Preserved higher-order mentalising during strategic interactions after medial prefrontal cortex damage
Abstract
Mentalising, the ability to infer the beliefs and intentions of others, is essential for successful social interaction. Previous studies have implicated the medial prefrontal cortex in mentalising, but whether this region is necessary for higher-order mentalising remains unclear. Here we show that people with focal damage to the medial prefrontal cortex retain the ability to engage in higher-order mentalising during a strategic social game. We compare their performance with patients with brain damage in other regions and lesion-free participants. Individuals with medial prefrontal cortex damage achieve similar rewards and use comparable mentalising strategies, but they are slower when making strategic decisions. Computational modelling indicates that this slowing reflects a greater tendency to require evidence before committing to a choice. Voxel-based lesion-symptom mapping identifies medial prefrontal regions linked to altered decision processes rather than mentalising. These findings suggest that the medial prefrontal cortex supports strategic decisions while higher-order mentalising remains intact.
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BibTeX
@article{hsieh2026preserved,
title = {{Preserved higher-order mentalising during strategic interactions after medial prefrontal cortex damage}},
author = {Yi-Chen Hsieh and Arkady Konovalov and Zhi-Lin Su and Todd A. Vogel and Sanjay G. Manohar and Matthew A. J. Apps and Masud Husain and Christian C. Ruff and Patricia L. Lockwood},
journal = {Nature Communications},
year = {2026},
month = oct,
doi = {10.1038/s41467-026-77235-3},
url = {https://www.nature.com/articles/s41467-026-77235-3},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preserved higher-order mentalising during strategic interactions after medial prefrontal cortex damage
AU - Yi-Chen Hsieh
AU - Arkady Konovalov
AU - Zhi-Lin Su
AU - Todd A. Vogel
AU - Sanjay G. Manohar
AU - Matthew A. J. Apps
AU - Masud Husain
AU - Christian C. Ruff
AU - Patricia L. Lockwood
PY - 2026
DA - 2026/10/10
JO - Nature Communications
DO - 10.1038/s41467-026-77235-3
UR - https://www.nature.com/articles/s41467-026-77235-3
AB - Mentalising, the ability to infer the beliefs and intentions of others, is essential for successful social interaction. Previous studies have implicated the medial prefrontal cortex in mentalising, but whether this region is necessary for higher-order mentalising remains unclear. Here we show that people with focal damage to the medial prefrontal cortex retain the ability to engage in higher-order mentalising during a strategic social game. We compare their performance with patients with brain damage in other regions and lesion-free participants. Individuals with medial prefrontal cortex damage achieve similar rewards and use comparable mentalising strategies, but they are slower when making strategic decisions. Computational modelling indicates that this slowing reflects a greater tendency to require evidence before committing to a choice. Voxel-based lesion-symptom mapping identifies medial prefrontal regions linked to altered decision processes rather than mentalising. These findings suggest that the medial prefrontal cortex supports strategic decisions while higher-order mentalising remains intact.
SN - 2041-1723
ER -