta oscillations.

Temporal Construal Effects Are Independent of Episodic Future Thought

Human thought is prone to biases. Some biases serve as beneficial heuristics to free up limited cognitive resources or improve well-being, but their neurocognitive basis is unclear. One such bias is a tendency to construe events in the distant future in abstract, general terms and events in the near future in concrete, detailed terms. Temporal construal may rely on our capacity to orient toward and/or imagine context-rich future events. We tested 21 individuals with impaired episodic future thinking resulting from lesions to the hippocampus or ventromedial prefrontal cortex (vmPFC) and 57 control participants (aged 45-76 years) from Canada and Italy on measures sensitive to temporal construal. We found that temporal construal persisted in most patients, even those with impaired episodic future thinking, but was abolished in some vmPFC cases, possibly in relation to difficulties forming and maintaining future intentions. The results confirm the fractionation of future thinking and that parts of vmPFC might critically support our ability to flexibly conceive and orient ourselves toward future events.

On the contribution of the ventromedial prefrontal cortex to the neural representation of past memories

Tallman and colleagues (this issue) showed that memory consolidation of laboratory materials produces, even at short intervals, changes in cortical activity within a widespread network of brain regions. These changes, however, do not encompass a core memory region, namely the ventromedial prefrontal cortex (vmPFC). Here, I discuss research showing that the neural activity of the vmPFC is sensitive to the remoteness of memories, especially using tasks that involve autobiographical recollection. Taken together, these findings appear to highlight a differential contribution of the vmPFC according to the nature of the to-be-remembered material (laboratory vs. autobiographical) that might be further investigated by future research.

Perspective-taking is associated with increased discriminability of affective states in the ventromedial prefrontal cortex

Recent work using multivariate-pattern analysis (MVPA) on functional magnetic resonance imaging (fMRI) data has found that distinct affective states produce correspondingly distinct patterns of neural activity in the cerebral cortex. However, it is unclear whether individual differences in the distinctiveness of neural patterns evoked by affective stimuli underlie empathic abilities such as perspective-taking (PT). Accordingly, we examined whether we could predict PT tendency from the classification of blood-oxygen-level-dependent (BOLD) fMRI activation patterns while participants (n = 57) imagined themselves in affectively charged scenarios. We used an MVPA searchlight analysis to map where in the brain activity patterns permitted the classification of four affective states: happiness, sadness, fear and disgust. Classification accuracy was significantly above chance levels in most of the prefrontal cortex and in the posterior medial cortices. Furthermore, participants' self-reported PT was positively associated with classification accuracy in the ventromedial prefrontal cortex and insula. This finding has implications for understanding affective processing in the prefrontal cortex and for interpreting the cognitive significance of classifiable affective brain states. Our multivariate approach suggests that PT ability may rely on the grain of internally simulated affective representations rather than simply the global strength.

Compromised future thinking: another cognitive cost of temporal lobe epilepsy

The ability to mentally travel forward through time allows humans to envisage a diverse array of possible events taking place in the future, helping us to choose which pathway to take in life. In epilepsy, we assume that patients use this cognitive ability when deciding between various treatment options, but this assumption has not been robustly tested. The temporal lobes are key contributors to this 'future thinking' and its building blocks include cognitive functions commonly impaired in temporal lobe epilepsy such as memory and language, giving rise to a hypothesis that 'future thinking' is impaired in this patient cohort. Participants were 68 adults: 37 with neurosurgically-naïve, unilateral temporal lobe epilepsy (51% right lateralized) and 31 healthy controls of similar age, sex and intellectual ability to the participants with epilepsy. Future thinking was measured using an imagined experiences task validated in other neurological populations. Tools well-established in temporal lobe epilepsy were used to measure potential cognitive correlates of future thinking. Analysis of variance revealed significantly impoverished future thinking in both left and right temporal lobe epilepsy relative to controls (P = 0.001, η p 2=0.206), with no difference between temporal lobe epilepsy groups (P > 0.05). Future thinking deficits in left temporal lobe epilepsy were paralleled by deficits in scene construction, whereas impoverished future thinking in right temporal lobe epilepsy occurred in the setting of intact scene construction. Deficits in future thinking were associated with reductions in lexical access and episodic autobiographic memory in both epilepsy groups. In sum, future thinking is compromised in both left and right temporal lobe epilepsy. The deficit in left temporal lobe epilepsy is largely explainable by dysfunction in verbal cognitive processes including scene construction. While the basis of the deficits observed with right temporal foci shares features with that of left temporal lobe epilepsy, their intact scene construction raises questions about the role of the left and right temporal lobes in future thinking and scene construction and the relationship between these two constructs, including whether right temporal lobe might play a specific role in future thinking in terms of creative processing. Clinicians should take impaired future thinking into account when counselling temporal lobe epilepsy patients about various treatment options, as they may struggle to vividly imagine what different outcomes might mean for their future selves.

Prefrontal contributions to the stability and variability of thought and conscious experience

The human prefrontal cortex is a structurally and functionally heterogenous brain region, including multiple subregions that have been linked to different large-scale brain networks. It contributes to a broad range of mental phenomena, from goal-directed thought and executive functions to mind-wandering and psychedelic experience. Here we review what is known about the functions of different prefrontal subregions and their affiliations with large-scale brain networks to examine how they may differentially contribute to the diversity of mental phenomena associated with prefrontal function. An important dimension that distinguishes across different kinds of conscious experience is the stability or variability of mental states across time. This dimension is a central feature of two recently introduced theoretical frameworks-the dynamic framework of thought (DFT) and the relaxed beliefs under psychedelics (REBUS) model-that treat neurocognitive dynamics as central to understanding and distinguishing between different mental phenomena. Here, we bring these two frameworks together to provide a synthesis of how prefrontal subregions may differentially contribute to the stability and variability of thought and conscious experience. We close by considering future directions for this work.

