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The orbitofrontal cortex (OFC) is a prefrontal cortex region in the frontal lobes in the brain which is involved in the cognitive processing of decision-making. In non-human primates it consists of the association cortex areas Brodmann area 11, 12 and 13; in humans it consists of Brodmann area 10, 11 and 47.[1]

Orbitofrontal cortex
MRI of orbitofrontal cortex.jpg
Approximate location of the OFC shown on a sagittal MRI
Gray729 orbital gyrus.png
Orbital surface of left frontal lobe.
Part of Frontal lobe
Latin cortex orbitofrontalis
NeuroNames 91
NeuroLex ID birnlex_1049
Anatomical terms of neuroanatomy

The OFC is considered anatomically synonymous with the ventromedial prefrontal cortex.[2] Therefore, the region is distinguished due to the distinct neural connections and the distinct functions it performs.[3] It is defined as the part of the prefrontal cortex that receives projections from the magnocellular, medial nucleus of the mediodorsal thalamus, and is thought to represent emotion and reward in decision making.[4] It gets its name from its position immediately above the orbits in which the eyes are located. Considerable individual variability has been found in the OFC of humans.[5] A related area is found in rodents.[6]



The OFC has been divided by structure and connections into a medial and a lateral part. The medial part is most strongly connected with the hippocampus and associated areas of the cingulate, retrosplenial and entorhinal cortices, anterior thalamus and septal diagonal band. The lateral part can be further subdivided into three sectors. The most caudal sector is characterized by strong connections with the amygdala, midline thalamus, non-isocortical insula and temporal pole. The most anterior sector has more pronounced connections with the granular insula, association cortex, mediodorsal thalamus, inferior parietal lobule and dorsolateral PFC.[7]


Tracer studies in monkeys have shown that the orbitofrontal cortex shares extensive connections with other association cortices, primary sensory and association cortices, limbic systems, and other subcortical areas. Corticocortical connections include extensive local projections to and from other prefrontal regions, as well as with motor, limbic, and sensory cortices. Areas projecting to motor areas are densely interconnected with other prefrontal cortical regions, reflecting integration for executive motor control.[8]

Sensory cortices additionally share highly complex reciprocal connections with the orbitofrontal cortex. All sensory modalities are represented in connections with the orbitofrontal cortex, including extensive innervation from areas associated with olfaction and gustatory somatic responses.[9] Somatosensory cortices including primary areas 1 and 2, particularly in areas associated with innervation of the hand and trigeminal complex, indicating the importance of the orbitofrontal cortex in face and hand sensation.[8]

Functionally distinct pathways for auditory processing in the orbitofrontal cortex include a rostral stream associated with phonetic processing, and a more caudal stream terminating just posterior to the orbitofrontal cortex in the periarcuate prefrontal cortex associated with auditory-spatial processing, though these connections share extensive overlap. Both ventral and dorsal visual streams share connections with orbitofrontal cortical areas, including rich projections to and from the superior temporal pole, important for integration of spatial and object processing.[8]

Connectivity of the orbitofrontal cortex with limbic areas includes reciprocal projections to granular, dysgranular, and agranular insular cortex, parahippocampal regions, and the hippocampus, particularly CA1 regions in a rostral-to caudal gradient.[8] The orbitofrontal cortex additionally shares extensive reciprocal connections with the amygdala, and direct and indirect connections to the hypothalamus.[10]

Additional subcortical projections are shared between the striatum, particularly ventral reward-related areas,.[1][11] Connectivity with thalamic and periaqueductal grey areas further suggests a role for the orbitofrontal cortex in both inhibitory and excitatory regulation of autonomic function.[8] Parallel processing loops in connectivity between cortico-striatal networks seem to be involved in the processing of goal-directed and habitual action, whereas cortico-limbic connectivity seems to be of prime importance for action selection, implicating the basolateral amygdala, and the integration of information into behavioral output.[12]

The connections between orbitofrontal cortex and amygdala play a notable role in emotional decision making process. These connections contribute in modulating the associative learning process and emotion regulation in amygdala.[13]

