Phineas gauged: decision-making and the human prefrontal cortex

Sinful pleasures and pious woes? Using fMRI to examine evaluative and hedonic emotion knowledge

Traditionally, lust and pride have been considered pleasurable, yet sinful in the West. Conversely, guilt is often considered aversive, yet valuable. These emotions illustrate how evaluations about specific emotions and beliefs about their hedonic properties may often diverge. Evaluations about specific emotions may shape important aspects of emotional life (e.g. in emotion regulation, emotion experience and acquisition of emotion concepts). Yet these evaluations are often understudied in affective neuroscience. Prior work in emotion regulation, affective experience, evaluation/attitudes and decision-making point to anterior prefrontal areas as candidates for supporting evaluative emotion knowledge. Thus, we examined the brain areas associated with evaluative and hedonic emotion knowledge, with a focus on the anterior prefrontal cortex. Participants (N = 25) made evaluative and hedonic ratings about emotion knowledge during functional magnetic resonance imaging (fMRI). We found that greater activity in the medial prefrontal cortex (mPFC), ventromedial PFC (vmPFC) and precuneus was associated with an evaluative (vs hedonic) focus on emotion knowledge. Our results suggest that the mPFC and vmPFC, in particular, may play a role in evaluating discrete emotions.

The Role of Leadership Level in College Students' Decision-Making: Evidence From Event-Related Potential Analysis

Although risk decision-making plays an important role in leadership practice, the distinction in behavior between humans with differing levels of leadership, as well as the underlying neurocognitive mechanisms involved, remain unclear. In this study, the Ultimatum Game (UG) was utilized in concert with electroencephalograms (EEG) to investigate the temporal course of cognitive and emotional processes involved in economic decision-making between high and low leadership level college students. Behavioral results from this study found that the acceptance rates in an economic transaction, when the partner was a computer under unfair/sub unfair condition, were significantly higher than in transactions with real human partners for the low leadership group, while there was no significant difference in acceptance rates for the high leadership group. Results from Event-Related Potentials (ERP) analysis further indicated that there was a larger P3 amplitude in the low leadership group than in the high leadership group. We concluded that the difference between high and low leadership groups was at least partly due to their different emotional management abilities.

Designing comprehensible healthcare public reports: An investigation of the use of narratives and tests of quality metrics to support healthcare public report sensemaking

A key challenge for designers of healthcare public reports is the development of a presentation format that accurately communicates the variability in the quality of care among healthcare systems. This study conducted in the United States explored whether presenting public report information within narratives and with tests of healthcare quality metrics supported the public report sensemaking process. The study involved 200 participants and employed a 2 (public report information presented in the standard format, presented within a narrative) * 2 (no tests of quality metrics added to standard report, metrics tests added) between-subjects experimental design. The participants viewed the scenario of a patient looking for dialysis facility-related information. They were then asked which dialysis facility they would choose for their care and their level of confidence in their choice. Subsequently, a knowledge quiz evaluating how the participants interpreted the information presented to them, the NASA-TLX workload survey, and a usability questionnaire were administered. The results showed that the probability of choosing the better facility from the perspective of the quality measures included in the report changed from 0.69 to 0.89 when information was presented within a narrative rather than with the standard public report format. The results also found a significantly higher comprehension score (M = 54.58, SD = 18.51) when information was presented within the narrative than when presented in the standard public report format (M = 44.57, SD = 25.13). When information was presented to the participants within a narrative, the narrative may have enabled the participants to visualize themselves as the person depicted in the narrative and this may have increased the perceived relevance of the quality measures. Total workload, mental demand and perceived usability were higher when information was presented within the narrative than when presented in the standard format. The high workload and mental demand may be due to the stress placed on the information processing channels while reading a narrative and the effort expended to relate it to the quality measures. They may also be markers of more deliberative decision making facilitated by the narratives. No significant effect of tests of quality metrics was found on the dependent variables of choice of the better healthcare facility, comprehension, and usability. There was also no significant effect of quality metrics tests on overall workload. However, the effect of quality metrics tests on the mental demand subscale of NASA-TLX was significant. Mental demand was higher without quality metrics tests than with quality metrics tests. No significant interaction was found between the two independent variables on the dependent variables of choice of the better healthcare facility, comprehension, workload, and usability. It is recommended that narratives be used to present public report information to support informed healthcare decisions.

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.

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.

