The human thalamus has been suggested to be involved in executive function, based on animal studies and correlational evidence from functional neuroimaging in humans. Human lesion studies, examining behavioral deficits associated with focal brain injuries, can directly test the necessity of the human thalamus for executive function. The goal of our study was to determine the specific lesion location within the thalamus as well as the potential disruption of specific thalamocortical functional networks, related to executive dysfunction. We assessed executive function in 15 patients with focal thalamic lesions and 34 comparison patients with lesions that spared the thalamus. We found that patients with mediodorsal thalamic lesions exhibited more severe impairment in executive function when compared to both patients with thalamic lesions that spared the mediodorsal nucleus and to comparison patients with lesions outside the thalamus. Furthermore, we employed a lesion network mapping approach to map cortical regions that show strong functional connectivity with the lesioned thalamic subregions in the normative functional connectome. We found that thalamic lesion sites associated with more severe deficits in executive function showed stronger functional connectivity with ACC, dorsomedial PFC, and frontoparietal network, compared to thalamic lesions not associated with executive dysfunction. These are brain regions and functional networks whose dysfunction could contribute to impaired executive functioning. In aggregate, our findings provide new evidence that delineates a thalamocortical network for executive function.

People tend to assume that outcomes are caused by dispositional factors, for example, a person's constitution or personality, even when the actual cause is due to situational factors, for example, luck or coincidence. This is known as the “correspondence bias.” This tendency can lead normal, intelligent persons to make suboptimal decisions. Here, we used a neuropsychological approach to investigate the neural basis of the correspondence bias, by studying economic decision-making in patients with damage to the ventromedial pFC (vmPFC). Given the role of the vmPFC in social cognition, we predicted that vmPFC is necessary for the normal correspondence bias. In our experiment, consistent with expectations, healthy ( n = 46) and brain-damaged ( n = 30) comparison participants displayed the correspondence bias during economic decision-making and invested no differently when given dispositional or situational information. By contrast, vmPFC patients ( n = 17) displayed a lack of correspondence bias and invested more when given dispositional than situational information. The results support the conclusion that vmPFC is critical for normal social inference and the correspondence bias. The findings help clarify the important (and sometimes disadvantageous) role of social inference in economic decision-making.

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.

Functional neuroimaging studies suggest that the medial PFC (mPFC) is a key component of a large-scale neural system supporting a variety of self-related processes. However, it remains unknown whether the mPFC is critical for such processes. In this study, we used a human lesion approach to examine this question. We administered a standard trait judgment paradigm [Kelley, W. M., Macrae, C. N., Wyland, C. L., Caglar, S., Inati, S., & Heatherton, T. F. Finding the self? An event-related fMRI study. Journal of Cognitive Neuroscience, 14, 785–794, 2002] to patients with focal brain damage to the mPFC. The self-reference effect (SRE), a memory advantage conferred by self-related processing, served as a measure of intact self-processing ability. We found that damage to the mPFC abolished the SRE. The results demonstrate that the mPFC is necessary for the SRE and suggest that this structure is important for self-referential processing and the neural representation of self.

Medial temporal lobe (MTL) contributions to the brief maintenance of visual representations were evaluated by studying a group of patients with MTL damage. Eye movements of patients and healthy comparison subjects were tracked while performing a visual search for a target among complex stimuli of varying similarity to that target. Despite the task having no imposed delays, patients were impaired behaviorally, and eye movement measures showed abnormally rapid degradation of target representations in the patients. Eye movement data showed a modulation of the duration of fixations as a function of the similarity of fixated array lures to the target, but the effect was attenuated in patients during long fixation paths away from the sample target. This effect manifested despite patients' shorter searches and more frequent fixations of the sample target. Novel techniques provided unique insight into visual representation without healthy MTL, which may support maintenance of information through hippocampal-dependent relational binding.

The ventromedial PFC (vmPFC) has been implicated as a critical neural substrate mediating the influence of emotion on moral reasoning. It has been shown that the vmPFC is especially important for making moral judgments about “high-conflict” moral dilemmas involving direct personal actions, that is, scenarios that pit compelling utilitarian considerations of aggregate welfare against the highly emotionally aversive act of directly causing harm to others [Koenigs, M., Young, L., Adolphs, R., Tranel, D., Cushman, F., Hauser, M., et al. Damage to the prefrontal cortex increases utilitarian moral judgments. Nature, 446, 908–911, 2007]. The current study was designed to elucidate further the role of the vmPFC in high-conflict moral judgments, including those that involve indirect personal actions, such as indirectly causing harm to one's kin to save a group of strangers. We found that patients with vmPFC lesions were more likely than brain-damaged and healthy comparison participants to endorse utilitarian outcomes on high-conflict dilemmas regardless of whether the dilemmas (1) entailed direct versus indirect personal harms and (2) were presented from the Self versus Other perspective. In addition, all groups were more likely to endorse utilitarian outcomes in the Other perspective as compared with the Self perspective. These results provide important extensions of previous work, and the findings align with the proposal that the vmPFC is critical for reasoning about moral dilemmas in which anticipating the social-emotional consequences of an action (e.g., guilt or remorse) is crucial for normal moral judgments [Greene, J. D. Why are VMPFC patients more utilitarian?: A dual-process theory of moral judgment explains. Trends in Cognitive Sciences, 11, 322–323, 2007; Koenigs, M., Young, L., Adolphs, R., Tranel, D., Cushman, F., Hauser, M., et al. Damage to the prefrontal cortex increases utilitarian moral judgments. Nature, 446, 908–911, 2007].

