A key process in decision-making is estimating the value of possible outcomes. Growing evidence suggests that different types of values are automatically encoded in the ventromedial prefrontal cortex (VMPFC). Here we extend this idea by suggesting that any overt judgment is accompanied by a second-order valuation (a confidence estimate), which is also automatically incorporated in VMPFC activity. In accordance with the predictions of our normative model of rating tasks, two behavioral experiments showed that confidence levels were quadratically related to first-order judgments (age, value or probability ratings). The analysis of three functional magnetic resonance imaging data sets using similar rating tasks confirmed that the quadratic extension of first-order ratings (our proxy for confidence) was encoded in VMPFC activity, even if no confidence judgment was required of the participants. Such an automatic aggregation of value and confidence in a same brain region might provide insight into many distortions of judgment and choice.

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A major challenge for decision theory is to account for the instability of expressed preferences across time and context. Such variability could arise from specific properties of the brain system used to assign subjective values. Growing evidence has identified the ventromedial prefrontal cortex (VMPFC) as a key node of the human brain valuation system. Here, we first replicate this observation with an fMRI study in humans showing that subjective values of painting pictures, as expressed in explicit pleasantness ratings, are specifically encoded in the VMPFC. We then establish a bridge with monkey electrophysiology, by comparing single-unit activity evoked by visual cues between the VMPFC and the orbitofrontal cortex. At the neural population level, expected reward magnitude was only encoded in the VMPFC, which also reflected subjective cue values, as expressed in Pavlovian appetitive responses. In addition, we demonstrate in both species that the additive effect of prestimulus activity on evoked activity has a significant impact on subjective values. In monkeys, the factor dominating prestimulus VMPFC activity was trial number, which likely indexed variations in internal dispositions related to fatigue or satiety. In humans, prestimulus VMPFC activity was externally manipulated through changes in the musical context, which induced a systematic bias in subjective values. Thus, the apparent stochasticity of preferences might relate to the VMPFC automatically aggregating the values of contextual features, which would bias subsequent valuation because of temporal autocorrelation in neural activity.

To survive in their complex environment, primates must integrate information over time and adjust their actions beyond immediate events. The underlying neurobiological processes, however, remain unclear. Here, we assessed the contribution of the ventromedial prefrontal cortex (VMPFC), a brain region important for value-based decision-making. We recorded single VMPFC neurons in monkeys performing a task where obtaining fluid rewards required squeezing a grip. The willingness to perform the action was modulated not only by visual information about Effort and Reward levels but also by contextual factors such as Trial Number (i.e., fatigue and/or satiety) or behavior in recent trials. A greater fraction of VMPFC neurons encoded contextual information, compared with visual stimuli. Moreover, the dynamics of VMPFC firing was more closely related to slow changes in motivational states driven by these contextual factors rather than rapid responses to individual task events. Thus, the firing of VMPFC neurons continuously integrated contextual information and reliably predicted the monkeys's willingness to perform the task. This function might be critical when animals forage in a complex environment and need to integrate information over time. Its relation with motivational states also resonates with the VMPFC's implication in the "default mode" or in mood disorders.

To survive in their complex environment, primates must integrate information over time and adjust their actions beyond immediate events. The underlying neurobiological processes, however, remain unclear. Here, we assessed the contribution of the ventromedial prefrontal cortex (VMPFC), a brain region important for value-based decision making. We recorded single VMPFC neurons in monkeys performing a task where obtaining fluid rewards required squeezing a grip. The willingness to perform the action was modulated not only by visual information about Effort and Reward levels, but also by contextual factors such as Trial Number (i.e fatigue and/or satiety) or behavior in recent trials. A greater fraction of VMPFC neurons encoded contextual information, compared to visual stimuli. Moreover, the dynamics of VMPFC firing was more closely related to slow changes in motivational states driven by these contextual factors rather than rapid responses to individual task events. Thus, the firing of VMPFC neurons continuously integrated contextual information and reliably predicted the monkeys's willingness to perform the task. This function might be critical when animals forage in a complex environment and need to integrate information over time. Its relation with motivational states also resonates with the VMPFC's implication in the 'default mode' or in mood disorders.