The Cognitive Neuroscience of Human Decision Making: A Review and Conceptual Framework

Decision making, the process of choosing between options, is a fundamental human behavior that has been studied intensively by disciplines ranging from cognitive psychology to economics. Despite the importance of this behavior, the neural substrates of decision making are only beginning to be understood. Impaired decision making is recognized in neuropsychiatric conditions such as dementia and drug addiction, and the inconsistencies and biases of healthy decision makers have been intensively studied. However, the tools of cognitive neuroscience have only recently been applied to understanding the brain basis of this complex behavior. This article reviews the literature on the cognitive neuroscience of human decision making, focusing on the roles of the frontal lobes, and provides a conceptual framework for organizing this disparate body of work.

Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety

BACKGROUND

Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review.

SCOPE AND METHODOLOGY

We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes.

FINDINGS AND CONCLUSION

Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research.

Insular neural system controls decision-making in healthy and methamphetamine-treated rats

Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making.

Genetic polymorphisms and traumatic brain injury: the contribution of individual differences to recovery

Recovery after Traumatic Brain Injury (TBI) is variable, even for patients with similar severity of brain injury. Recent research has highlighted the contribution that genetic predisposition plays in determining TBI outcome. This review considers the potential for genetic polymorphisms to influence recovery of cognitive and social processes following TBI. Limitations and considerations that researchers should make when assessing the potential impact of polymorphisms on TBI outcome are also discussed. Understanding the genetic factors that support neuroplasticity will contribute to an understanding of the variation in outcome following injury and help to identify potential targets for rehabilitation.

Effects of working memory load on uncertain decision-making: evidence from the Iowa Gambling Task

The Iowa Gambling Task (IGT) simulates uncertain gains and losses in real life situations and thus is a good measure of uncertain decision-making. The role of working memory (WM) in IGT performance still remains unclear. The present study aimed to examine the effect of WM on IGT performance. Three groups of participants matched on gender ratio were randomly assigned to no WM load, low WM load, and high WM load conditions. Initially the three groups did not show significant difference in WM capacity. They finished a modified version of IGT and then their implicit learning effect and explicit cognition on IGT were assessed. Results indicated a linear increasing trend of IGT performance among high WM load, low WM load and no WM load groups; participants in the no WM load and low WM load groups revealed implicit learning effect, while participants in the high WM load group did not; all participants showed explicit cognition on IGT to the same level. These results suggested that participants in the high WM load group showed good explicit cognition to IGT but showed poor performance. This pattern is similar to frontal patients. Further studies should be conducted to explore this issue.

Economic risk coding by single neurons in the orbitofrontal cortex

Risk is a ubiquitous feature of the environment for all organisms. Very few things in life are achieved with absolute certainty. Therefore, it is essential that organisms process risky information efficiently to promote adaptive behaviour and enhance survival. Here we outline a clear definition of economic risk derived from economic theory and focus on two experiments in which we have shown subpopulations of single neurons in the orbitofrontal cortex of rhesus macaques that code either economic risk per se or an error-related risk signal, namely a risk prediction error. These biological risk signals are essential for processing and updating risky information in the environment to contribute to efficient decision making and adaptive behaviour.

Risk-sensitive decision-making in patients with posterior parietal and ventromedial prefrontal cortex injury

Successful choice under risk requires the integration of information about outcome probabilities and values and implicates a brain network including the ventromedial prefrontal cortex (vmPFC) and posterior parietal cortex (pPAR). Damage to the vmPFC is linked to poor decision-making and increased risk-taking. Electrophysiological and neuroimaging data implicate the pPAR in the processing of reward probability during choice, but the causal contribution of this area has not been established. We compared patients with lesions to the pPAR (n = 13), vmPFC (n = 13), and healthy volunteers (n = 22) on the Roulette Betting Task, a measure of risk-sensitive decision-making. Both lesion groups were impaired in adjusting their bets to the probability of winning. This impairment was correlated with the extent of pPAR, but not vmPFC, damage. In addition, the vmPFC group chose higher bets than healthy controls overall, an effect that correlated with lesion volume in the medial orbitofrontal cortex. Both lesion groups earned fewer points than healthy controls. The groups did not differ on 2 tasks assessing probabilistic reasoning outside of a risk-reward context. Our results demonstrate the causal involvement of both the pPAR and vmPFC in risk-sensitive choice and indicate distinguishable roles of these areas in probability processing and risk appetite.

