Also referred to as the orbitofrontal cortex, the ventromedial prefrontal cortex (VmPC) is the part of the forebrain that is particularly involved in decision-making and personality. Located at the anterior-most portion of the frontal lobes, the ventromedial prefrontal cortex has been dubbed the "moral brain center" and its function is not completely understood. Research indicates that this area of the brain plays a role in psychopathy, characterized by a severe absence of empathy, emotion, and complete lack in the ability to be remorseful.
An excellent example demonstrating the significance of the ventromedial prefrontal cortex's function is in the case of Phineas Gage, a railroad foreman who sustained an explosion-propelled rod through his brain's VmPC and survived. While Mr. Gage had lived through the trauma with consciousness completely preserved, his doctor began to observe a remarkable change in personality after battling a life-threatening infection. Once considered an articulate, respectable man, Gage exhibited a marked decrease in cognition and intellectual abilities, couldn't plan, began to shout obscenities without restraint, and could no longer perform his job. Friends and acquaintances observed that, whatever made Phineas Gage distinct, was gone.
Important to planning, emotional control, and forming judgments, the VmPC receives input from the limbic system, a network of structures responsible for generating emotions and memories. Total maturation of the prefrontal cortex occurs after all brain development is accomplished, with the VmPC being the absolute last part of the brain to finish developing. Limbic system structures mature to completion before the ventromedial prefrontal cortex, explaining why adolescents frequently engage in taking risks, seem disorganized, and make quick, haphazard decisions. Children who have been neglected or abused can have problems with controlling emotion or experience a developmental delay in this area.
Research experiments comparing patients with damage to the VmPC with people diagnosed as psychopathic show striking similarities. Leading to behavior that is considered to be morally deviant or repressed, particularly remarkable is their dull emotional reactions and propensity to impulsiveness, demonstrating difficulty with self-control. While psychopaths have the ability to distinguish between morally right and wrong behavior, it doesn't matter much to them. Most tend to have a reduced response when fear, anger, or duress is expressed by others as imaging studies reveal, showing decreased action in the VmPC and the amygdala, the limbic system structure responsible for generating these emotions.