The Multifaceted Role of the Ventromedial Prefrontal Cortex in Emotion, Decision Making, Social Cognition, and Psychopathology

Abstract

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.

Ventromedial prefrontal cortex connectivity during and after psychological stress in women

“…Lastly, the vmPFC is a large and heterogeneous region of the brain, which encompasses many subregions that may have different functional characteristics during periods of psychological stress. The vmPFC anatomical mask used in the present study likely encompassed many functionally distinct areas (Hiser & Koenigs, ). A study using a smaller vmPFC seed, specifically targeting the intersection of the default mode network and salience network, demonstrated vmPFC connectivity with the pgACC (perigenual anterior cigulate cortex), dorsal ACC, mid‐ACC, and left superior temporal gyrus positively correlated with heart rate variability (Jennings et al, ).…”

Modulating functional connectivity between medial frontopolar cortex and amygdala by inhibitory and excitatory transcranial magnetic stimulation

“…Because the mFP shows FC with several brain regions (Hiser & Koenigs, ; M. Roy, Shohamy, & Wager, ), we additionally performed seed‐based (mFP[R], i.e., MNI: x = 10, y = 63, z = 25) explorative whole brain FC analyses in SPM8 for graphical illustration ( p < .005 uncorrected). Only the 3 × 2 factorial MD‐ANOVA with the between‐subject‐factor stimulation‐group (1 Hz rTMS, sham TMS, 20 Hz rTMS) and the within‐subject‐factor session (Pre‐TMS, Post‐1‐TMS; see Section 3.2) was conducted.…”

“…Because the mFP shows FC with several brain regions (Hiser & Koenigs, 2018;M. Roy, Shohamy, & Wager, 2012), we additionally performed seed-based (mFP[R], i.e., MNI: x = 10, y = 63, z = 25) explorative whole brain FC analyses in SPM8 for graphical illustration (p < .005 uncorrected).…”

Resting‐state amplitude of low‐frequency fluctuation is associated with suicidal ideation

“…The vmPFC is involved with multiple brain functions that are linked to depression (Hiser & Koenigs, 2018), including reward and value-based decision making, generation and regulation of negative affect, and aspects of social cognition (Van Overwalle, 2009). The vmPFC is involved with multiple brain functions that are linked to depression (Hiser & Koenigs, 2018), including reward and value-based decision making, generation and regulation of negative affect, and aspects of social cognition (Van Overwalle, 2009).…”

“…Our machine learning analyses identified the ventromedial prefrontal cortex (vmPFC) to be driving the differentiation between depressed suicidal ideators and nonideators. The vmPFC is involved with multiple brain functions that are linked to depression (Hiser & Koenigs, 2018), including reward and value-based decision making, generation and regulation of negative affect, and aspects of social cognition (Van Overwalle, 2009). Surprisingly, there was little overlap between the statistical parametric maps obtained from the grouplevel univariate analysis with maps of informative features in the MVPA.…”