Processing of action- but not stimulus-related prediction errors differs between active and observational feedback learning

Learning of stimulus-response-outcome associations is driven by outcome prediction errors (PEs). Previous studies have shown larger PE-dependent activity in the striatum for learning from own as compared to observed actions and the following outcomes despite comparable learning rates. We hypothesised that this finding relates primarily to a stronger integration of action and outcome information in active learners. Using functional magnetic resonance imaging, we investigated brain activations related to action-dependent PEs, reflecting the deviation between action values and obtained outcomes, and action-independent PEs, reflecting the deviation between subjective values of response-preceding cues and obtained outcomes. To this end, 16 active and 15 observational learners engaged in a probabilistic learning card-guessing paradigm. On each trial, active learners saw one out of five cues and pressed either a left or right response button to receive feedback (monetary win or loss). Each observational learner observed exactly those cues, responses and outcomes of one active learner. Learning performance was assessed in active test trials without feedback and did not differ between groups. For both types of PEs, activations were found in the globus pallidus, putamen, cerebellum, and insula in active learners. However, only for action-dependent PEs, activations in these structures and the anterior cingulate were increased in active relative to observational learners. Thus, PE-related activity in the reward system is not generally enhanced in active relative to observational learning but only for action-dependent PEs. For the cerebellum, additional activations were found across groups for cue-related uncertainty, thereby emphasising the cerebellum's role in stimulus-outcome learning.

Neural mechanisms underlying context-dependent shifts in risk preferences

Studies of risky decision-making have demonstrated that humans typically prefer risky options after incurring a financial loss, while generally preferring safer options after a monetary gain. Here, we examined the neural processes underlying these inconsistent risk preferences by investigating the evaluation of gains and losses, and demonstrating how these responses can impact subsequent preference for either risky or safe choice options. Participants performed a task while undergoing fMRI in which they experienced both gains and losses. Immediately following a gain or loss, participants decided to either play or pass on a "double-or-quits" gamble. The outcome of the gamble could either double or eliminate their initial gain (from the time-estimation task) or redeem or double their initial loss. If they chose not to play this gamble, they retained the initial gain or loss. We demonstrate a shift in risk-taking preferences for identical sets of gambles as a function of previous gains or losses, with participants showing a greater preference towards riskier decisions in the context of a prior loss. An interaction between evaluating gain/loss contexts and subsequent behavioral risk pattern revealed an increased BOLD response in the ventromedial prefrontal cortex (vmPFC), with stronger responses for both gambling in a loss context and safety in a gain context. This suggests that the vmPFC is responsible for integrating these contextual effects, with these processes impacting on subsequent risky choice.

Risk prediction error coding in orbitofrontal neurons

Risk is a ubiquitous feature of life. It plays an important role in economic decisions by affecting subjective reward value. Informed decisions require accurate risk information for each choice option. However, risk is often not constant but changes dynamically in the environment. Therefore, risk information should be updated to the current risk level. Potential mechanisms involve error-driven updating, whereby differences between current and predicted risk levels (risk prediction errors) are used to obtain currently accurate risk predictions. As a major reward structure, the orbitofrontal cortex is involved in coding key reward parameters such as reward value and risk. In this study, monkeys viewed different visual stimuli indicating specific levels of risk that deviated from the overall risk predicted by a common earlier stimulus. A group of orbitofrontal neurons displayed a risk signal that tracked the discrepancy between current and predicted risk. Such neuronal signals may be involved in the updating of risk information.

Lesion mapping of cognitive control and value-based decision making in the prefrontal cortex

A considerable body of previous research on the prefrontal cortex (PFC) has helped characterize the regional specificity of various cognitive functions, such as cognitive control and decision making. Here we provide definitive findings on this topic, using a neuropsychological approach that takes advantage of a unique dataset accrued over several decades. We applied voxel-based lesion-symptom mapping in 344 individuals with focal lesions (165 involving the PFC) who had been tested on a comprehensive battery of neuropsychological tasks. Two distinct functional-anatomical networks were revealed within the PFC: one associated with cognitive control (response inhibition, conflict monitoring, and switching), which included the dorsolateral prefrontal cortex and anterior cingulate cortex and a second associated with value-based decision-making, which included the orbitofrontal, ventromedial, and frontopolar cortex. Furthermore, cognitive control tasks shared a common performance factor related to set shifting that was linked to the rostral anterior cingulate cortex. By contrast, regions in the ventral PFC were required for decision-making. These findings provide detailed causal evidence for a remarkable functional-anatomical specificity in the human PFC.

Genetic polymorphisms influence recovery from traumatic brain injury

Traumatic brain injury (TBI) is a major public health concern in both civilian and military populations. Recently, genetics studies have begun to identify individual differences in polymorphisms that could affect recovery and outcome of cognitive and social processes following TBI. This review considers the potential for polymorphisms to influence six specific cognitive and social functions, which represent the most prominent domains of impairment following TBI: working memory, executive function, decision making, inhibition and impulsivity, aggression, and social and emotional function. Examining the influence of polymorphisms on TBI outcome has the potential to contribute to an understanding of variations in TBI outcome, aid in the triaging and treatment of TBI patients, and ultimately lead to targeted interventions based on genetic profiles.

