Lesions of anterior cingulate cortex disrupt an electrophysiological signature of goal completion in humans

Abstract The reward positivity (RewP) is an event-related brain potential (ERP) component associated with feedback and goal completion. Although the component is said to be generated in anterior cingulate cortex (ACC), this inference is disputed because of the inverse problem. Recent intracranial electroencephalogram (EEG) current source density analyses provided direct evidence that the RewP is generated in caudal ACC, specifically Brodmann areas 24c’ and 32’. To further test this hypothesis, we examined the effects of damage to frontal cortex damage on RewP amplitude. Scalp EEG was recorded from 68 stroke patients with frontal lesions while they performed a trial-and-error guessing task used to elicit a canonical RewP. Non-parametric voxel-based lesion-symptom mapping revealed that damage to Brodmann areas 24c’ and 32’ significantly attenuated RewP amplitude. These results align with evidence suggesting a single generator of the RewP in the caudal ACC, supporting the role of caudal ACC in motivation of extended behaviors.