Abstract

The functional roles of ventromedial prefrontal cortex (VMPF) and amygdala in affecting emotional processing in decision-making have been raised in support of the somatic marker hypothesis. However, later studies demonstrated challenges to such support based on preserved cognition in the form of reversal learning in VMPF damaged patients tested with a shuffled variant of Iowa Gambling Task. This finding provides implications for cognitive neglect in somatic marker hypothesis with its magnified emphasis on the link between somatic markers and emotion-guided decision-making. It also suggests that cognition could compensate for emotion impairment in the absence of crucial prefrontal cortical region needed for low-risk choice and decision-making. Emotional somatic marker signaling is proposed to be an assistive initiation mechanism for choice decision-making between gains and losses instead of a fixated necessity in the process, and that it works in concert with concurrent conscious knowledge and cognition of the situation, building upon the nature of close connections between the VMPF and other brain region(s).