The role of ventromedial prefrontal cortex in navigation: a case of impaired wayfinding and rehabilitation.

A patient with ventromedial prefrontal damage, LG, is described who had a severe difficulty in wayfinding in his home town, despite intact knowledge for landmarks and routes in town. Although able to recall his spatial goals, LG often headed to familiar, "attractor" locations while navigating, losing his way in the process. Both a laboratory and an ecological study showed that spatial navigation improved when the patient was periodically reminded of, or asked to recall, the goal destination along his route. It is suggested that the ventromedial prefrontal cortex is necessary to maintain actively the goal destination in working memory, for use in navigation.