Journal
CEREBRAL CORTEX
Volume 26, Issue 12, Pages 4590-4601Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cercor/bhv220
Keywords
choice; confabulation; metacognition; reward; valuation confidence
Categories
Funding
- Natural Sciences and Engineering Research Council of Canada [378291]
- Centre for Stroke Recovery [209903]
- FP6 Marie-Curie International Recruitment Grant (European Union) [MIRG-CT-2006-046544]
- Natural Sciences and Engineering Research Council of Canada Canadian Graduate Scholarship-Masters
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The ventromedial prefrontal cortex (vmPFC) prominently and separately features in neurobiological models of decision-making (e.g., value-encoding) and of memory (e.g., automatic veracity-monitoring). Recent decision-making models propose value judgments that inherently comprise of second-order confidence estimates. These demonstrate quadratic relationships with first-order judgments and are automatically encoded in vmPFC activity. Memory studies use Quantity-Accuracy Profiles to capture similar first-order and second-order meta-mnemonic processes, suggesting convergence across domains. Patients with PFC damage answered general knowledge questionnaires under 2 conditions. During forced report, they chose an answer and rated the probability of it being correct (first-order monitoring). During free report, they could choose to volunteer or withhold their previous answers (second-order control) to maximize performance. We found quadratic relationships between first-order and second-order meta-mnemonic processes; voxel-based lesion-symptom mapping demonstrated that vmPFC damage diminished that relationship. Furthermore, damage to subcallosal vmPFC was specifically associated with impaired monitoring and additional damage to posterior orbitofrontal cortex led to deficient control. In decision-making, these regions typically support valuation and choice, respectively. Persistent spontaneous confabulation (false memory production) confirmed the clinical relevance of these dissociations. Compared with patients with no confabulation history, patients who currently confabulate were impaired on both monitoring and control, whereas former confabulators demonstrated impaired monitoring but intact control.
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