Human ventromedial prefrontal lesions alter incentivisation by reward
Open accessAbstract
Although medial frontal brain regions are implicated in valuation of rewards, evidence from focal lesions to these areas is scant, with many conflicting results regarding motivation and affect, and no human studies specifically examining incentivisation by reward. Here, 19 patients with isolated, focal damage in ventral and medial prefrontal cortex were selected from a database of 453 individuals with subarachnoid haemorrhage. Using a speeded saccadic task based on the oculomotor capture paradigm, we manipulated the maximum reward available on each trial using an auditory incentive cue. Modulation of behaviour by motivation permitted quantification of reward sensitivity. At the group level, medial frontal damage was overall associated with significantly reduced effects of reward on invigorating saccadic velocity and autonomic (pupil) responses compared to age-matched, healthy controls. Crucially, however, some individuals instead showed abnormally strong incentivisation effects for vigour. Increased sensitivity to rewards within the lesion group correlated with damage in subgenual ventromedial prefrontal cortex (vmPFC) areas, which have recently become the target for deep brain stimulation (DBS) in depression. Lesion correlations with clinical apathy suggested that the apathy associated with prefrontal damage is in fact reduced by damage at those coordinates. Reduced reward sensitivity showed a trend to correlate with damage near nucleus accumbens. Lesions did not, on the other hand, influence reward sensitivity of cognitive control, as measured by distractibility. Thus, although medial frontal lesions may generally reduce reward sensitivity, damage to key subregions paradoxically protect from this effect.
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Patients with a lesion in the ventromedial frontal cortex did not show intertrial reward priming, whereas healthy controls and patients with a lesion in the lateral or dorsomedial frontal lobe did.
“Vaidya and Fellows (2015) found that while healthy controls and patients with a lesion in the lateral or the dorsomedial frontal lobe showed intertrial reward priming, patients with a lesion in the ventromedial frontal cortex (vmPFC) did not (but see Manohar & Husain, 2016).”
From Selection history: How reward modulates selectivity of visual attention. (2018) · cites this paper as Manohar & Husain, 2016
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“For example, Vaidya and Fellows (2015) found that while healthy controls and patients with a lesion in the lateral or the dorsomedial frontal lobe showed intertrial reward priming, patients with a lesion in the ventromedial frontal cortex (vmPFC) did not (but see Manohar & Husain, 2016).”
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Peer Review #2 of "Cortical modulation of pupillary function: systematic review (v0.1)"
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Neuroimaging of Reward Processing in Anxiety and Obsessive-Compulsive Disorders
Couto, M. B., & Morgado, P. F. (2025) · Springer eBooks · doi:10.1007/978-3-031-73368-0_14
- Authors
- Manohar, S. G., & Husain, M.
- Affiliations
- John Radcliffe Hospital (GB)
- Corresponding author
- Manohar, Sanjay G.
- ORCID
- Manohar, Sanjay G.
- Venue
- Cortex
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 76
- Pages
- 104-120
- ISSN
- 0010-9452 (ISSN-L)
- PMC
- PMC4786053
- OpenAlex
- W2283257048
- Cited by
- 62
- References
- 106
- Citations by year
- 2025: 4 · 2024: 10 · 2023: 6 · 2022: 2 · 2021: 8 · 2020: 3 · 2019: 9 · 2018: 9 · 2017: 5 · 2016: 6
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Cortex (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (098282)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- ventromedial prefrontal cortex, reward sensitivity, oculomotor capture, saccadic velocity, pupil response, subgenual prefrontal cortex, nucleus accumbens, apathy, cognitive control, distractibility, motivation
- MeSH terms
- Adult, Aged, Brain Mapping, Decision Making, Female, Humans, Male, Middle Aged, Motivation, Neuropsychological Tests, Reward, Prefrontal Cortex, Deep Brain Stimulation
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