Sentence processing in Lewy body spectrum disorder: the role of working memory

Prior work has related sentence processing to executive deficits in non-demented patients with Parkinson's disease (PD). We extended this investigation to patients with dementia with Lewy bodies (DLB) and PD dementia (PDD) by examining grammatical and working memory components of sentence processing in the full range of patients with Lewy body spectrum disorder (LBSD). Thirty-three patients with LBSD were given a two-alternative, forced-choice sentence-picture matching task. Sentence type, working memory, and grammatical structure were systematically manipulated in the sentences. We found that patients with PDD and DLB were significantly impaired relative to non-demented PD patients and healthy controls. The deficit in PDD/DLB was most pronounced for sentences lengthened by the strategic placement of an additional prepositional phrase and for sentences with an additional proposition due to a center-embedded clause. However, there was no effect for subject-relative versus object-relative grammatical structure. An MRI voxel-based morphometry analysis in a subset of patients showed significant gray matter thinning in the frontal lobe bilaterally, and this extended to temporal, parietal and occipital regions. A regression analysis related sentence processing difficulty in LBSD to frontal neocortex, including inferior prefrontal, premotor, and dorsolateral prefrontal regions, as well as right superior temporal cortex. These findings are consistent with the hypothesis that patients with PDD and DLB have difficulty processing sentences with increased working memory demands and that this deficit is related in part to their frontal disease.

Neural processes of an indirect analog of risk taking in young nondependent adult alcohol drinkers-an FMRI study of the stop signal task

BACKGROUND

Alcohol abuse and dependence are common problems in the United States that stem from a variety of factors, one of which may be a period of high level social drinking during college and early adulthood. Extant study implicates risk taking as a cognitive factor that contributes to habitual and heavy drinking. We sought to examine the neural processes of risk taking in young, nondependent drinkers.

METHODS

We compared 20 young adult social drinkers with a high level of alcohol use (AH), as defined by number of drinks per month, and 21 demographically matched drinkers with low to moderate alcohol use (ALM) in a functional magnetic resonance imaging study of the stop signal task. By contrasting risk taking (speeded) to risk aversion (slowed) trials, we examined the neural correlates of risk taking. Brain imaging data were analyzed with Statistical Parametric Mapping. Regions of interest were identified and corresponding effect sizes were examined for correlations with self-reported alcohol use.

RESULTS

The results showed that, compared with ALM, AH demonstrated decreased activation in right superior frontal gyrus and left caudate nucleus when contrasting risk taking and risk aversion trials at p < 0.001, uncorrected. Furthermore, examination of the effect size data showed that the extent of these decreased regional activations correlated with frequency of drinking in women, but not men.

CONCLUSIONS

These findings suggest a neural analog of nondependent, high level drinking. Specifically, high level social drinking is associated with altered activation of the caudate and superior frontal cortex, an association that appears to be stronger in women than in men and is strongly tied to the frequency of drinking. These results are relevant in understanding risk taking behavior in social drinking as well as in examining the potential path from high level social use in young adults to dangerous alcohol consumption later in life.

Transcranial alternating current stimulation increases risk-taking behavior in the balloon analog risk task

The process of evaluating risks and benefits involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC). It has been proposed that in conflict and reward situations, theta-band (4–8 Hz) oscillatory activity in the frontal cortex may reflect an electrophysiological mechanism for coordinating neural networks monitoring behavior, as well as facilitating task-specific adaptive changes. The goal of the present study was to investigate the hypothesis that theta-band oscillatory balance between right and left frontal and prefrontal regions, with a predominance role to the right hemisphere (RH), is crucial for regulatory control during decision-making under risk. In order to explore this hypothesis, we used transcranial alternating current stimulation, a novel technique that provides the opportunity to explore the functional role of neuronal oscillatory activities and to establish a causal link between specific oscillations and functional lateralization in risky decision-making situations. For this aim, healthy participants were randomly allocated to one of three stimulation groups (LH stimulation/RH stimulation/Sham stimulation), with active AC stimulation delivered in a frequency-dependent manner (at 6.5 Hz; 1 mA peak-to-peak). During the AC stimulation, participants performed the Balloon Analog Risk Task. This experiment revealed that participants receiving LH stimulation displayed riskier decision-making style compared to sham and RH stimulation groups. However, there was no difference in decision-making behaviors between sham and RH stimulation groups. The current study extends the notion that DLPFC activity is critical for adaptive decision-making in the context of risk-taking and emphasis the role of theta-band oscillatory activity during risky decision-making situations.

