Chapter 13 - A neuropsychological perspective on the role of the prefrontal cortex in reward processing and decision-making

Abstract

The aim of this chapter is to highlight insights from the field of neuropsychology into prefrontal brain functions such as reward processing and decision-making. The ventromedial prefrontal cortex (VMPC) in humans plays important roles in cognition and emotion regulation. Lesions of the human ventromedial prefrontal cortex (VMPC) have been shown to impair higher-order behavioral guidance, social conduct, and emotional regulation, even though functions such as language, movement, and perception are spared. When the VMPC is damaged, patients fail to appreciate and take into account the long-term consequences of their decisions. Lesions of the VMPC also lead to an increase in utilitarian moral judgments and irrational responses to unfair social interactions, both of which have been attributed to emotional dysregulation. Aging has been shown to cause similar decision-making deficits in a substantial subset of older adults, suggesting that the VMPC region can be disproportionately affected by neurological aging.