We hypothesized that the ventromedial pFC (vmPFC) is critical for making transitive inferences (e.g., the logical operation that if A > B and B > C, then A > C). To test this, participants with focal vmPFC damage, brain-damaged comparison participants, and neurologically normal participants completed a transitive inference task consisting an ordered set of arbitrary patterns. Participants first learned through trial-and-error the relationships of the patterns (e.g., Pattern A > Pattern B, Pattern B > Pattern C). After initial learning, participants were presented with novel pairings, some of which required transitive inference (e.g., Pattern A > Pattern C from the relationship above). We observed that vmPFC damage led to a specific deficit in transitive inference, suggesting that an intact vmPFC is necessary for making normal transitive inferences. Given the usefulness of transitivity in inferring social relationships, this deficit may be one of the basic features of social conduct problems associated with vmPFC damage.

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