A Critical Role for Human Ventromedial Frontal Lobe in Value Comparison of Complex Objects Based on Attribute Configuration.

In making decisions, we often choose from among 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, some evidence from patients with ventromedial frontal lobe (VMF) damage argues against a very general role for this region in value integration, suggesting instead that it contributes critically to a specific value inference or comparison process. Here, we tested value-based decision-making involving artificial multiattribute objects in humans with focal damage to the VMF ( = 12) compared with a healthy group matched for age and education ( = 24) and with a group with frontal lobe damage sparing the VMF ( = 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 the VMF is critical for inferring the value of whole objects in a multiattribute 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. Neuroeconomic models propose that the ventromedial frontal lobe (VMF) supports multiattribute decisions by integrating the values of attributes. However, researchers have been uncertain about the underlying mechanisms for this process. Patients with VMF damage made multiattribute choices under two conditions: in one, attribute values could be summed to guide choice; in the other, value was predicted by the conjunction of attributes. VMF damage impaired only the latter. This argues that the VMF is critical for inferring value from configural information to guide multiattribute object choice. This region may be key for judging the emergent "value of the forest," rather than for integrating the individual "value of each tree."