Prefrontal cortex damage abolishes brand-cued changes in cola preference.

Human decision-making is remarkably susceptible to commercial advertising, yet the neurobiological basis of this phenomenon remains largely unexplored. With a series of Coke and Pepsi taste tests we show that patients with damage specifically involving ventromedial prefrontal cortex (VMPC), an area important for emotion, did not demonstrate the normal preference bias when exposed to brand information. Both comparison groups (neurologically normal adults and lesion patients with intact VMPC) preferred Pepsi in a blind taste test, but in subsequent taste tests that featured brand information ('semi-blind' taste tests), both comparison groups' preferences were skewed toward Coke, illustrating the so-called 'Pepsi paradox'. Like comparison groups, the VMPC patients preferred Pepsi in the blind taste test, but unlike comparison groups, the VMPC patients maintained their Pepsi preference in the semi-blind test. The result that VMPC damage abolishes the 'Pepsi paradox' suggests that the VMPC is an important part of the neural substrate for translating commercial images into brand preferences.