Impairment of social and moral behavior related to early damage in human prefrontal cortex

The long-term consequences of early prefrontal cortex lesions occurring bef ore 16 months were investigated in two adults. As is the case when such dam age occurs in adulthood, the two early-onset patients had severely impaired social behavior despite normal basic cognitive abilities, and showed insen sitivity to future consequences of decisions, defective autonomic responses to punishment contingencies and failure to respond to behavioral intervent ions. Unlike adult-onset patients, however, the two patients had defective social and moral reasoning, suggesting that the acquisition of complex soci al conventions and moral rules had been impaired. Thus early-onset prefront al damage resulted in a syndrome resembling psychopathy.