Scientific approaches to understand the neural processes underlying how we make decisions have used a variety of methods in their quest to describe how the brain makes decisions, including functional neuroimaging, and work with brain damaged patients. We studied the decision-making capabilities of patients who had suffered injury to the ventromedial sector of their prefrontal cortex. At the time, the decision-making deficit seen in these patients presented a puzzling defect because their impairment was obvious in their real life, but there was no laboratory probe to detect and measure this decision-making impairment in the clinic. Many of these challenges were overcome with the development of what became known as the Iowa Gambling Task (IGT). The development of this task enabled investigators to detect these patients’ elusive impairment in the laboratory, measure it, and investigate its possible causes.

There have been many application of this research on decision-making to understanding the neurobiology of addiction. We have linked substance addiction behaviors to impaired decision-making and a dysfunctional ventromedial prefrontal cortex.

Another key research area relates to the finding that the insula is critical for smoking addiction (and potentially other substances of abuse). This finding brought to light the potential role of a new neural region, the insular cortex, which was completely ignored in the past in the psychopathology of addiction.

There is currently an extension of this decision neuroscience research to behavioral addictions where attempts are being made to understand the brain mechanisms that underlie human choice, particularly in the areas of making healthy food choices, gambling behaviors, and problematic Internet use.


Antoine Bechara, PhD

Ofir Turel, PhD

Damien Brevers, PhD

Quinhua He, PhD

Tasha Poppa

Highly Cited Publications

A. Bechara, A.R. Damasio, H. Damasio, SW Anderson, Insensitivity To Future Consequences Following Damage To Human Prefrontal Cortex, Cognition, Vol 50 (1994) DOI 10.1016/0010-0277(94)90018-3

A. Bechara, H. Damasio, A.R. Damasio, Emotion, decision making and the orbitofrontal cortex, CEREBRAL CORTEX, Vol 10 (2000) DOI 10.1093/cercor/10.3.295

A. Bechara, H. Damasio, D. Tranel, A.R. Damasio, Deciding advantageously before knowing the advantageous strategy SCIENCE, Vol 275, DOI 10.1126/science.275.5304.1293

A.R. Damasio, T.J. Grabowski, A. Bechara, H. Damasio, LLB Ponto, J. Parvizi, R.D. Hichwa, Subcortical and cortical brain activity during the feeling of self-generated emotions, NATURE NEUROSCIENCE, Vol 3 (2000), DOI 10.1038/79871

A. Bechara, H. Damasio, A.R. Damasio, G.P. Lee, Different contributions of the human amygdala and ventromedial prefrontal cortex to decision-making, JOURNAL OF NEUROSCIENCE, Vol 19 (1999), Issue 13

A. Bechara, D. Tranel, H. Damasio, Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions, BRAIN, Vol 123, DOI 10.1093/brain/123.11.2189

S.W. Anderson, A. Bechara, H. Damasio, D. Tranel, A.R. Damasio, Impairment of social and moral behavior related to early damage in human prefrontal cortex, NATURE NEUROSCIENCE, Vol 2 (1999)

A. Bechara, D. Tranel, H. Damasio, R. Adolphs, C. Rockland, A.R. Damasio, Double Dissociation Of Conditioning And Declarative Knowledge Relative To The Amygdala And Hippocampus In Humans, SCIENCE, Vol 269 (1995) DOI 10.1126/science.7652558

A. Bechara, A.R. Damasio, The somatic marker hypothesis: A neural theory of economic decision, GAMES AND ECONOMIC BEHAVIOR, Vol 52 (2005) DOI 10.1016/j.geb.2004.06.010

A. Bechara, D. Tranel, H. Damasio, A.R. Damasio, Failure to respond autonomically to anticipated future outcomes following damage to prefrontal cortex, CEREBRAL CORTEX, Vol 6 (1996) DOI 10.1093/cercor/6.2.215
Recent Publications

Q.H. He, X.L. Huang, S.Y. Zhang, O. Turel, L.S. Ma, A. Bechara, Dynamic Causal Modeling of Insular, Striatal, and Prefrontal Cortex Activities During a Food-Specific Go/NoGo Task, BIOLOGICAL PSYCHIATRY-COGNITIVE NEUROSCIENCE AND NEUROIMAGING, Vol 4 (2019), DOI 10.1016/j.bpsc.2018.12.005

A. Bechara, K.C. Berridge, W.K. Bickel, J.A. Moron, S.B. Williams, J.S. Stein, A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction, PSYCHOLOGICAL SCIENCE IN THE PUBLIC INTEREST, Vol 20 (2019) DOI 10.1177/1529100619860513

Q.H. He, O. Turel, D. Brevers, A. Bechara, Excess social media use in normal populations is associated with amygdala-striatal but not with prefrontal morphology, PSYCHIATRY RESEARCH-NEUROIMAGING, Vol 269 (2017) DOI 10.1016/j.pscychresns.2017.09.003

O. Turel, Q.H. He, D. Brevers, A. Bechara, Delay discounting mediates the association between posterior insular cortex volume and social media addiction symptoms, COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE, Vol 18 (2018) DOI 10.3758/s13415-018-0597-1

O. Turel, Q. He, D. Brevers, A. Bechara, Social networking sites use and the morphology of a social-semantic brain network, SOCIAL NEUROSCIENCE, Vol 13 (2018) DOI 10.1080/17470919.2017.1382387


“In Clue to Addiction, Brain Injury Halts Smoking.” The New York Times, January 26, 2007.

“A Gift for Better Eating.” USC Dornsife News, July 28, 2015.