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Intertemporal choices require trade-offs between short-term and long-term outcomes. Ventromedial prefrontal cortex (vmPFC) damage causes steep discounting of future rewards (delay discounting [DD]) and impoverished episodic future thinking (EFT). The role of vmPFC in reward valuation, EFT, and their interaction during intertemporal choice is still unclear. Here, 12 patients with lesions to vmPFC and 41 healthy controls chose between smaller-immediate and larger-delayed hypothetical monetary rewards while we manipulated reward magnitude and the availability of EFT cues. In the EFT condition, participants imagined personal events to occur at the delays associated with the larger-delayed rewards. We found that DD was steeper in vmPFC patients compared to controls, and not modulated by reward magnitude. However, EFT cues downregulated DD in vmPFC patients as well as controls. These findings indicate that vmPFC integrity is critical for the valuation of (future) rewards, but not to instill EFT in intertemporal choice., Competing Interests: EC, FD, DK, JM, FB, VK, CC, LG, JM, SR No competing interests declared, (© 2021, Ciaramelli et al.)

It has been suggested that the mental construction of scene imagery is a core process underpinning functions such as autobiographical memory, future thinking and spatial navigation. Damage to the ventromedial prefrontal cortex in humans can cause deficits in all of these cognitive domains. Moreover, it has also been reported that patients with ventromedial prefrontal cortex lesions are impaired at imagining fictitious scenes, although they seem able to describe specific scenes from autobiographical events. In general, not much is known about how ventromedial prefrontal cortex patients process scenes. Here, we deployed a recently-developed task to provide insights into this issue, which involved detecting either semantic (e.g. an elephant with butterflies for ears) or constructive (e.g. an endless staircase) violations in scene images. Identifying constructive violations typically provokes the formation of internal scene models in healthy control participants. We tested patients with bilateral ventromedial prefrontal cortex damage, brain-damaged control patients and healthy control participants. We found no evidence for statistically significant differences between the groups in detecting either type of violation. These results suggest that an intact ventromedial prefrontal cortex is not necessary for some aspects of scene processing, with implications for understanding its role in functions such as autobiographical memory and future thinking.

The ventromedial prefrontal cortex (vmPFC) and hippocampus have been implicated in the mental construction of scenes and events. However, little is known about their specific contributions to these cognitive functions. Boundary extension (BE) is a robust indicator of fast, automatic, and implicit scene construction. BE occurs when individuals who are viewing scenes automatically imagine what might be beyond the view, and consequently later misremember having seen a greater expanse of the scene. Patients with hippocampal damage show attenuated BE because of their scene construction impairment. In the current study, we administered BE tasks to patients with vmPFC damage, brain-damaged control patients, and healthy control participants. We also contrasted the performance of these patients to the previously-published data from patients with hippocampal lesions (Mullally, Intraub, & Maguire, 2012). We found that vmPFC-damaged patients showed reduced BE compared to brain-damaged and healthy controls. Indeed, BE attenuation was similar following vmPFC or hippocampal damage. Notably, however, whereas hippocampal damage seems to particularly impair the spatial coherence of scenes, vmPFC damage leads to a difficulty constructing scenes in a broader sense, with the prediction of what should be in a scene, and the monitoring or integration of the scene elements being particularly compromised. We conclude that vmPFC and hippocampus play important and complementary roles in scene construction., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The hippocampus and ventromedial prefrontal cortex (vmPFC) are closely connected brain regions whose functions are still debated. In order to offer a fresh perspective on understanding the contributions of these two brain regions to cognition, in this review we considered cognitive tasks that usually elicit deficits in hippocampal-damaged patients (e.g., autobiographical memory retrieval), and examined the performance of vmPFC-lesioned patients on these tasks. We then took cognitive tasks where performance is typically compromised following vmPFC damage (e.g., decision making), and looked at how these are affected by hippocampal lesions. Three salient motifs emerged. First, there are surprising gaps in our knowledge about how hippocampal and vmPFC patients perform on tasks typically associated with the other group. Second, while hippocampal or vmPFC damage seems to adversely affect performance on so-called hippocampal tasks, the performance of hippocampal and vmPFC patients clearly diverges on classic vmPFC tasks. Third, although performance appears analogous on hippocampal tasks, on closer inspection, there are significant disparities between hippocampal and vmPFC patients. Based on these findings, we suggest a tentative hierarchical model to explain the functions of the hippocampus and vmPFC. We propose that the vmPFC initiates the construction of mental scenes by coordinating the curation of relevant elements from neocortical areas, which are then funneled into the hippocampus to build a scene. The vmPFC then engages in iterative re-initiation via feedback loops with neocortex and hippocampus to facilitate the flow and integration of the multiple scenes that comprise the coherent unfolding of an extended mental event., (Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: Functional neuroimaging and lesion studies show that the ventromedial prefrontal cortex (vmPFC) is implicated in episodic future thinking (EFT), yet its role remains unclear. In this study, we sought to (a) confirm recent findings of impaired EFT in patients with lesions to the vmPFC (vmPFC patients) using a new task, and (b) investigate the influence of nonepisodic mechanisms, namely, narrative construction and working memory maintenance, on vmPFC patients' EFT performance., Method: vmPFC patients and healthy participants imagined future events using pictures as cues, described pictures, or described pictures while maintaining them in working memory after an observation phase., Results: Compared with the controls, vmPFC patients produced less specific reports across all conditions, as indicated by fewer internal (episodic) but a similar number of external (semantic) details. However, controlling for description and working memory performance did not eliminate group differences in EFT. Moreover, vmPFC damage reduced the proportion of internal-to-total details for EFT only., Conclusions: These results indicate that EFT problems in vmPFC patients are not merely the reflection of problems in maintaining in working memory and narrating events, but, more likely, of an impairment upstream, in creating novel events. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)