Present and future self in memory: the role of vmPFC in the self-reference effect

Self-related information is remembered better than other-related information (self-reference effect; SRE), a phenomenon that has been convincingly linked to the medial prefrontal cortex. It is not clear whether information related to our future self would also have a privileged status in memory, as medial prefrontal cortex (mPFC) regions respond less to the future than to the present self, as if it were an 'other'. Here we ask whether the integrity of the ventral mPFC (vmPFC) is necessary for the emergence of the present and future SRE, if any. vmPFC patients and brain-damaged and healthy controls judged whether each of a series of trait adjectives was descriptive of their present self, future self, another person and that person in the future and later recognized studied traits among distractors. Information relevant to the present (vs future) was generally recognized better, across groups. However, whereas healthy and brain-damaged controls exhibited strong present and future SREs, these were absent in vmPFC patients, who concomitantly showed reduced certainty about their own present and anticipated traits compared to the control groups. These findings indicate that vmPFC is necessary to impart a special mnemonic status to self-related information, including our envisioned future self, possibly by instantiating the self-schema.

Navigating through the ebbs and flows of language

Is progress in understanding the neural basis for spatial navigation relevant to the human language faculty? Not so much at the shortest scale, where movement is continuous, a recent study in the space of vowels suggests. At a much larger scale, however, that of the verbalization of run-away thoughts, a rich phenomenology appears to involve critical contributions by some of the brain structures also involved in spatial cognition. Their interactions may have to be approached with models operating at an integrated cortical level and allowing for the compositionality of multiple local attractor states. A useful window on the latching dynamics enabled by cortico-cortical interactions may be offered by altered states of consciousness. As an example, psychedelic states have been reported to alter the graph properties of functional connectivity in the cortex so as to facilitate wide-ranging trips.

The role of ventromedial prefrontal cortex in reward valuation and future thinking during intertemporal choice

Intertemporal choices require trade-offs between short-term and long-term outcomes. Ventromedial prefrontal cortex (vmPFC) damage causes steep discounting of future rewards (delay discounting [DD]) and impoverished episodic future thinking (EFT). The role of vmPFC in reward valuation, EFT, and their interaction during intertemporal choice is still unclear. Here, 12 patients with lesions to vmPFC and 41 healthy controls chose between smaller-immediate and larger-delayed hypothetical monetary rewards while we manipulated reward magnitude and the availability of EFT cues. In the EFT condition, participants imagined personal events to occur at the delays associated with the larger-delayed rewards. We found that DD was steeper in vmPFC patients compared to controls, and not modulated by reward magnitude. However, EFT cues downregulated DD in vmPFC patients as well as controls. These findings indicate that vmPFC integrity is critical for the valuation of (future) rewards, but not to instill EFT in intertemporal choice.

Does Ventromedial Prefrontal Cortex Damage Really Increase Impulsiveness? Delay and Probability Discounting in Patients with Focal Lesions

If the tendency to discount rewards reflects individuals' general level of impulsiveness, then the discounting of delayed and probabilistic rewards should be negatively correlated: The less a person is able to wait for delayed rewards, the more they should take chances on receiving probabilistic rewards. It has been suggested that damage to the ventromedial prefrontal cortex (vMPFC) increases individuals' impulsiveness, but both intertemporal choice and risky choice have only recently been assayed in the same patients with vMPFC damage. Here, we assess both delay and probability discounting in individuals with vMPFC damage (n = 8) or with medial temporal lobe (MTL) damage (n = 10), and in age- and education-matched controls (n = 30). On average, MTL-lesioned individuals discounted delayed rewards at normal rates but discounted probabilistic rewards more shallowly than controls. In contrast, vMPFC-lesioned individuals discounted delayed rewards more steeply but probabilistic rewards more shallowly than controls. These results suggest that vMPFC lesions affect the weighting of reward amount relative to delay and certainty in opposite ways. Moreover, whereas MTL-lesioned individuals and controls showed typical, nonsignificant correlations between the discounting of delayed and probabilistic rewards, vMPFC-lesioned individuals showed a significant negative correlation, as would be expected if vMPFC damage increases impulsiveness more in some patients than in others. Although these results are consistent with the hypothesis that vMPFC plays a role in impulsiveness, it is unclear how they could be explained by a single mechanism governing valuation of both delayed and probabilistic rewards.

The self in context: brain systems linking mental and physical health

Increasing evidence suggests that mental health and physical health are linked by neural systems that jointly regulate somatic physiology and high-level cognition. Key systems include the ventromedial prefrontal cortex and the related default-mode network. These systems help to construct models of the 'self-in-context', compressing information across time and sensory modalities into conceptions of the underlying causes of experience. Self-in-context models endow events with personal meaning and allow predictive control over behaviour and peripheral physiology, including autonomic, neuroendocrine and immune function. They guide learning from experience and the formation of narratives about the self and one's world. Disorders of mental and physical health, especially those with high co-occurrence and convergent alterations in the functionality of the ventromedial prefrontal cortex and the default-mode network, could benefit from interventions focused on understanding and shaping mindsets and beliefs about the self, illness and treatment.

