Cambridge research shows that age and brain damage affects awareness of why we act the way we do

New research by experts at CPFT and University of Cambridge shows that people can react to changes in the consequences of their actions without being aware of the changes and this gets worse as we get older or if there has damage to the brain’s prefrontal cortex.

Cambridge research shows that age and brain damage affects awareness of why we act the way we do
23 February 2018

Cambridge research shows that age and particular kinds of brain injury affect awareness of why we act the way we do

New research by experts at CPFT and University of Cambridge shows that people can react to changes in the consequences of their actions without being aware of the changes and this gets worse as we get older or if there has damage to the brain’s prefrontal cortex.

When you act, you do so based on the consequences of your actions, and you are aware of these consequences. One might think that choices follow from knowledge - that you act because you are aware of the consequences.

In research published in Neuropsychologia Dr Claire O'Callaghan and colleagues from the University of Cambridge and CPFT, Dr Rudolf Cardinal, have shown that people can react to changes in the consequences of their actions without awareness of the changes

This separation of knowledge and performance becomes more likely as people get older, and if the ventromedial (lower centre) part of the prefrontal cortex (vmPFC) is damaged such as following neurosurgery for benign brain tumours.

In older adults and people with vmPFC damage, actions changed as their consequences changed, but awareness of that change was lost under some circumstances. This brain region may be important for "knowing that you know" things.

Fifteen individuals with adult-onset brain lesions that were stable and chronic (sustained more than four years beforehand) were recruited from the Cambridge Cognitive Neuroscience Research Panel at the MRC Cognition and Brain Sciences Unit, Cambridge

Seventeen healthy subjects (age range: 52–71 years) were selected from a volunteer panel to serve as age-matched controls for the lesion groups. To replicate the findings from this first older control group and contrast them with a younger control group, a further 15 age-matched older adults (age range: 55–76 years), as well as 15 young adults (18–25 years) were recruited.

Recruitment and characterisation of individuals with brain lesions was made possible by the Cambridge Cognitive Neuroscience Research Panel at the MRC Cognition and Brain Sciences Unit, Cambridge. We acknowledge the contribution of Dr Sharon Erzinçlioğlu, Prof. Facundo Manes and Dr Tilak Das, consultant radiologist, Addenbroke's Hospital, for their involvement in co-ordinating the panel, lesion tracing, and referral to the panel.


This research was funded by a Wellcome Trust Senior Investigator Award. Work was completed at the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK, supported by a joint award from the Medical Research Council and Wellcome Trust.

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