Decision-making, behavioral supervision and learning: an executive role for the ventral premotor cortex?

In order to adjust the behavioral performance in a changing environment, subjects have to monitor their evolving actions and to know whether their responses were correct or incorrect. This requires self-awareness, cognitive flexibility, working memory (WM), and decision making that frequently are impaired in psychosis. What is the neural substrate of these processes and where are these substrates located? Dysfunction of prefrontal, parietal, temporal cortices, and associated subcortical structures are known to be involved in some of these symptoms. The prefrontal-subcortical circuits have been the main focus of study while other cortical areas such as the premotor cortex have received less attention. The main focus of this review is about the evidence that the ventral premotor cortex processes both recent sensory information and that from long-term memory to decide and evaluate the behavior of previous decisions. This process may serve for learning and thus adapting future behavior to environmental demands. Therefore, dysfunction of this cortical area could be related to some cognitive neuropsychiatric disorders.