Orbitofrontal contributions to human working memory

Although cognitive neuroscience has made remarkable progress in understanding the involvement of the prefrontal cortex in human memory, the necessity of the orbitofrontal cortex for key competencies of working memory remains largely unexplored. We therefore studied human brain lesion patients to determine whether the orbitofrontal cortex is necessary for working memory function, administering subtests of the Wechsler memory scale, the Wechsler adult intelligence scale, and the n-back task to 3 participant groups: orbitofrontal lesions (n = 24), prefrontal lesions not involving orbitofrontal cortex (n = 40), and no brain lesions (n = 54). Orbitofrontal damage was reliably associated with deficits on neuropsychological tests involving the coordination of working memory maintenance, manipulation, and monitoring processes (n-back task) but not on pure tests of working memory maintenance (digit/spatial span forward) or manipulation (digit/spatial span backward and letter-number sequencing). Our findings elucidate a central component of the neural architecture of working memory, providing key neuropsychological evidence for the necessity of the orbitofrontal cortex in executive control functions underlying the joint maintenance, manipulation, and monitoring of information in working memory.

"Studying injured minds" - the Vietnam head injury study and 40 years of brain injury research

The study of those who have sustained traumatic brain injuries (TBI) during military conflicts has greatly facilitated research in the fields of neuropsychology, neurosurgery, psychiatry, neurology, and neuroimaging. The Vietnam Head Injury Study (VHIS) is a prospective, long-term follow-up study of a cohort of 1,221 Vietnam veterans with mostly penetrating brain injuries, which has stretched over more than 40 years. The scope of this study, both in terms of the types of injury and fields of examination, has been extremely broad. It has been instrumental in extending the field of TBI research and in exposing pressing medical and social issues that affect those who suffer such injuries. This review summarizes the history of conflict-related TBI research and the VHIS to date, as well as the vast range of important findings the VHIS has established.

Distinct cognitive mechanisms in a gambling task share neural mechanisms

Distinct psychological processes have been proposed to unfold in decision-making. The time course of neural mechanisms supporting these processes has not been fully identified. The present MEG study examined spatio-temporal activity related to components of decision-making proposed to support reward valuation, reward prediction, and outcome evaluation. Each trial presented information on reward value (10 or 50 cents) and reward probability (10%, 50%, or 90%). Brain activity related to those inputs and to outcome feedback was evaluated via electromagnetic responses in source space. Distributed dipole activity reflected reward value and reward probability 150-350 ms after information arrival. Neural responses to reward-value information peaked earlier than those to reward-probability information. Results suggest that valuation, prediction, and outcome evaluation share neural structures and mechanisms even on a relatively fine time scale.

Recency gets larger as lesions move from anterior to posterior locations within the ventromedial prefrontal cortex

In the past two decades neuroimaging research has substantiated the important role of the prefrontal cortex (PFC) in decision-making. In the current study, we use the complementary lesion based approach to deepen our knowledge concerning the specific cognitive mechanisms modulated by prefrontal activity. Specifically, we assessed the brain substrates implicated in two decision making dimensions in a sample of prefrontal cortex patients: (a) the tendency to differently weigh recent compared to past experience; and (b) the tendency to differently weigh gains compared to losses. The participants performed the Iowa Gambling Task, a complex experience-based decision-making task, which was analyzed with a formal cognitive model (the Expectancy-Valance model). The results indicated that decisions become influenced by more recent, as opposed to older, events when the damage reaches the posterior sectors of the ventromedial prefrontal cortex (VMPC). Furthermore, the degree of this recency deficit was related to the size of the lesion. These results suggest that the posterior area of the prefrontal cortex directly modulates the capacity to use time-delayed information. In contrast, we did not find similar modulation for the sensitivity to gains versus losses.

Reward networks in the brain as captured by connectivity measures

An assortment of human behaviors is thought to be driven by rewards including reinforcement learning, novelty processing, learning, decision making, economic choice, incentive motivation, and addiction. In each case the ventral tegmental area/ventral striatum (nucleus accumbens) (VTA–VS) system has been implicated as a key structure by functional imaging studies, mostly on the basis of standard, univariate analyses. Here we propose that standard functional magnetic resonance imaging analysis needs to be complemented by methods that take into account the differential connectivity of the VTA–VS system in the different behavioral contexts in order to describe reward based processes more appropriately. We first consider the wider network for reward processing as it emerged from animal experimentation. Subsequently, an example for a method to assess functional connectivity is given. Finally, we illustrate the usefulness of such analyses by examples regarding reward valuation, reward expectation and the role of reward in addiction.

