A critical role for human ventromedial frontal lobe in value comparison based on multi-attribute configuration

Abstract

Real-life decisions are often between options with multiple value-relevant attributes. Neuroeconomic models propose that the value associated with each attribute is integrated in a global value for each option. However, evidence from patients with ventromedial frontal (VMF) damage argues against a very general role for this region in value integration, suggesting instead that it contributes critically to specific value inference or comparison processes. Here, we tested value-based decision-making between artificial multi-attribute objects in 12 men and women with focal damage to VMF, compared to a healthy control group (N=24) and a control group with frontal lobe damage sparing VMF (N=12). In a configural condition, overall object value was predicted by the conjunction of two attributes, while in an elemental condition, object value could be assessed by combining the independent values of individual attributes. Patients with VMF damage were impaired in making choices when value was uniquely predicted by the configuration of attributes, but intact when choosing based on elemental attribute-values. This is evidence that VMF is critical for inferring the value of whole objects in multi-attribute choice. These findings have implications for models of value-based choice, and add to emerging views of how this region may interact with medial temporal lobe systems involved in configural object processing and relational memory.