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Soc Cogn Affect Neurosci. 2019 Aug 7;14(6):601-612. doi: 10.1093/scan/nsz039.

Patients with dorsolateral prefrontal cortex lesions are capable of discriminatory threat learning but appear impaired in cognitive regulation of subjective fear.

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Department of Psychology, New York University, New York, NY 10003, USA.
Center for Neural Science, New York University, New York, NY 10003, USA.
Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, Netherlands.
Department of Psychiatry, University of Texas at Austin, Austin, TX 78712, USA.
Department of Neurology, New York University School of Medicine, New York, NY 10016, USA.
Department of Psychology, Harvard, Cambridge, MA 02138, USA.


Humans are able to cognitively regulate emotions by changing their thoughts. Neuroimaging studies show correlations between dorsolateral prefrontal cortex (dlPFC) activity and cognitive regulation of emotions. Here our objective was to investigate whether dlPFC damage is associated with impaired cognitive regulation of emotion. We therefore tested the ability of patients with dlPFC lesions (N = 6) and matched control participants (N = 19) to utilize a laboratory version of cognitive regulation training (CRT) to regulate subjective fear and autonomic threat responses following Pavlovian threat conditioning. We found that patients with dlPFC lesions were able to acquire conditioned threat but seemed impaired in their ability to utilize CRT to cognitively regulate subjective fear to a threatening stimulus. Despite inclusion of a limited number of lesion patients, our results suggest that the dlPFC is important for the cognitive regulation of subjective fear.


cognition; emotion; lesions; patients; prefrontal cortex; regulation

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