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Brain. 2014 Oct;137(Pt 10):2811-22. doi: 10.1093/brain/awu221. Epub 2014 Aug 6.

Domain-specific impairment in metacognitive accuracy following anterior prefrontal lesions.

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1 Centre for Neural Science, New York University, USA 2 Department of Experimental Psychology, University of Oxford, UK
1 Centre for Neural Science, New York University, USA 3 Department of Psychology, City University of New York, USA.
4 Department of Neurosurgery, New York University School of Medicine, USA.
5 Department of Neurology, New York University School of Medicine, USA.


Humans have the capacity to evaluate the success of cognitive processes, known as metacognition. Convergent evidence supports a role for anterior prefrontal cortex in metacognitive judgements of perceptual processes. However, it is unknown whether metacognition is a global phenomenon, with anterior prefrontal cortex supporting metacognition across domains, or whether it relies on domain-specific neural substrates. To address this question, we measured metacognitive accuracy in patients with lesions to anterior prefrontal cortex (n = 7) in two distinct domains, perception and memory, by assessing the correspondence between objective performance and subjective ratings of performance. Despite performing equivalently to a comparison group with temporal lobe lesions (n = 11) and healthy controls (n = 19), patients with lesions to the anterior prefrontal cortex showed a selective deficit in perceptual metacognitive accuracy (meta-d'/d', 95% confidence interval 0.28-0.64). Crucially, however, the anterior prefrontal cortex lesion group's metacognitive accuracy on an equivalent memory task remained unimpaired (meta-d'/d', 95% confidence interval 0.78-1.29). Metacognitive accuracy in the temporal lobe group was intact in both domains. Our results support a causal role for anterior prefrontal cortex in perceptual metacognition, and indicate that the neural architecture of metacognition, while often considered global and domain-general, comprises domain-specific components that may be differentially affected by neurological insult.


cognitive control; consciousness; neuropsychology; prefrontal cortex; temporal lobe

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