Decision Time – The Orbitofrontal Cortex

Balancing emotion and reason – or more?

When it comes to decision-making the orbitofrontal cortex is the star. It is considered the region that is involved in all sorts of decision making especially those that involve emotion and reason. But, as usual, when one digs into the research, there are some twists and turns to these ideas and data – and on one hand the orbitofrontal cortex may not be all it is cracked up to be – and on another maybe it is much more.

The most famous, and tired, story in neuroscience is that of Phineas Gage. In summary (Wikipedia has an extensive review), in a freak accident while building a railroad, Gage had an iron rod blasted up through his skull, entering under his left cheekbone, taking out his left eye, passing through his left prefrontal cortex, and exiting the skull to land about 25 meters away.

Despite having this meter long iron rod blast through his skull Phineas Gage miraculously survived, and amazingly, according to accounts, remained conscious, and talkative to boot – after having been taken to his lodging and awaiting the doctor he sat on his porch proudly telling passers - by what had happened! This accident led further support to the localisation theory that said that different brain regions were responsible for different functions, famously proposed by Broca and Wernicke with respect to language function in the 1800s.

The incident is mind-boggling which is why it has fascinated students and casual observers for centuries. Gage subsequently became impulsive and aggressive and unable to hold down a job – though we’d probably expect a lot worse after having a hefty metal rod pass through you brain taking large chunks of brain matter with it.