Dorsal medial prefrontal cortex plays a necessary role in rapid error prediction in humans

Activity in human dorsal anterior cingulate cortex (dACC) is correlated with errors, near-misses, and response conflict. Based on these observations, this region has been cast as playing a central role in models of error processing, conflict monitoring, and cognitive control. However, clear evidence that this region of the brain is necessary for these processes has been elusive. We studied the effects of damage to this region on four different error-related measures in five patients, and 19 healthy participants. Most error-related indices were not affected by such damage: patients had intact post-error slowing, and were able to report and to correct errors after they were made with accuracies comparable with the control group. However, all five patients were notably slow to correct errors, suggesting a deficit in on-line error prediction. This slowing was associated with impairment in the conscious prediction of error likelihood before a response. This finding constitutes important converging evidence for a critical role for human dACC in error monitoring, and sheds light on the selectivity and timing of the error-related process affected by dACC damage.