Little is known about the mechanisms by which memory for relations is accomplished, or about the time course of the critical processes. Here, eye movement measures were used to examine the time course of subjects' access to and use of relational memory. In four experiments, participants studied faces superimposed on scenic backgrounds and were tested with three-face displays superimposed on the scenes viewed earlier. Participants exhibited disproportionate viewing of the face originally studied with the scene, compared to other equally familiar faces in the test display. When a preview of a previously viewed scene was provided, permitting expectancies about the to-be-presented face to emerge, disproportionate viewing was manifested within 500–750 msec after test display onset, more than a full second in advance of explicit behavioral responses, and occurred even when overt responses were not required. In the absence of preview, the viewing effects were delayed by approximately 1 sec. Relational memory effects were absent in the eye movement behavior of amnesic patients with hippocampal damage, suggesting that these effects depend critically on the hippocampal system. The results provide an index of memory for face-scene relations, indicate the time by which retrieval and identification of these relations occur, and suggest that retrieval and use of relational memory depends critically on the hippocampus and occurs obligatorily, regardless of response requirements.

We have proposed that the left inferotemporal (IT) region contains structures that mediate between conceptual knowledge retrieval and word-form retrieval, and we have hypothesized that these structures are utilized for word retrieval irrespective of the sensory modality through which an entity is apprehended, thus being “modality neutral.” We tested this idea in two sensory modalities, visual and auditory, and for two categories of concrete entities, tools and animals. In a PET experiment, 10 normal participants named tools and animals either from pictures or from characteristic sounds (e.g., “scissors” from a picture of a scissors or from the sound of a scissors cutting; “rooster” from a picture of a rooster or from the sound of a rooster crowing). Visual and auditory naming of tools activated the left posterior/lateral IT; visual and auditory naming of animals activated the left anterior/ ventral IT. For both tools and animals, the left IT activations were similar in location and magnitude regardless of whether participants were naming entities from pictures or from sounds. The results provide novel evidence to support the notion that left IT structures contain “modality-neutral” systems for mediating between conceptual knowledge and word retrieval.

Damage to the human ventromedial prefrontal cortex (VM) can result in dramatic and maladaptive changes in social behavior despite preservation of most other cognitive abilities. One important aspect of social cognition is the ability to detect social dominance, a process of attributing from particular social signals another person's relative standing in the social world. To test the role of the VM in making attributions of social dominance, we designed two experiments: one requiring dominance judgments from static pictures of faces, the second requiring dominance judgments from film clips. We tested three demographically matched groups of subjects: subjects with focal lesions in the VM (n = 15), brain-damaged comparison subjects with lesions excluding the VM (n = 11), and a reference group of normal individuals with no history of neurological disease (n = 32). Contrary to our expectation, we found that subjects with VM lesions gave dominance judgments on both tasks that did not differ significantly from those given by the other groups. Despite their grossly normal performance, however, subjects with VM lesions showed more subtle impairments specifically when judging static faces: They were less discriminative in their dominance judgments, and did not appear to make normal use of gender and age of the faces in forming their judgments. The findings suggest that, in the laboratory tasks we used, damage to the VM does not necessarily impair judgments of social dominance, although it appears to result in alterations in strategy that might translate into behavioral impairments in real life.

Humans are able to use nonverbal behavior to make fast, reliable judgments of both emotional states and personality traits. Whereas a sizeable body of research has identified neural structures critical for emotion recognition, the neural substrates of personality trait attribution have not been explored in detail. In the present study, we investigated the neural systems involved in emotion and personality trait judgments. We used a type of visual stimulus that is known to convey both emotion and personality information, namely, point-light walkers. We compared the emotion and personality trait judgments made by subjects with brain damage to those made by neurologically normal subjects and then conducted a lesion overlap analysis to identify neural regions critical for these two tasks. Impairments on the two tasks dissociated: Some subjects were impaired at emotion recognition, but judged personality normally; other subjects were impaired on the personality task, but normal at emotion recognition. Moreover, these dissociations in performance were associated with damage to specific neural regions: Right somatosensory cortices were a primary focus of lesion overlap in subjects impaired on the emotion task, whereas left frontal opercular cortices were a primary focus of lesion overlap in subjects impaired on the personality task. These findings suggest that attributions of emotional states and personality traits are accomplished by partially dissociable neural systems.