Though invasive tracer studies are largely not possible in humans, diffusion tensor imaging (DTI) tractography studies have also been used to map the connectivity of the orbitofrontal cortex to cortical and subcortical brain structures. Connections in the human orbitofrontal cortex follow a conserved pattern, similar to what is shown in tracer studies in rhesus macaques, but with a distinct pattern of connectivity with regions of the striatum.[14]


Multiple functions have been ascribed to the OFC including context specific responding,[15] encoding contingencies in a flexible manner, encoding value, encoding inferred value, inhibiting responses, learning changes in contingency, emotional appraisal,[16] altering behavior through somatic markers, driving social behavior, and representing state spaces.[17] While most of these theories explain certain aspects of electrophysiological observations and lesion related changes in behavior, they often fail to explain, or are contradicted by other findings. The recent proposal that the OFC encodes state spaces, or the discrete configuration of internal and external characteristics associated with a situation and its contingencies, may encompass earlier proposals of OFC function.[18] For example the proposal that the OFC encodes economic value may be a reflection task state value.[15] The representation of task states could also explain the proposal that the OFC acts as a flexible map of contingencies, as a switch in task state would enable the encoding of new contingencies in one state, with the preservation of old contingencies in a separate state, enabling switching contingencies when the old task state becomes relevant again.[17] The representation of task states is supporting by electrophysiological evidence demonstrating that the OFC responds to a diverse array of task features, and is capable of rapidly remapping during contingency shifts.[17] The representation of task states may influence behavior through multiple potential mechanisms. The OFC is necessary for ventral tegmental area (VTA) neurons to produce a dopaminergic reward prediction error, and the OFC may encode expectations for computation of RPEs in the VTA.[15]

Specific functions have been ascribed to subregions of the OFC. The lateral OFC has been proposed to reflect potential choice value, enabling fictive(counterfactual) prediction errors to potentially mediate switching choices during reversal, extinction and devaluation. Optogenetic activation of the lOFC enhances goal directed over habitual behavior, possibly reflecting increased sensitivity to potential choices and therefore increased switching. The mOFC, on the other hand, has been proposed to reflect relative subjective value.[16] In rodents, a similar function has been ascribed to the mOFC, encoding action value in a graded fashion, while the lOFC has been proposed to encode specific sensory features of outcomes.[19] The lOFC has also been proposed to encode stimulus outcome associations, which are then compared by value in the mOFC.[20] Meta analysis of neuroimaging studies in humans reveals that a medial-lateral valence gradient exists, with the medial OFC responding most often to reward, and the lateral OFC responding most often to punishment. A posterior-anterior abstractness gradient was also found, with the posterior OFC responding to more simple reward, and the anterior OFC responding more to abstract rewards.[21]

The OFC and basolteral amygdala (BLA) are highly interconnected, and their connectivity is necessary for devaluation tasks. Damage to either the BLA or the OFC before, but only the OFC after devaluation impairs performance.[22] While the BLA only responds to cues predicting salient outcomes in a graded fashion in accordance with value, the OFC responds to both value and the specific sensory attributes of cue-outcome associations. While OFC neurons that, early in learning, respond to outcome receipt normally transfer their response to the onset of cues that predict the outcome, damage to the BLA impairs this form of learning.[23]

The posterior orbitofrontal cortex (pOFC) is connected to the amygdala via multiple paths, that are capable of both upregulating and downregulating autonomic nervous system activity.[24] Tentative evidence suggests that the neuromodulator dopamine plays a role in mediating the balance between the inhibitory and excitatory pathways, with a high dopamine state driving autonomic activity.[25]

It is suggested that the medial OFC is involved in making stimulus-reward associations and with the reinforcement of behavior, while the lateral OFC is involved in stimulus-outcome associations and the evaluation and possibly reversal of behavior.[26] Activity in the lateral OFC is found, for example, when subjects encode new expectations about punishment and social reprisal.[27][28]

The mid-anterior OFC has been found to consistently track subjective pleasure in neuroimaging studies. A hedonic hotspot has been discovered in the anterior OFC, which is capable of enhancing liking response to sucrose. The OFC is also capable of biasing the affective responses induced by AMPA antagonism in nucleus accumbens towards appetitive responses.[29]


