Alvaro Pascual-Leone – 2009

11th Annual Lecture

Alvaro Pascual-Leone
Berenson-Allen Center for Noninvasive Brain Stimulation
Harvard University

March 20, 2009
Cohen Hall Auditorium


Modifying Decision Making

In recent years, dual-process theories that contrast automated and controlled processes have been put forward to explain different areas of human cognition. In this context, will-power refers to goal-driven cognitive control or regulation of impulses, passions, cravings, and habits. Such regulation may be conceptualized as cognitive control over the balance between a “cool”, reflective mental system that effortfully represents rational and reasoned goals, such as long-term mental and physical health, and a “hot”, reflexic mental system that automatically guides quick, impulsive, and emotional responses to environmental stimuli.

In recent years, lesion and functional neuroimaging studies suggest that the prefrontal cortex is a critical component of the neural circuitry engaged when people voluntarily and consciously regulate their behavior. In addition to neuroimaging studies, lesion studies suggest that particularly the right prefrontal cortex plays a central role in behavioral regulation and the control of impulsive, reflexic tendencies.

Modulation of will-power and dual-process theories offer a valuable framework that can serve to guide translational insights from cognitive neuroscience into the clinic. Proof-of-principle studies reveal that noninvasive brain stimulation of the dorsolateral prefrontal cortex with repetitive transcranial magnetic stimulation or transcranial direct current stimulation can influence decision-making, enhance will-power and promote reflective processes in healthy subjects. The same type of noninvasive brain stimulation can suppress alcohol, cocaine, nicotine and even food craving in patients, who are known to have impaired decision-making behaviors. Modulation of decision making, and enhanced cognitive regulation of emotion, reward, and gratification could have widespread mental and physical health benefits, including mood disorders, anxiety, ADHD, PTSD, substance abuse, smoking, and obesity.



Lecture Video