Uncovering the prevalence and neural substrates of anhedonia in frontotemporal dementia

Much of human behaviour is motivated by the drive to experience pleasure. The capacity to envisage pleasurable outcomes and to engage in goal-directed behaviour to secure these outcomes depends upon the integrity of frontostriatal circuits in the brain. Anhedonia refers to the diminished ability to experience, and to pursue, pleasurable outcomes, and represents a prominent motivational disturbance in neuropsychiatric disorders. Despite increasing evidence of motivational disturbances in frontotemporal dementia (FTD), no study to date has explored the hedonic experience in these syndromes. Here, we present the first study to document the prevalence and neural correlates of anhedonia in FTD in comparison with Alzheimer's disease, and its potential overlap with related motivational symptoms including apathy and depression. A total of 172 participants were recruited, including 87 FTD, 34 Alzheimer's disease, and 51 healthy older control participants. Within the FTD group, 55 cases were diagnosed with clinically probable behavioural variant FTD, 24 presented with semantic dementia, and eight cases had progressive non-fluent aphasia (PNFA). Premorbid and current anhedonia was measured using the Snaith-Hamilton Pleasure Scale, while apathy was assessed using the Dimensional Apathy Scale, and depression was indexed via the Depression, Anxiety and Stress Scale. Whole-brain voxel-based morphometry analysis was used to examine associations between grey matter atrophy and levels of anhedonia, apathy, and depression in patients. Relative to controls, behavioural variant FTD and semantic dementia, but not PNFA or Alzheimer's disease, patients showed clinically significant anhedonia, representing a clear departure from pre-morbid levels. Voxel-based morphometry analyses revealed that anhedonia was associated with atrophy in an extended frontostriatal network including orbitofrontal and medial prefrontal, paracingulate and insular cortices, as well as the putamen. Although correlated on the behavioural level, the neural correlates of anhedonia were largely dissociable from that of apathy, with only a small region of overlap detected in the right orbitofrontal cortices whilst no overlapping regions were found between anhedonia and depression. This is the first study, to our knowledge, to demonstrate profound anhedonia in FTD syndromes, reflecting atrophy of predominantly frontostriatal brain regions specialized for hedonic tone. Our findings point to the importance of considering anhedonia as a primary presenting feature of behavioural variant FTD and semantic dementia, with distinct neural drivers to that of apathy or depression. Future studies will be essential to address the impact of anhedonia on everyday activities, and to inform the development of targeted interventions to improve quality of life in patients and their families.

An asymmetry in past and future mental time travel following vmPFC damage

The role of ventromedial prefrontal cortex (vmPFC) in mental time travel toward the past and the future is debated. Here, patients with focal lesions to the vmPFC and brain-damaged and healthy controls mentally projected themselves to a past, present or future moment of subjective time (self-projection) and classified a series of events as past or future relative to the adopted temporal self-location (self-reference). We found that vmPFC patients were selectively impaired in projecting themselves to the future and in recognizing relative-future events. These findings indicate that vmPFC damage hinders the mental processing of and movement toward future events, pointing to a prominent, multifaceted role of vmPFC in future-oriented mental time travel.

Lesion network mapping demonstrates that mind-wandering is associated with the default mode network

Functional neuroimaging research has consistently associated brain structures within the default mode network (DMN) and frontoparietal network (FPN) with mind-wandering. Targeted lesion research has documented impairments in mind-wandering after damage to the medial prefrontal cortex (mPFC) and hippocampal regions associated with the DMN. However, no lesion studies to date have applied lesion network mapping to identify common networks associated with deficits in mind-wandering. In lesion network mapping, resting-state functional connectivity data from healthy participants are used to infer which brain regions are functionally connected to each lesion location from a sample with brain injury. In the current study, we conducted a lesion network mapping analysis to test the hypothesis that lesions affecting the DMN and FPN would be associated with diminished mind-wandering. We assessed mind-wandering frequency on the Imaginal Processes Inventory (IPI) in participants with brain injury (n = 29) and healthy comparison participants without brain injury (n = 19). Lesion network mapping analyses showed the strongest association of reduced mind-wandering with the left inferior parietal lobule within the DMN. In addition, traditional lesion symptom mapping results revealed that reduced mind-wandering was associated with lesions of the dorsal, ventral, and anterior sectors of mPFC, parietal lobule, and inferior frontal gyrus in the DMN (p < 0.05 uncorrected). These findings provide novel lesion support for the role of the DMN in mind-wandering and contribute to a burgeoning literature on the neural correlates of spontaneous cognition.

The Role of Hippocampal-Ventromedial Prefrontal Cortex Neural Dynamics in Building Mental Representations

The hippocampus and ventromedial prefrontal cortex (vmPFC) play key roles in numerous cognitive domains including mind-wandering, episodic memory, and imagining the future. Perspectives differ on precisely how they support these diverse functions, but there is general agreement that it involves constructing representations composed of numerous elements. Visual scenes have been deployed extensively in cognitive neuroscience because they are paradigmatic multielement stimuli. However, it remains unclear whether scenes, rather than other types of multifeature stimuli, preferentially engage hippocampus and vmPFC. Here, we leveraged the high temporal resolution of magnetoencephalography to test participants as they gradually built scene imagery from three successive auditorily presented object descriptions and an imagined 3-D space. This was contrasted with constructing mental images of nonscene arrays that were composed of three objects and an imagined 2-D space. The scene and array stimuli were, therefore, highly matched, and this paradigm permitted a closer examination of step-by-step mental construction than has been undertaken previously. We observed modulation of theta power in our two regions of interest-anterior hippocampus during the initial stage and vmPFC during the first two stages, of scene relative to array construction. Moreover, the scene-specific anterior hippocampal activity during the first construction stage was driven by the vmPFC, with mutual entrainment between the two brain regions thereafter. These findings suggest that hippocampal and vmPFC neural activity is especially tuned to scene representations during the earliest stage of their formation, with implications for theories of how these brain areas enable cognitive functions such as episodic memory.