A functional imaging investigation of moral deliberation and moral intuition

Prior functional imaging studies of moral processing have utilized 'explicit' moral tasks that involve moral deliberation (e.g., reading statements such as 'he shot the victim' and rating the moral appropriateness of the behavior) or 'implicit' moral tasks that involve moral intuition (e.g., reading similar statements and memorizing them for a test but not rating their moral appropriateness). Although the neural mechanisms underlying moral deliberation and moral intuition may differ, these have not been directly compared. Studies using explicit moral tasks have reported increased activity in several regions, most consistently the medial prefrontal cortex and temporo-parietal junction. In the few studies that have utilized implicit moral tasks, medial prefrontal activity has been less consistent, suggesting the medial prefrontal cortex is more critical for moral deliberation than moral intuition. Thus, we hypothesized that medial prefrontal activity would be increased during an explicit, but not an implicit, moral task. Participants (n=28) were scanned using fMRI while viewing 50 unpleasant pictures, half of which depicted moral violations. Half of the participants rated pictures on moral violation severity (explicit task) while the other half indicated whether pictures occurred indoors or outdoors (implicit task). As predicted, participants performing the explicit, but not the implicit, task showed increased ventromedial prefrontal activity while viewing moral pictures. Both groups showed increased temporo-parietal junction activity while viewing moral pictures. These results suggest that the ventromedial prefrontal cortex may contribute more to moral deliberation than moral intuition, whereas the temporo-parietal junction may contribute more to moral intuition than moral deliberation.

Risk-dependent reward value signal in human prefrontal cortex

When making choices under uncertainty, people usually consider both the expected value and risk of each option, and choose the one with the higher utility. Expected value increases the expected utility of an option for all individuals. Risk increases the utility of an option for risk-seeking individuals, but decreases it for risk averse individuals. In 2 separate experiments, one involving imperative (no-choice), the other choice situations, we investigated how predicted risk and expected value aggregate into a common reward signal in the human brain. Blood oxygen level dependent responses in lateral regions of the prefrontal cortex increased monotonically with increasing reward value in the absence of risk in both experiments. Risk enhanced these responses in risk-seeking participants, but reduced them in risk-averse participants. The aggregate value and risk responses in lateral prefrontal cortex contrasted with pure value signals independent of risk in the striatum. These results demonstrate an aggregate risk and value signal in the prefrontal cortex that would be compatible with basic assumptions underlying the mean-variance approach to utility.

Explicit neural signals reflecting reward uncertainty

The acknowledged importance of uncertainty in economic decision making has stimulated the search for neural signals that could influence learning and inform decision mechanisms. Current views distinguish two forms of uncertainty, namely risk and ambiguity, depending on whether the probability distributions of outcomes are known or unknown. Behavioural neurophysiological studies on dopamine neurons revealed a risk signal, which covaried with the standard deviation or variance of the magnitude of juice rewards and occurred separately from reward value coding. Human imaging studies identified similarly distinct risk signals for monetary rewards in the striatum and orbitofrontal cortex (OFC), thus fulfilling a requirement for the mean variance approach of economic decision theory. The orbitofrontal risk signal covaried with individual risk attitudes, possibly explaining individual differences in risk perception and risky decision making. Ambiguous gambles with incomplete probabilistic information induced stronger brain signals than risky gambles in OFC and amygdala, suggesting that the brain's reward system signals the partial lack of information. The brain can use the uncertainty signals to assess the uncertainty of rewards, influence learning, modulate the value of uncertain rewards and make appropriate behavioural choices between only partly known options.

Differential effects of insular and ventromedial prefrontal cortex lesions on risky decision-making

The ventromedial prefrontal cortex (vmPFC) and insular cortex are implicated in distributed neural circuitry that supports emotional decision-making. Previous studies of patients with vmPFC lesions have focused primarily on decision-making under uncertainty, when outcome probabilities are ambiguous (e.g. the Iowa Gambling Task). It remains unclear whether vmPFC is also necessary for decision-making under risk, when outcome probabilities are explicit. It is not known whether the effect of insular damage is analogous to the effect of vmPFC damage, or whether these regions contribute differentially to choice behaviour. Four groups of participants were compared on the Cambridge Gamble Task, a well-characterized measure of risky decision-making where outcome probabilities are presented explicitly, thus minimizing additional learning and working memory demands. Patients with focal, stable lesions to the vmPFC (n = 20) and the insular cortex (n = 13) were compared against healthy subjects (n = 41) and a group of lesion controls (n = 12) with damage predominantly affecting the dorsal and lateral frontal cortex. The vmPFC and insular cortex patients showed selective and distinctive disruptions of betting behaviour. VmPFC damage was associated with increased betting regardless of the odds of winning, consistent with a role of vmPFC in biasing healthy individuals towards conservative options under risk. In contrast, patients with insular cortex lesions failed to adjust their bets by the odds of winning, consistent with a role of the insular cortex in signalling the probability of aversive outcomes. The insular group attained a lower point score on the task and experienced more 'bankruptcies'. There were no group differences in probability judgement. These data confirm the necessary role of the vmPFC and insular regions in decision-making under risk. Poor decision-making in clinical populations can arise via multiple routes, with functionally dissociable effects of vmPFC and insular cortex damage.

