The Multifaceted Role of the Ventromedial Prefrontal Cortex in Emotion, Decision Making, Social Cognition, and Psychopathology
Open accessAbstract
The ventromedial prefrontal cortex (vmPFC) has been implicated in a variety of social, cognitive, and affective functions that are commonly disrupted in mental illness. In this review, we summarize data from a diverse array of human and animal studies demonstrating that the vmPFC is a key node of cortical and subcortical networks that subserve at least three broad domains of psychological function linked to psychopathology. One track of research indicates that the vmPFC is critical for the representation of reward- and value-based decision making, through interactions with the ventral striatum and amygdala. A second track of research demonstrates that the vmPFC is critical for the generation and regulation of negative emotion, through its interactions with the amygdala, bed nucleus of the stria terminalis, periaqueductal gray, hippocampus, and dorsal anterior cingulate cortex. A third track of research shows the importance of the vmPFC in multiple aspects of social cognition, such as facial emotion recognition, theory-of-mind ability, and processing self-relevant information, through its interactions with the posterior cingulate cortex, precuneus, dorsomedial PFC, and amygdala. We then present meta-analytic data revealing distinct subregions within the vmPFC that correspond to each of these three functions, as well as the associations between these subregions and specific psychiatric disorders (depression, posttraumatic stress disorder, addiction, social anxiety disorder, bipolar disorder, schizophrenia, and attention-deficit/hyperactivity disorder). We conclude by describing several translational possibilities for clinical studies of vmPFC-based circuits, including neuropsychological assessment of transdiagnostic functions, anatomical targets for intervention, predictors of treatment response, markers of treatment efficacy, and subtyping within disorders.
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Cortical regions involved in emotional processing and decision-making, including the medial prefrontal cortex, anterior cingulate cortex, and insular cortex, have been implicated in social function in rodents and humans alike.
“Cortical regions involved in emotional processing and decision-making, including the mPFC, ACC, and IC, have also been implicated in social function in rodents and humans alike [81,82,83].”
From The Neurobiology of Love and Pair Bonding from Human and Animal Perspectives (2023) · cites this paper as [81]
The Social Cognition and Self-Relevance section links vmPFC to social cognition, and the Value and Decision-Making section describes decision-making evidence from rodents and humans. The paper does not establish the sentence’s broader claim about social function for the anterior cingulate and insular cortices in both species; its discussion of social cognition chiefly describes human vmPFC findings. The cited passages provide no page numbers. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMany structures of the social brain network and social decision-making network have been implicated in human social function.
“Many of the structures of the SBN and SDMN have been implicated in human social function [43,46,81].”
From The Neurobiology of Love and Pair Bonding from Human and Animal Perspectives (2023) · cites this paper as [81]
The Social Cognition and Self-Relevance section links vmPFC and amygdala to human social-cognitive functions. The Subregions Within vmPFC section also identifies dorsomedial PFC, precuneus, and temporoparietal cortex in a social-cognition activity network. However, the paper does not identify these regions as members of the SBN or SDMN, so it does not establish the claim about many structures of those particular networks. (LLM, conf=0.82)
Experimental — accuracy not yet measuredStructural abnormalities spanning the subgenual anterior cingulate cortex and orbitofrontal cortex emerge early in major depressive disorder and affect regions playing a key role in the regulation of negative emotion, value representation, and self-referential processing.
“Thus, structural abnormalities spanning the sgACC and OFC emerge early in MDD and affect regions playing a key role in the regulation of negative emotion, value representation, and self-referential processing [17].”
From Prefrontal cortex and depression (2022) · cites this paper as [17]
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- Authors
- Hiser, J., & Koenigs, M.
- Affiliations
- University of Wisconsin–Madison (US)
- Corresponding author
- Koenigs, Michael
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 83
- Issue
- 8
- Pages
- 638-647
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC5862740
- OpenAlex
- W2768172955
- Cited by
- 972
- References
- 148
- Citations by year
- 2026: 113 · 2025: 168 · 2024: 135 · 2023: 121 · 2022: 121 · 2021: 148 · 2020: 86 · 2019: 56 · 2018: 23 · 2012: 1
- FWCI
- 5.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Biological Psychiatry (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH101162)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Keywords
- ventromedial prefrontal cortex, reward-based decision-making, value-based decision making, negative emotion regulation, social cognition, facial emotion recognition, theory of mind, amygdala, ventral striatum, bed nucleus of the stria terminalis, periaqueductal gray, hippocampus, posterior cingulate cortex, dorsomedial prefrontal cortex, mental illness, depression, post-traumatic stress disorder, addiction, social anxiety disorder, bipolar disorder, schizophrenia, attention deficit hyperactivity disorder, treatment response prediction, treatment efficacy marker
- MeSH terms
- Facial Recognition, Animals, Mental Disorders, Decision Making, Emotions, Humans, Reward, Social Perception, Prefrontal Cortex, Theory of Mind
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