The Effect of Object Type on Building Scene Imagery-an MEG Study

Previous studies have reported that some objects evoke a sense of local three-dimensional space (space-defining; SD), while others do not (space-ambiguous; SA), despite being imagined or viewed in isolation devoid of a background context. Moreover, people show a strong preference for SD objects when given a choice of objects with which to mentally construct scene imagery. When deconstructing scenes, people retain significantly more SD objects than SA objects. It, therefore, seems that SD objects might enjoy a privileged role in scene construction. In the current study, we leveraged the high temporal resolution of magnetoencephalography (MEG) to compare the neural responses to SD and SA objects while they were being used to build imagined scene representations, as this has not been examined before using neuroimaging. On each trial, participants gradually built a scene image from three successive auditorily-presented object descriptions and an imagined 3D space. We then examined the neural dynamics associated with the points during scene construction when either SD or SA objects were being imagined. We found that SD objects elicited theta changes relative to SA objects in two brain regions, the right ventromedial prefrontal cortex (vmPFC) and the right superior temporal gyrus (STG). Furthermore, using dynamic causal modeling, we observed that the vmPFC drove STG activity. These findings may indicate that SD objects serve to activate schematic and conceptual knowledge in vmPFC and STG upon which scene representations are then built.

Pattern similarity and connectivity of hippocampal-neocortical regions support empathy for pain

Empathy is thought to engage mental simulation, which in turn is known to rely on hippocampal-neocortical processing. Here, we tested how hippocampal-neocortical pattern similarity and connectivity contributed to pain empathy. Using this approach, we analyzed a data set of 102 human participants who underwent functional MRI while painful and non-painful electrical stimulation was delivered to themselves or to a confederate. As hypothesized, results revealed increased pattern similarity between first-hand pain and pain empathy (compared to non-painful control conditions) within the hippocampus, retrosplenial cortex, the temporo-parietal junction and anterior insula. While representations in these regions were unaffected by confederate similarity, pattern similarity in the dorsal medial prefrontal cortex was increased the more dissimilar the other individual was perceived. Hippocampal-neocortical connectivity during first-hand pain and pain empathy engaged largely distinct but neighboring primary motor regions, and empathy-related hippocampal coupling with the fusiform gyrus positively scaled with trait measures of perspective taking. These findings suggest that shared representations and mental simulation might contribute to pain empathy via hippocampal-neocortical pattern similarity and connectivity, partially affected by personality traits and the similarity of the observed individual.

Scene processing following damage to the ventromedial prefrontal cortex

It has been suggested that the mental construction of scene imagery is a core process underpinning functions such as autobiographical memory, future thinking and spatial navigation. Damage to the ventromedial prefrontal cortex in humans can cause deficits in all of these cognitive domains. Moreover, it has also been reported that patients with ventromedial prefrontal cortex lesions are impaired at imagining fictitious scenes, although they seem able to describe specific scenes from autobiographical events. In general, not much is known about how ventromedial prefrontal cortex patients process scenes. Here, we deployed a recently-developed task to provide insights into this issue, which involved detecting either semantic (e.g. an elephant with butterflies for ears) or constructive (e.g. an endless staircase) violations in scene images. Identifying constructive violations typically provokes the formation of internal scene models in healthy control participants. We tested patients with bilateral ventromedial prefrontal cortex damage, brain-damaged control patients and healthy control participants. We found no evidence for statistically significant differences between the groups in detecting either type of violation. These results suggest that an intact ventromedial prefrontal cortex is not necessary for some aspects of scene processing, with implications for understanding its role in functions such as autobiographical memory and future thinking.

Zooming In and Out on One's Life: Autobiographical Representations at Multiple Time Scales

The ability to decouple from the present environment and explore other times is a central feature of the human mind. Research in cognitive psychology and neuroscience has shown that the personal past and future is represented at multiple timescales and levels of resolution, from broad lifetime periods that span years to short-time slices of experience that span seconds. Here, I review this evidence and propose a theoretical framework for understanding mental time travel as the capacity to flexibly navigate hierarchical layers of autobiographical representations. On this view, past and future thoughts rely on two main systems-event simulation and autobiographical knowledge-that allow us to represent experiential contents that are decoupled from sensory input and to place these on a personal timeline scaffolded from conceptual knowledge of the content and structure of our life. The neural basis of this cognitive architecture is discussed, emphasizing the possible role of the medial pFC in integrating layers of autobiographical representations in the service of mental time travel.

