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 firstorder and second-order meta-mnemonic processes; voxel-based lesion-symptom mapping demonstrated that vmPFC damage diminished that relationship. Furthermore, damage to subcallosal vmPFCwas 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 confabulatewere impaired on both monitoring and control, whereas former confabulators demonstrated impaired monitoring but intact control.
Bibliographical noteFunding Information:
This work was supported by grants from the Natural Sciences and Engineering Research Council of Canada (grant 378291 to A.G.) and Centre for Stroke Recovery (grant 209903 to A.G.), as well as an FP6 Marie-Curie International Recruitment Grant (European Union; grant MIRG-CT-2006-046544 to A.G.). Additional support was provided by the Natural Sciences and Engineering Research Council of Canada Canadian Graduate Scholarship-Masters (to M.H.).
© The Author 2015.
- Valuation confidence
ASJC Scopus subject areas
- Cognitive Neuroscience
- Cellular and Molecular Neuroscience