Lesion mapping of cognitive control and value-based decision making in the prefrontal cortex
- Divisions of aHumanities and Social Sciences and
- cBiology, California Institute of Technology, Pasadena, CA 91125;
- bInstitute for Systems Neuroscience, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
- dDana and David Dornsife Cognitive Neuroscience Imaging Institute and
- eBrain and Creativity Institute, University of Southern California, Los Angeles, CA 90089;
- fDepartment of Psychiatry, McGill University, Montreal, QC, Canada H3A 1A1; and
- Departments of gNeurology and
- hPsychology, University of Iowa, Iowa City, IA 52242
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Edited by Marcus E. Raichle, Washington University in St. Louis, St. Louis, MO, and approved July 26, 2012 (received for review April 19, 2012)

Abstract
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.
Footnotes
- ↵1To whom correspondence may be addressed. E-mail: glaescher{at}uke.uni-hamburg.de, radolphs{at}caltech.edu, or daniel-tranel{at}uiowa.edu.
Author contributions: J.G. and R.A. designed research; H.D., A.B., D.R., M.C., and D.T. performed research; J.G., R.A., M.C., and L.K.P. analyzed data; and J.G., R.A., H.D., A.B., D.R., L.K.P., and D.T. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1206608109/-/DCSupplemental.