Neuropathology of a remarkable case of memory impairment informs human memory

Kent Cochrane (K.C.) has been investigated by researchers for nearly three decades after intracranial trauma from a motorcycle accident at age 30 resulted in a striking profile of amnesia. K.C. suffered severe anterograde amnesia in both verbal and non-verbal domains which was accompanied by selective retrograde amnesia for personal events experienced prior to the time of his injury (episodic memory), with relative preservation of memory for personal and world facts (semantic memory), and of implicit memory. This pattern of spared and impaired memory extended to spatial memory for large-scale environments and beyond memory to future imagining and decision-making. Post-mortem brain findings at age 62 included moderate diffuse atrophy, left orbitofrontal contusion, left posterior cerebral artery infarct, and left anterior frontal watershed infarct. Notably, there was severe neuronal loss and gliosis of the hippocampi bilaterally. The left hippocampus was severely affected anteriorly and posteriorly, but CA2, CA4, and the dentate gyrus (DG) were focally spared. There was associated degeneration of the left fornix. The right hippocampus showed near complete destruction anteriorly, with relative preservation posteriorly, mainly of CA4 and DG. Bilateral parahippocampal gyri and left anterior thalamus also showed neuron loss and gliosis. There was no evidence of co-existing neurodegenerative phenomena on beta-amyloid, phosphorylated tau, or TDP-43 immunostaining. The extent of damage to medial temporal lobe structures is in keeping with K.C.'s profound anterograde and retrograde amnesia, with the exception of the unexpected finding of preserved CA2/CA4 and DG. K.C.'s case demonstrates that relatively clean functional dissociations are still possible following widespread brain damage, with structurally compromised brain regions unlikely to be critical to cognitive functions found to be intact. In this way, the findings presented here add to K.C.'s significant contributions to our understanding of clinical-anatomical relationships in memory.

Scene construction impairments in frontotemporal dementia: Evidence for a primary hippocampal contribution

The capacity to generate naturalistic three-dimensional and spatially coherent representations of the world, i.e., scene construction, is posited to lie at the heart of a wide range of complex cognitive endeavours. Clinical populations with selective damage to key nodes of a putative scene construction network of the brain have provided important insights regarding the contribution of medial temporal and prefrontal regions in this regard. Here, we explored the capacity for atemporal scene construction, and its associated neural substrates, in the behavioural-variant of frontotemporal dementia (bvFTD); a neurodegenerative brain disorder in which atrophy systematically erodes medial and lateral prefrontal cortices with variable medial temporal lobe involvement. Nineteen bvFTD patients were compared to 18 typical Alzheimer's Disease (AD), and 25 healthy older Control participants on a scene construction task. Relative to Controls, both patient groups displayed marked impairments in generating contextually detailed and spatially coherent scenes, with bvFTD indistinguishable from AD patients across the majority of task metrics. Voxel-based morphometry, based on structural brain MRI, revealed divergent neural substrates of scene construction performance in each patient group. Despite widespread medial and lateral prefrontal atrophy, the capacity to generate richly detailed and spatially coherent scenes in bvFTD was found to rely predominantly upon the integrity of right medial temporal structures, including the hippocampus and parahippocampal gyrus. Scene construction impairments in AD, by contrast, hinged upon the integrity of posterior parietal brain regions. Our findings in bvFTD resonate with a large body of work implicating the right hippocampus in the construction of spatially integrated scene imagery. How these impairments relate to changes in autobiographical memory and prospection in bvFTD will be an important question for future studies to address.

Beyond a rod through the skull: A systematic review of lesion studies of the human ventromedial frontal lobe

Neuropsychological studies from the past century have associated damage to the ventromedial frontal lobes (VMF) with impairments in a variety of domains, including memory, executive function, emotion, social cognition, and valuation. A central question in the literature is whether these seemingly distinct functions are subserved by different sub-regions within the VMF, or whether VMF supports a broader cognitive process that is crucial to these varied domains. In this comprehensive review of the neuropsychological literature from the last two decades, we present a qualitative synthesis of 184 papers that have examined the psychological impairments that result from VMF damage. We discuss these findings in the context of several theoretical frameworks and advocate for the view that VMF is critical for the formation and representation of schema and cognitive maps.

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.

Dissociation between Private and Social Counterfactual Value Signals Following Ventromedial Prefrontal Cortex Damage

Individuals learn by comparing the outcome of chosen and unchosen actions. A negative counterfactual value signal is generated when this comparison is unfavorable. This can happen in private as well as in social settings—where the foregone outcome results from the choice of another person. We hypothesized that, despite sharing similar features such as supporting learning, these two counterfactual signals might implicate distinct brain networks. We conducted a neuropsychological study on the role of private and social counterfactual value signals in risky decision-making. Patients with lesions in the ventromedial prefrontal cortex (vmPFC), lesion controls, and healthy controls repeatedly chose between lotteries. In private trials, participants could observe the outcomes of their choices and the outcomes of the unselected lotteries. In social trials, participants could also see the other player's choices and outcome. At the time of outcome, vmPFC patients were insensitive to private counterfactual value signals, whereas their responses to social comparison were similar to those of control participants. At the time of choice, intact vmPFC was necessary to integrate counterfactual signals in decisions, although amelioration was observed during the course of the task, possibly driven by social trials. We conclude that if the vmPFC is critical in processing private counterfactual signals and in integrating those signals in decision-making, then distinct brain areas might support the processing of social counterfactual signals.