The human OFC is among the least-understood regions of the human brain; but it has been proposed that the OFC is involved in sensory integration, in representing the affective value of reinforcers, and in decision-making and expectation.[1] In particular, the OFC seems to be important in signaling the expected rewards/punishments of an action given the particular details of a situation.[30] In doing this, the brain is capable of comparing the expected reward/punishment with the actual delivery of reward/punishment, thus, making the OFC critical for adaptive learning. This is supported by research in humans, non-human primates, and rodents. Human research has focused on neuroimaging research in healthy participants and neuropsychology research in patients with damage to discrete parts of the OFC. Research at the University of Leipzig shows that the human OFC is activated during intuitive coherence judgements.[31]

Psychiatric disordersEdit

The orbitofrontal cortex has been implicated in schizophrenia, major depressive disorder, bipolar disorder, obsessive-compulsive disorder, addiction, post-traumatic stress disorder, and panic disorder. Although neuroimaging studies have provided evidence for dysfunction in a wide variety of psychiatric disorders, the enigmatic nature of the OFCs role in behavior complicates the understanding of its role in the pathophysiology of psychiatric disorders.[32] The function of the OFC is not known, but its anatomical connections with the ventral striatum, amygdala, hypothalamus, hippocampus, and periaqueductal grey support a role in mediating reward and fear related behaviors.[33]

Obsessive compulsive disorderEdit

Meta analyses of neuroimaging studies in OCD report hyperactivity in areas generally considered to be part of the orbitofrontal segment of the cortico-basal ganglia-thalamo-cortical loop such as the caudate nucleus, thalamus and orbitofrontal cortex. OCD has been proposed to reflect a positive feedback loop due to mutual excitation of the OFC and subcortical structures.[34] While the OFC is usually overactive during symptom provocation tasks, cognitive tasks usually elicit hypoactivity of the OFC;[35] this may reflect a distinction between emotional and non emotional tasks, lateral and medial OFC,[36] or simply just inconsistent methodologies.[37]


Animal models, and cell specific manipulations in relation to drug seeking behavior implicate dsyfunction of the OFC in addiction.[38]



Using functional magnetic resonance imaging (fMRI) to image the human OFC is a challenge, because this brain region is in proximity to the air-filled sinuses. This means that signal dropout, geometric distortion and susceptibility artifacts are common when using EPI at higher magnetic field strengths. Extra care is therefore recommended for obtaining a good signal from the orbitofrontal cortex, and a number of strategies have been devised, such as automatic shimming at high static magnetic field strengths.[39]

The published neuroimaging studies have found that the reward value, the expected reward value, and even the subjective pleasantness of foods and other reinforcers are represented in the OFC. A large meta-analysis of the existing neuroimaging evidence demonstrated that activity in medial parts of the OFC is related to the monitoring, learning, and memory of the reward value of reinforcers, whereas activity in lateral OFC is related to the evaluation of punishers, which may lead to a change in ongoing behaviour.[40] Similarly, a posterior-anterior distinction was found with more complex or abstract reinforcers (such as monetary gain and loss) being represented more anteriorly in the orbitofrontal cortex than less-complex reinforcers such as taste. It has even been proposed that the human OFC has a role in mediating subjective hedonic experience.[1]

The orbitofrontal cortex (OFC) represents the main neocortical target of primary olfactory cortex. In non-human primates, the olfactory neocortex is situated along the basal surface of the caudal frontal lobes, encompassing agranular and dysgranular OFC medially and agranular insula laterally, where this latter structure wraps onto the posterior orbital surface. Direct afferent inputs arrive from most primary olfactory areas, including piriform cortex, amygdala, and entorhinal cortex, in the absence of an obligatory thalamic relay.[41]

Visual discrimination testEdit

This has two components. In the first component, "reversal learning", participants are presented with one of two pictures, A and B. They learn that they will be rewarded if they press a button when picture A is displayed, but punished if they press the button when picture B is displayed. Once this rule has been established, the rule swaps. In other words, now it is correct to press the button for picture B, not picture A. Most healthy participants pick up on this rule reversal almost immediately, but patients with OFC damage continue to respond to the original pattern of reinforcement, although they are now being punished for persevering with it. Rolls et al.[42] noted that this pattern of behaviour is particularly unusual given that the patients reported that they understood the rule.