Working memory involved in predicting future outcomes based on past experiences

Deficits in working memory have been shown to contribute to poor performance on the Iowa Gambling Task [IGT: Bechara, A., & Martin, E.M. (2004). Impaired decision making related to working memory deficits in individuals with substance addictions. Neuropsychology, 18, 152-162]. Similarly, a secondary memory load task has been shown to impair task performance [Hinson, J., Jameson, T. & Whitney, P. (2002). Somatic markers, working memory, and decision making. Cognitive, Affective, & Behavioural Neuroscience, 2, 341-353]. In the present study, we investigate whether the latter findings were due to increased random responding [Franco-Watkins, A. M., Pashler, H., & Rickard, T. C. (2006). Does working memory load lead to greater impulsivity? Commentary on Hinson, Jameson, and Whitney's (2003). Journal of Experimental Psychology: Learning, Memory & Cognition, 32, 443-447]. Participants were tested under Low Working Memory (LWM; n=18) or High Working Memory (HWM; n=17) conditions while performing the Reversed IGT in which punishment was immediate and reward delayed [Bechara, A., Dolan, S., & Hindes, A. (2002). Decision making and addiction (part II): Myopia for the future or hypersensitivity to reward? Neuropsychologia, 40, 1690-1705]. In support of a role for working memory in emotional decision making, compared to the LWM condition, participants in the HWM condition made significantly greater number of disadvantageous selections than that predicted by chance. Performance by the HWM group could not be fully explained by random responding.

Modulation of human risky decision making by flunitrazepam

RATIONALE

GABA-modulating drugs produce disinhibitory effects that increase the probability of risk-taking behavior. Previous reports suggest that the misuse of the benzodiazepine flunitrazepam is associated with several forms of harmful risky behavior, including theft, violence, and intoxication-related auto accidents.

OBJECTIVES

The present study examined the dose-response relationships between acute flunitrazepam administration and human decision making under conditions of risk. The analyses also examined flunitrazepam-mediated changes in decision-making processes using a computational modeling approach, the expectancy valence model (EVM).

MATERIALS AND METHODS

Using a laboratory measure of risky decision making designed to address acute drug effects, 12 adults were administered placebo, 0.5, 1.0, and 2.0 mg/70 kg flunitrazepam in a within-subject, repeated measures counterbalanced design. Flunitrazepam was compounded and doses were administered in an 8-oz liquid solution. Primary data analyses examined subjective effects, response rates, distribution of choices between the risky and nonrisky option, and personality correlates related to peak drug effects. Individual-subject data were submitted to a computational modeling analysis (EVM) that provided parameter estimates corresponding to components of valence; updating expectancies about alternatives (learning/memory); and consistency between choices and expected outcomes (sensitivity to learned outcomes).

RESULTS

Flunitrazepam produced dose-related changes in subjective effects and response rates, and increased selection of the risky response option. High doses significantly changed decision-making processes related to the learning/memory and consistency parameters.

CONCLUSIONS

At sufficiently high doses, flunitrazepam can engender increases in risky decision making. Globally, these changes appear similar to previous effects we have observed after acute administration of alcohol and alprazolam. As suggested by the EVM outcomes, the mechanisms underlying the changes in risky decision making are more similar to alprazolam than alcohol.

Impulsivity and risk-taking behavior in focal frontal lobe lesions

Frontal lobe dysfunction may underlie excessively impulsive and risky behavior observed in a range of neurological disorders. We devised a gambling task to examine these behavior tendencies in a sample of patients who had sustained focal damage to the frontal lobes or nonfrontal cortical regions as well as in a matched sample of healthy control subjects. The main objectives of the study were: (1) to behaviorally dissociate impulsivity and risk-taking; (2) to examine potential associations between specific frontal lesion sites and impulsivity or risk-taking; (3) to investigate the influence of reinforcement and trial timing on both behaviors. Our results indicated that patients and controls were equally likely to perform impulsively. Risk-taking performance strategies, however, were related to left ventrolateral and orbital lesion sites. Moreover, risk-taking was also associated with blunted response alteration following a nonrewarded trial. Patients and control subjects showed identical responses to reward-timing manipulations consistent with formal decision-making theory. These findings suggest that ventrolateral and orbital lesions are related to the reward-based aspects of decision-making (risk-taking) rather than to simple response disinhibition (impulsivity). Reduced reaction to the negative consequences of one's actions may underlie this behavior pattern.