The Neural Dynamics of Novel Scene Imagery

Retrieval of long-term episodic memories is characterized by synchronized neural activity between hippocampus and ventromedial prefrontal cortex (vmPFC), with additional evidence that vmPFC activity leads that of the hippocampus. It has been proposed that the mental generation of scene imagery is a crucial component of episodic memory processing. If this is the case, then a comparable interaction between the two brain regions should exist during the construction of novel scene imagery. To address this question, we leveraged the high temporal resolution of MEG to investigate the construction of novel mental imagery. We tasked male and female humans with imagining scenes and single isolated objects in response to one-word cues. We performed source-level power, coherence, and causality analyses to characterize the underlying interregional interactions. Both scene and object imagination resulted in theta power changes in the anterior hippocampus. However, higher theta coherence was observed between the hippocampus and vmPFC in the scene compared with the object condition. This interregional theta coherence also predicted whether imagined scenes were subsequently remembered. Dynamic causal modeling of this interaction revealed that vmPFC drove activity in hippocampus during novel scene construction. Additionally, theta power changes in the vmPFC preceded those observed in the hippocampus. These results constitute the first evidence in humans that episodic memory retrieval and scene imagination rely on similar vmPFC–hippocampus neural dynamics. Furthermore, they provide support for theories emphasizing similarities between both cognitive processes and perspectives that propose the vmPFC guides the construction of context-relevant representations in the hippocampus.

SIGNIFICANCE STATEMENT Episodic memory retrieval is characterized by a dialog between hippocampus and ventromedial prefrontal cortex (vmPFC). It has been proposed that the mental generation of scene imagery is a crucial component of episodic memory processing. An ensuing prediction would be of a comparable interaction between the two brain regions during the construction of novel scene imagery. Here, we leveraged the high temporal resolution of MEG and combined it with a scene imagination task. We found that a hippocampal–vmPFC dialog existed and that it took the form of vmPFC driving the hippocampus. We conclude that episodic memory and scene imagination share fundamental neural dynamics and the process of constructing vivid, spatially coherent, contextually appropriate scene imagery is strongly modulated by vmPFC.

Measuring mental time travel: Is the hippocampus really critical for episodic memory and episodic foresight?

Mental time travel is an adaptive capacity that enables humans to engage in deliberate, prudent action on the basis of remembering past episodes (episodic memory) and simulating future scenarios (episodic foresight). This capacity has become a popular and rapidly growing topic of interdisciplinary research. Perhaps the most influential and frequently tested neuroscientific hypothesis in this domain is that the hippocampus is a hub in a critical neural network for mental time travel, support for which is now commonly assumed by most researchers in the area. In light of recent findings revealing limitations with existing measures of episodic foresight, we critically evaluate the available evidence for this hypothesis and find that it is inconclusive. We suggest that this is due in significant part to the exclusive and widespread reliance on noisy verbal measures and discuss this case as an example of a more general issue pertaining to the measurement of episodic foresight. Accordingly, we suggest that an essential focus of future research should concern the development of objective measures that capture capacity differences by requiring people to put foresight not just into words, but into action.

To do it now or later: The cognitive mechanisms and neural substrates underlying procrastination

Procrastination, the voluntary and irrational delay of an intended course of action, has troubled individuals and society extensively. Various studies have been conducted to explain why people procrastinate and to explore the neural substrates of procrastination. First, research has identified many contributing factors to procrastination. Specifically, task aversiveness, future incentives, and time delay of these incentives have been confirmed as three prominent task characteristics that affect procrastination. On the other hand, self-control and impulsivity have been identified as two most predictive traits of procrastination. After identifying contributing factors, two important theories proposed to explain procrastination by integrating these factors are reviewed. Specifically, an emotion-regulation perspective regards procrastination as a form of self-regulation failure that reflects giving priority to short-term mood repair over achieving long-term goals. However, temporal motivation theory explains why people's motivation to act increases when time approaches a deadline with time discounting effect. To further specify the cognitive mechanism underlying procrastination, this study proposes a novel theoretical model which clarifies how the motivation to act and the motivation to avoid vary differently when delaying a task, explaining why people decide not to act now but are willing to act in the future. Of note, few recent studies have investigated neural correlates of procrastination. Specifically, it was revealed that individual differences in procrastination are correlated with structural abnormalities and altered spontaneous metabolism in the parahippocampal cortex and the prefrontal cortex, which might contribute to procrastination through episodic future thinking or memory and emotion regulation, respectively. This article is categorized under: Economics > Individual Decision Making Psychology > Theory and Methods Psychology > Emotion and Motivation Psychology > Reasoning and Decision Making.

Social, self, (situational), and affective processes in medial prefrontal cortex (MPFC): Causal, multivariate, and reverse inference evidence

The medial prefrontal cortex (MPFC) has been posited to serve a variety of social, affective, and cognitive functions. These conclusions have largely been driven by forward inference analyses (e.g. GLM fMRI studies and meta-analyses) that indicate where domain-specific tasks tend to produce activity but tell us little about what those regions do. Here, we take a multi-method, multi-domain approach to the functionality of MPFC subdivisions within Brodmann areas 9-11. We consider four methods that each have reverse inference or causal inference value: lesion work, transcranial magnetic stimulation, multivariate pattern analysis, and Neurosynth analyses. The Neurosynth analyses include multi-term reverse inference analyses that compare several domains of interest to one another at once. We examine the evidence supporting structure-function links in five domains: social cognition, self, value, emotional experience, and mental time travel. The evidence is considered for each of three MPFC subdivisions: dorsomedial prefrontal cortex (DMPFC), anteromedial prefrontal cortex (AMPFC), and ventromedial prefrontal cortex (VMPFC). Although there is evidentiary variability across methods, the results suggest that social processes are functionally linked to DMPFC (and somewhat surprisingly in VMPFC), self processes are linked to AMPFC, and affective processes are linked to AMPFC and VMPFC. There is also a relatively non-selective region of VMPFC that may support situational processing, a process key to each domain, but also independent of each.

