期刊
BRAIN
卷 140, 期 -, 页码 1743-1756出版社
OXFORD UNIV PRESS
DOI: 10.1093/brain/awx105
关键词
vmPFC; devaluation; reward; instrumental; decision-making
资金
- McDonnell Foundation Collaborative Action Award [220020387]
- Kiwanis Foundation
- NIH Predoctoral Training Award [T32 GM108540]
- Conte Center from NIMH [1 P50 MH094258-04A1]
Neuroimaging studies suggest that the human ventromedial prefrontal cortex is a key region for goal-directed behaviour. However, it remains unclear whether the ventromedial prefrontal cortex is necessary for such behaviour. Here we used a canonical test from the animal literature designed to distinguish goal-directed from habit-based choice: namely, outcome devaluation. Patients with focal damage to the ventromedial prefrontal cortex showed deficits in goal-directed choice by persistently selecting actions for a food outcome that had been devalued through selective satiation. By contrast, the same patients had entirely intact acquisition of instrumental contingencies, demonstrating preserved habitual control, and also gave normal ratings of the hedonic value of the devalued food. These findings for the first time demonstrate a necessary and selective role for the human ventromedial prefrontal cortex in goal-directed choice, reconciling prior neuroimaging results in humans with lesion studies in animals, and providing a mechanistic explanation of the real-life deficits in decision-making that have been documented in patients with damage to this structure.
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