A Frontal Account of False Alarms

Prior research has demonstrated that the frontal lobes play a critical role in the top-down control of behavior, and damage to the frontal cortex impairs performance on tasks that require executive control [Burgess, P. W., & Stuss, D. T. Fifty years of prefrontal cortex research: Impact on assessment. Journal of the International Neuropsychological Society, 23, 755-767, 2017; Stuss, D. T., & Levine, B. Adult clinical neuropsychology: Lessons from studies of the frontal lobes. Annual Review of Psychology, 53, 401-433, 2002]. Across executive functioning tasks, performance deficits are often quantified as the number of false alarms per total number of nontarget trials. However, most studies of frontal lobe function focus on individual task performance and do not discuss commonalities of errors committed across different tasks. Here, we describe a neurocognitive account that explores the link between deficient frontal lobe function and increased false alarms across an array of experimental tasks from a variety of task domains. We review evidence for heightened false alarms following frontal deficits in episodic long-term memory tests, working memory tasks (e.g., n-back), attentional tasks (e.g., continuous performance tasks), interference control tasks (e.g., recent probes), and inhibitory control tasks (e.g., go/no-go). We examine this relationship via neuroimaging studies, lesion studies, and across age groups and pathologies that impact the pFC, and we propose 11 issues in cognitive processing that can result in false alarms. In our review, some overlapping neural regions were implicated in the regulation of false alarms. Ultimately, however, we find evidence for the fractionation and localization of certain frontal processes related to the commission of specific types of false alarms. We outline avenues for additional research that will enable further delineation of the fractionation of the frontal lobes' regulation of false alarms.