Alexithymia and the Reduced Ability to Represent the Value of Aversively Motivated Actions

Alexithymia is a subclinical trait defined by difficulties in identifying and describing feelings and a cognitive style avoidant of introspection. Extensive literature shows that alexithymia is characterized by multifaceted impairments in processing emotional stimuli. Nevertheless, the mechanisms that may account for such impairments remain elusive. Here, we hypothesize that alexithymia may be understood as impairment in learning the emotional value of one’s own actions and test this comparing performance of participants with high (HA) and low (LA) levels of alexithymia on a probabilistic selection task. Results show that, compared to LA, HA need more time to learn the value of individual stimuli and associated actions as difference in reinforcement rate between stimuli decreases. In addition, HA appear less able to generalize the value of previously learned actions that lead to a negative outcome, to make adaptive choices in a new context, requiring more time to avoid the most negative stimulus between two negative stimuli. Together, the results indicate that individuals with alexithymia show impaired learning of the value of aversively motivated actions. We argue that this impairment may hinder the construction of internal representations of emotional stimuli and actions and represent a mechanism that may account for the difficulties of alexithymia in processing emotional stimuli.

Boundary extension is attenuated in patients with ventromedial prefrontal cortex damage

The ventromedial prefrontal cortex (vmPFC) and hippocampus have been implicated in the mental construction of scenes and events. However, little is known about their specific contributions to these cognitive functions. Boundary extension (BE) is a robust indicator of fast, automatic, and implicit scene construction. BE occurs when individuals who are viewing scenes automatically imagine what might be beyond the view, and consequently later misremember having seen a greater expanse of the scene. Patients with hippocampal damage show attenuated BE because of their scene construction impairment. In the current study, we administered BE tasks to patients with vmPFC damage, brain-damaged control patients, and healthy control participants. We also contrasted the performance of these patients to the previously-published data from patients with hippocampal lesions (Mullally, Intraub, & Maguire, 2012). We found that vmPFC-damaged patients showed reduced BE compared to brain-damaged and healthy controls. Indeed, BE attenuation was similar following vmPFC or hippocampal damage. Notably, however, whereas hippocampal damage seems to particularly impair the spatial coherence of scenes, vmPFC damage leads to a difficulty constructing scenes in a broader sense, with the prediction of what should be in a scene, and the monitoring or integration of the scene elements being particularly compromised. We conclude that vmPFC and hippocampus play important and complementary roles in scene construction.

Comparing and Contrasting the Cognitive Effects of Hippocampal and Ventromedial Prefrontal Cortex Damage: A Review of Human Lesion Studies

The hippocampus and ventromedial prefrontal cortex (vmPFC) are closely connected brain regions whose functions are still debated. In order to offer a fresh perspective on understanding the contributions of these two brain regions to cognition, in this review we considered cognitive tasks that usually elicit deficits in hippocampal-damaged patients (e.g., autobiographical memory retrieval), and examined the performance of vmPFC-lesioned patients on these tasks. We then took cognitive tasks where performance is typically compromised following vmPFC damage (e.g., decision making), and looked at how these are affected by hippocampal lesions. Three salient motifs emerged. First, there are surprising gaps in our knowledge about how hippocampal and vmPFC patients perform on tasks typically associated with the other group. Second, while hippocampal or vmPFC damage seems to adversely affect performance on so-called hippocampal tasks, the performance of hippocampal and vmPFC patients clearly diverges on classic vmPFC tasks. Third, although performance appears analogous on hippocampal tasks, on closer inspection, there are significant disparities between hippocampal and vmPFC patients. Based on these findings, we suggest a tentative hierarchical model to explain the functions of the hippocampus and vmPFC. We propose that the vmPFC initiates the construction of mental scenes by coordinating the curation of relevant elements from neocortical areas, which are then funneled into the hippocampus to build a scene. The vmPFC then engages in iterative re-initiation via feedback loops with neocortex and hippocampus to facilitate the flow and integration of the multiple scenes that comprise the coherent unfolding of an extended mental event.

Neuropsychological Investigations of Human Amnesia: Insights Into the Role of the Medial Temporal Lobes in Cognition

The past 30 years of research on human amnesia has yielded important changes in our understanding of the role of the medial temporal lobes (MTL) in memory. On the one hand, this body of evidence has highlighted that not all types of memory are impaired in patients with MTL lesions. On the other hand, this research has made apparent that the role of the MTL extends beyond the domain of long-term memory, to include working memory, perception, and future thinking. In this article, we review the discoveries and controversies that have characterized this literature and that set the stage for a new conceptualization of the role of the MTL in cognition. This shift toward a more nuanced understanding of MTL function has direct relevance for a range of clinical disorders in which the MTL is implicated, potentially shaping not only theoretical understanding but also clinical practice. (JINS, 2017, 23, 732-740).

