Value Neglect: A Critical Role for Ventromedial Frontal Lobe in Learning the Value of Spatial Locations

Whether you are a gazelle bounding to the richest tract of grassland or a return customer heading to the freshest farm stand at a crowded market, the ability to learn the value of spatial locations is important in adaptive behavior. The ventromedial frontal lobe (VMF) is implicated in value-based decisions between objects and in flexibly learning to choose between objects based on feedback. However, it is unclear if this region plays a material-general role in reward learning. Here, we tested whether VMF is necessary for learning the value of spatial locations. People with VMF damage were compared with healthy participants and a control group with frontal damage sparing VMF in an incentivized spatial search task. Participants chose among spatial targets distributed among distractors, rewarded with an expected value that varied along the right-left axis of the screen. People with VMF damage showed a weaker tendency to reap reward in contralesional hemispace. In some individuals, this impairment could be dissociated from the ability to make value-based decisions between objects, assessed separately. This is the first evidence that the VMF is critically involved in reward-guided spatial search and offers a novel perspective on the relationships between value, spatial attention, and decision-making.