Does Ventromedial Prefrontal Cortex Damage Really Increase Impulsiveness? Delay and Probability Discounting in Patients with Focal Lesions.

If the tendency to discount rewards reflects individuals' general level of impulsiveness, then the discounting of delayed and probabilistic rewards should be negatively correlated: The less a person is able to wait for delayed rewards, the more they should take chances on receiving probabilistic rewards. It has been suggested that damage to the ventromedial prefrontal cortex (vMPFC) increases individuals' impulsiveness, but both intertemporal choice and risky choice have only recently been assayed in the same patients with vMPFC damage. Here, we assess both delay and probability discounting in individuals with vMPFC damage (n = 8) or with medial temporal lobe (MTL) damage (n = 10), and in age- and education-matched controls (n = 30). On average, MTL-lesioned individuals discounted delayed rewards at normal rates but discounted probabilistic rewards more shallowly than controls. In contrast, vMPFC-lesioned individuals discounted delayed rewards more steeply but probabilistic rewards more shallowly than controls. These results suggest that vMPFC lesions affect the weighting of reward amount relative to delay and certainty in opposite ways. Moreover, whereas MTL-lesioned individuals and controls showed typical, nonsignificant correlations between the discounting of delayed and probabilistic rewards, vMPFC-lesioned individuals showed a significant negative correlation, as would be expected if vMPFC damage increases impulsiveness more in some patients than in others. Although these results are consistent with the hypothesis that vMPFC plays a role in impulsiveness, it is unclear how they could be explained by a single mechanism governing valuation of both delayed and probabilistic rewards.

Is it time? Episodic imagining and the discounting of delayed and probabilistic rewards in young and older adults.

Remembering and imagining specific, personal experiences can help shape our decisions. For example, cues to imagine future events can reduce delay discounting (i.e., increase the subjective value of future rewards). It is not known, however, whether such cues can also modulate other forms of reward discounting, such as probability discounting (i.e., the decrease in the subjective value of a possible reward as the odds against its occurrence increase). In addition, it is unclear whether there are age-related differences in the effects of cueing on either delay or probability discounting. Accordingly, young and older adult participants were administered delay and probability discounting tasks both with and without cues to imagine specific, personally meaningful events. As expected, cued episodic imagining decreased the discounting of delayed rewards. Notably, however, this effect was significantly less pronounced in older adults. In contrast to the effects of cueing on delay discounting, personally relevant event cues had little or no effect on the discounting of probabilistic rewards in either young or older adults; Bayesian analysis revealed compelling support for the null hypothesis that event cues do not modulate the subjective value of probabilistic rewards. In sum, imagining future events appears only to affect decisions involving delayed rewards. Although the cueing effect is smaller in older adults, nevertheless, it likely contributes to how adults of all ages evaluate delayed rewards and thus, it is, in fact, about time.