Although the amygdala's role in processing facial expressions of fear has been well established, its role in the processing of other emotions is unclear. In particular, evidence for the amygdala's involvement in processing expressions of happiness and sadness remains controversial. To clarify this issue, we constructed a series of morphed stimuli whose emotional expression varied gradually from very faint to more pronounced. Five morphs each of sadness and happiness, as well as neutral faces, were shown to 27 subjects with unilateral amygdala damage and 5 with complete bilateral amygdala damage, whose data were compared to those from 12 braindamaged and 26 normal controls. Subjects were asked to rate the intensity and to label the stimuli. Subjects with unilateral amygdala damage performed very comparably to controls. By contrast, subjects with bilateral amygdala damage showed a specific impairment in rating sad faces, but performed normally in rating happy faces. Furthermore, subjects with right unilateral amygdala damage performed somewhat worse than subjects with left unilateral amygdala damage. The findings suggest that the amygdala's role in processing of emotional facial expressions encompasses multiple negatively valenced emotions, including fear and sadness.

Lesion, functional imaging, and single-unit studies in human and nonhuman animals have demonstrated a role for the amygdala in processing stimuli with emotional and social significance. We investigated the recognition of a wide variety of facial expressions, including basic emotions (e.g., happiness, anger) and social emotions (e.g., guilt, admiration, flirtatiousness). Prior findings with a standardized set of stimuli indicated that recognition of social emotions can be signaled by the eye region of the face and is disproportionately impaired in autism (Baron-Cohen, Wheelwright, & Jolliffe, 1997). To test the hypothesis that the recognition of social emotions depends on the amygdala, we administered the same stimuli to 30 subjects with unilateral amygdala damage (16 left, 14 right), 2 with bilateral amygdala damage, 47 brain-damaged controls, and 19 normal controls. Compared with controls, subjects with unilateral or bilateral amygdala damage were impaired when recognizing social emotions; moreover, they were more impaired in recognition of social emotions than in recognition of basic emotions, and, like previously described patients with autism, they were impaired also when asked to recognize social emotions from the eye region of the face alone. The findings suggest that the human amygdala is relatively specialized to process stimuli with complex social significance. The results also provide further support for the idea that some of the impairments in social cognition seen in patients with autism may result from dysfunction of the amygdala.

Bilateral damage to the human amygdala impairs retrieval of emotional and social information from faces. An important unanswered question concerns the specificity of the impairment for faces. To address this question, we examined preferences for a broad class of visual stimuli in two subjects with complete bilateral amygdala damage, both of whom were impaired in judgments of faces. Relative to controls, the subjects showed a positive bias for simple nonsense figures, color patterns, three-dimensional-looking objects and landscapes. The impairment was most pronounced in regard to those stimuli that are normally liked the least. The human amygdala thus appears to play a general role in guiding preferences for visual stimuli that are normally judged to be aversive.

Some patients with face agnosia (prosopagnosia) caused by occipitotemporal damage produce discriminatory covert responses to the familiar faces that they fail to identify overtly. For example, their average skin conductance responses (SCRs) to familiar faces are significantly larger than average SCRs to unfamiliar faces. In this study we describe the opposite dissociation in four patients with bilateral ventromedial frontal damage: The patients recognized the identity of familiar faces normally, yet failed to generate discriminatory SCRs to those same familiar faces. Taken together, the two sets of results constitute a double dissociation: bilateral occipitotemporal damage impairs recognition but allows SCR discrimination, whereas bilateral ventromedial damage causes the opposite. The findings suggest that the neural systems that process the somatic-based valence of stimuli are separate from and parallel to the neural systems that process the factual, nonsomatic information associated with the same stimuli.

Following bilateral damage to the entire medial temporal lobe and interconnected cortices in the anterior temporal and medial frontal regions, patient Boswell developed a severe learning defect for all types and levels of Factual knowledge, including faces. In the experiments described here, however, we demonstrate that Boswell can acquire a non conscious bond between entirely new persons and the affective valence they display. The finding is important on the followng accounts. First, Boswell's lesions guarantee that the entorhinal and perirhinal cortices, hippocampus, amygdala, and higher-order neocortices in the anterior temporal region are not required to support this form of covert learning. Second, this demonstration is possible only in a patient such as Boswell, because in individuals with normal or only partially impaired factual learning, fact memory will contaminate the performance.