Using epsilon-greedy reinforcement learning methods to further understand ventromedial prefrontal patients' deficits on the Iowa Gambling Task

An important component of decision making is evaluating the expected result of a choice, using past experience. The way past experience is used to predict future rewards and punishments can have profound effects on decision making. The aim of this study is to further understand the possible role played by the ventromedial prefrontal cortex in decision making, using results from the Iowa Gambling Task (IGT). A number of theories in the literature offer potential explanations for the underlying cause of the deficit(s) found in bilateral ventromedial prefrontal lesion (VMF) patients on the IGT. An error-driven epsilon-greedy reinforcement learning method was found to produce a good match to both human normative and VMF patient groups from a number of studies. The model supports the theory that the VMF patients are less strategic (more explorative), which could be due to a working memory deficit, and are more reactive than healthy controls. This last aspect seems consistent with a 'myopia' for future consequences.

The role of ventromedial prefrontal cortex in decision making: judgment under uncertainty or judgment per se?

Ventromedial prefrontal cortex (VMF) is thought to be important in human decision making, but studies to date have focused on decision making under conditions of uncertainty, including risky or ambiguous decisions. Other lines of evidence suggest that this area of the brain represents quite basic information about the relative "economic" value of options, predicting a role for this region in value-based decision making even in the absence of uncertainty. We tested this prediction in human subjects with VMF damage. Preference judgment is a simple form of value-based decision making under certainty. We asked whether VMF damage in humans would lead to inconsistent preference judgments in a simple pairwise choice task. Twenty-one participants with focal damage to the frontal lobes were compared with 19 age- and education-matched control subjects. Subjects with VMF damage were significantly more inconsistent in their preferences than controls, whereas those with frontal damage that spared the VMF performed normally. These results argue that VMF plays a necessary role in certain as well as uncertain decision making in humans.

Hemispheric Specialization in Human Prefrontal Cortex for Resolving Certain and Uncertain Inferences

Uncertainty is a fact of life that must be accommodated in real-world decision making. Although it has been suggested that the right prefrontal cortex (PFC) has a special role to play in decision making under uncertainty, there is very little hard data to support this hypothesis. To better understand the roles of left and right PFCs in reasoning and decision making in situations with complete and incomplete information, we administered simple inference problems to 18 patients with lateralized focal lesions to PFC (9 right hemisphere, 9 left hemisphere) and 22 age- and education-matched normal controls. The stimuli were systematically manipulated for completeness of information regarding the status of the conclusion. Our results demonstrated a 2-way interaction such that patients with left PFC lesions were selectively impaired in trials with complete information, whereas patients with right PFC lesions were selectively impaired in trials with incomplete information. These results provide compelling evidence for hemispheric specialization for reasoning in PFC and suggest that the right PFC has a critical role to play in reasoning about incompletely specified situations. We postulate this role involves the maintenance of ambiguous mental representations that temper premature overinterpretation by the left hemisphere.

Reward value coding distinct from risk attitude-related uncertainty coding in human reward systems

When deciding between different options, individuals are guided by the expected (mean) value of the different outcomes and by the associated degrees of uncertainty. We used functional magnetic resonance imaging to identify brain activations coding the key decision parameters of expected value (magnitude and probability) separately from uncertainty (statistical variance) of monetary rewards. Participants discriminated behaviorally between stimuli associated with different expected values and uncertainty. Stimuli associated with higher expected values elicited monotonically increasing activations in distinct regions of the striatum, irrespective of different combinations of magnitude and probability. Stimuli associated with higher uncertainty (variance) elicited increasing activations in the lateral orbitofrontal cortex. Uncertainty-related activations covaried with individual risk aversion in lateral orbitofrontal regions and risk-seeking in more medial areas. Furthermore, activations in expected value-coding regions in prefrontal cortex covaried differentially with uncertainty depending on risk attitudes of individual participants, suggesting that separate prefrontal regions are involved in risk aversion and seeking. These data demonstrate the distinct coding in key reward structures of the two basic and crucial decision parameters, expected value, and uncertainty.