Human lesion studies of ventromedial prefrontal cortex

Studies of neurological patients with focal lesions involving ventromedial prefrontal cortex (vmPFC) have demonstrated a critical role for this brain area in various aspects of cognition, emotion, and behavior. In this article, we review the key themes, methods, and findings from neuropsychological research on vmPFC lesion patients. Early case studies demonstrated profound disruptions in personality and behavior following vmPFC damage, including blunted affect, poor decision-making, and inappropriate social behavior. Subsequent laboratory investigations with groups of vmPFC lesion patients have revealed deficits in a host of interrelated functions, such as value-based decision-making, future and counterfactual thinking, physiological arousal to emotional stimuli, emotion recognition, empathy, moral judgment, and memory confabulation. The compendium of findings described here demonstrates that vmPFC is crucial for diverse aspects of adaptive function.

Hippocampal Damage Increases Deontological Responses during Moral Decision Making

Complex moral decision making is associated with the ventromedial prefrontal cortex (vmPFC) in humans, and damage to this region significantly increases the frequency of utilitarian judgments. Since the vmPFC has strong anatomical and functional links with the hippocampus, here we asked how patients with selective bilateral hippocampal damage would derive moral decisions on a classic moral dilemmas paradigm. We found that the patients approved of the utilitarian options significantly less often than control participants, favoring instead deontological responses—rejecting actions that harm even one person. Thus, patients with hippocampal damage have a strikingly opposite approach to moral decision making than vmPFC-lesioned patients. Skin-conductance data collected during the task showed increased emotional arousal in the hippocampal-damaged patients and they stated that their moral decisions were based on emotional instinct. By contrast, control participants made moral decisions based on the integration of an adverse emotional response to harming others, visualization of the consequences of one's action, and the rational re-evaluation of future benefits. This integration may be disturbed in patients with either hippocampal or vmPFC damage. Hippocampal lesions decreased the ability to visualize a scenario and its future consequences, which seemed to render the adverse emotional response overwhelmingly dominant. In patients with vmPFC damage, visualization might also be reduced alongside an inability to detect the adverse emotional response, leaving only the utilitarian option open. Overall, these results provide insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions.

SIGNIFICANCE STATEMENT The ventromedial prefrontal cortex (vmPFC) is closely associated with the ability to make complex moral judgements. When this area is damaged, patients become more utilitarian (the ends justify the means) and have decreased emotional arousal during moral decision making. The vmPFC is closely connected with another brain region—the hippocampus. In this study we found that patients with selective bilateral hippocampal damage show a strikingly opposite response pattern to those with vmPFC damage when making moral judgements. They rejected harmful actions of any kind (thus their responses were deontological) and showed increased emotional arousal. These results provide new insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions.

Episodic Future Thinking: Mechanisms and Functions

Episodic future thinking refers to the capacity to imagine or simulate experiences that might occur in one's personal future. Cognitive, neuropsychological, and neuroimaging research concerning episodic future thinking has accelerated during recent years. This article discusses research that has delineated cognitive and neural mechanisms that support episodic future thinking as well as the functions that episodic future thinking serves. Studies focused on mechanisms have identified a core brain network that underlies episodic future thinking and have begun to tease apart the relative contributions of particular regions in this network, and the specific cognitive processes that they support. Studies concerned with functions have identified several domains in which episodic future thinking produces performance benefits, including decision making, emotion regulation, prospective memory, and spatial navigation.

Ventromedial prefrontal damage reduces mind-wandering and biases its temporal focus

Mind-wandering, an ubiquitous expression of humans' mental life, reflects a drift of attention away from the current task towards self-generated thoughts, and has been associated with activity in the brain default network. To date, however, little is understood about the contribution of individual nodes of this network to mind-wandering. Here, we investigated whether the ventromedial prefrontal cortex (vmPFC) is critically involved in mind-wandering, by studying the propensity to mind-wander in patients with lesion to the vmPFC (vmPFC patients), control patients with lesions not involving the vmPFC, and healthy individuals. Participants performed three tasks varying in cognitive demands while their thoughts were periodically sampled, and a self-report scale of daydreaming in daily life. vmPFC patients exhibited reduced mind-wandering rates across tasks, and claimed less frequent daydreaming, than both healthy and brain-damaged controls. vmPFC damage reduced off-task thoughts related to the future, while it promoted those about the present. These results indicate that vmPFC critically supports mind-wandering, possibly by helping to construct future-related scenarios and thoughts that have the potential to draw attention inward, away from the ongoing tasks.

Novel Therapeutics for Addiction: Behavioral and Neuroeconomic Approaches

The maturing fields of behavioral- and neuro-economics provides conceptual understanding of the Competing Neurobehavioral Decision Systems theory (CNDS) and reinforcer pathology (i.e. high valuation of and excessive preference for drug reinforcers) allowing us to coherently categorize treatments into a theoretically comprehensive framework of addiction. In this chapter, we identify and clarify how existing and novel interventions can ameliorate reinforcer pathology in light of the CNDS and be leveraged to treat addiction.

The role of personal goals in autonoetic experience when imagining future events

Although autonoetic experience-a sense of mental time travel-has been considered as the hallmark of episodic future thinking, what determines this subjective feeling is not yet fully understood. Here, we investigated the role of autobiographical knowledge by manipulating the relevance of imagined events for personal goals. Participants were asked to imagine three types of events (goal-related future events, experimenter-provided future events, and atemporal events) and to assess various characteristics of their mental representations. The results showed that the three types of events were represented with similar levels of detail and vividness. Importantly, however, goal-related future events were associated with a stronger autonoetic experience. Furthermore, autonoetic experience was significantly predicted by the importance of imagined events for personal goals. These findings suggest that the subjective feeling of pre-experiencing one's personal future in part depends on the extent to which imagined events can be placed in an autobiographical context.