Bechara · Cerebral cortex (New York, N.Y. : 1991) 1996 · case-control study · n=19

Failure to respond autonomically to anticipated future outcomes following damage to prefrontal cortex.

Cited 1182 times in the scientific literature.

Level 4 - case-series / case-control

Small observational case-control physiological study comparing lesion patients to healthy controls

PubMed 8670652 · doi:10.1093/cercor/6.2.215 · record verified 2026-08-26

What was done

Skin conductance responses (SCRs) were measured in 7 patients with prefrontal cortex damage and 12 normal controls during a novel card task that simulates real-life decision making involving uncertainty, rewards, and penalties. SCRs were evaluated after card selection (in response to penalties or rewards) and prior to card selection (anticipatory responses while pondering deck choice).

What was found

The abstract reports no numerical values, percentages, or statistical metrics. Both patients and controls generated SCRs following card selection with penalties or rewards. Normal controls began generating anticipatory SCRs prior to card selection after a number of trials, whereas no patients with prefrontal cortex damage showed anticipatory SCRs.

Why it matters

This study provides physiological evidence for the somatic marker hypothesis, demonstrating that prefrontal damage impairs the generation of anticipatory bodily signals that guide decision making under uncertainty.

Limits

The sample size is very small (n=19 total: 7 patients, 12 controls). The abstract does not provide quantitative data, confidence intervals, or specific anatomical localization beyond general prefrontal sectors, and real-world behavior is inferred from a simulated laboratory card task.

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