The second component of the test is "extinction". Again, participants learn to press the button for picture A but not picture B. However this time, instead of the rules reversing, the rule changes altogether. Now the participant will be punished for pressing the button in response to either picture. The correct response is not to press the button at all, but people with OFC dysfunction find it difficult to resist the temptation to press the button despite being punished for it.

Iowa gambling taskEdit

A simulation of real life decision-making, the Iowa gambling task is widely used in cognition and emotion research.[43] Participants are presented with four virtual decks of cards on a computer screen. They are told that each time they choose a card they will win some game money. Every so often, however, when they choose a card they will lose some money.[further explanation needed] They are told that the aim of the game is to win as much money as possible. The task is meant to be opaque, that is, participants are not meant to consciously work out the rule, and they are supposed to choose cards based on their "gut reaction." Two of the decks are "bad decks", which means that, over a long enough time, they will make a net loss; the other two decks are "good decks" and will make a net gain over time.

Most healthy participants sample cards from each deck, and after about 40 or 50 selections are fairly good at sticking to the good decks. Patients with OFC dysfunction, however, continue to perseverate with the bad decks, sometimes even though they know that they are losing money overall. Concurrent measurement of galvanic skin response shows that healthy participants show a "stress" reaction to hovering over the bad decks after only 10 trials, long before conscious sensation that the decks are bad. By contrast, patients with OFC dysfunction never develop this physiological reaction to impending punishment. Bechara and his colleagues explain this in terms of the somatic marker hypothesis. The Iowa gambling task is currently being used by a number of research groups using fMRI to investigate which brain regions are activated by the task in healthy volunteers as well as clinical groups with conditions such as schizophrenia and obsessive compulsive disorder.

Faux pas testEdit

This is a series of vignettes recounting a social occasion during which someone said something that should not have been said, or an awkward occurrence. The participant's task is to identify what was said that was awkward, why it was awkward, how people would have felt in reaction to the faux pas and to a factual control question. Although first designed for use in people on the autism spectrum,[44] the test is also sensitive to patients with OFC dysfunction, who cannot judge when something socially awkward has happened despite appearing to understand the story perfectly well.

Clinical significanceEdit


Destruction of the OFC through acquired brain injury typically leads to a pattern of disinhibited behaviour. Examples include swearing excessively, hypersexuality, poor social interaction, compulsive gambling, drug use (including alcohol and tobacco), and poor empathising ability. Disinhibited behaviour by patients with some forms of frontotemporal dementia is thought to be caused by degeneration of the OFC.[45]


When OFC connections are disrupted, a number of cognitive, behavioral, and emotional consequences may arise. Research supports that the main disorders associated with dysregulated OFC connectivity/circuitry center around decision-making, emotion regulation, and reward expectation.[46][47][48] A recent multi-modal human neuroimaging study shows disrupted structural and functional connectivity of the OFC with the subcortical limbic structures (e.g., amygdala or hippocampus) and other frontal regions (e.g., dorsal prefrontal cortex or anterior cingulate cortex) correlates with abnormal OFC affect (e.g., fear) processing in clinically anxious adults.[49]

One clear extension of problems with decision-making is drug addiction/substance dependence, which can result from disruption of the striato-thalamo-orbitofrontal circuit.[48][46][50] Attention deficit hyperactivity disorder (ADHD) has also been implicated in dysfunction of neural reward circuitry controlling motivation, reward, and impulsivity, including OFC systems.[47] Other disorders of executive functioning and impulse control may be affected by OFC circuitry dysregulation, such as obsessive–compulsive disorder and trichotillomania[51][52][53]

Some dementias are also associated with OFC connectivity disruptions. The behavioral variant of frontotemporal dementia[54] is associated with neural atrophy patterns of white and gray matter projection fibers involved with OFC connectivity.[55] Finally, some research suggests that later stages of Alzheimer’s Disease be impacted by altered connectivity of OFC systems.[53]

See alsoEdit

Additional imagesEdit


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