Pattern of Neural Activity in Ventromedial Prefrontal Cortex Predicts High- and Low-Risk Behavior in Healthy Subjects

We are confronted with high- and low-risk decisions in our everyday life. Damasio argues in his somatic marker theory that not only cognitive components but also affective components are crucial in decision making. Since emotional judgment requires an interplay between emotional and cognitive function, it might be considered a key component in decision making. Although the ventromedial prefrontal cortex (VMPFC) has been demonstrated to be crucial in decision making, determination of high- and low-risk decisions via emotional judgment and underlying VMPFC function has not been demonstrated yet. We therefore investigated neural activity in VMPFC during emotional judgment and related it to performance in decision making. In this study, we investigated using fMRI the neural correlates of emotional judgment in healthy subjects. We incorporated a judgment expectancy period in our paradigm to shift the accent from the emotional component (=emotional reactions and experience) to the cognitive component (=judgment) within emotional judgment. We then tested whether the BOLD effect of emotional judgment and expectancy could be related to high- and low-risk decisions as measured by the Iowa Gambling Task (IGT). For this purpose we correlated IGT performance with fMRI results during emotional judgement without and with expectancy. Our main findings included: 1) expectancy reverses the signal type in the VMPFC during emotional judgment from signal increases to signal decreases; 2) global IGT performance correlates significantly with signal changes in VMPFC, namely with signal increases and decreases during emotional judgment without and with expectancy, respectively; 3) predominant high- and low-risk IGT performers differ significantly in VMPFC activity during emotional judgment without and with expectancy. Our results demonstrate that emotional judgment induces signal changes in VMPFC which, in turn, determine whether high-or low-risk decisions are made. In conclusion, our findings provide evidence for emotional judgment and thus the affective component being a key component in decision making. This complements the theory of somatic marker as suggested by Damasio by revealing the neural correlates of the affective component in decision making.