The ventromedial prefrontal cortex (vmPFC) is a key brain structure implicated in mood and anxiety disorders, based primarily on evidence from correlational neuroimaging studies. Composed of a number of brain regions with distinct architecture and connectivity, dissecting its functional heterogeneity will provide key insights into the symptomatology of these disorders. Focusing on area 14, lying on the medial and orbital surfaces of the gyrus rectus, this study addresses a key question of causality. Do changes in area 14 activity induce changes in threat- and reward-elicited responses within the nonhuman primate, the common marmoset, similar to that seen in mood and anxiety disorders? Area 14 overactivation was found to induce heightened responsivity to uncertain, low-imminence threat while blunting cardiovascular and behavioral anticipatory arousal to high-value food reward. Conversely, inactivation enhanced the arousal to high-value reward cues while dampening the acquisition of cardiovascular and behavioral responses to a Pavlovian threat cue. Basal cardiovascular activity, including heart rate variability and sympathovagal balance, which are dysfunctional in mood and anxiety disorders, are insensitive to alterations in area 14 activity as is the extinction of conditioned threat responses. The distinct pattern of dysregulation compared to neighboring region area 25 highlights the heterogeneity of function within vmPFC and reveals how the effects of area 14 overactivation on positive and negative reactivity mirror symptoms of anhedonia and anxiety that are so often comorbid in mood disorders.

腹侧前额叶皮层（vmPFC）是涉及情绪和焦虑症的关键大脑结构，主要基于相关神经影像学研究的证据。解剖其功能异质性由许多具有不同结构和连通性的大脑区域组成，将提供对这些疾病的症状学的关键见解。重点研究位于直回内侧和眶表面的区域14，该研究解决了因果关系的关键问题。14区活动的变化是否会引起非人灵长类动物（即普通mar猴）中威胁和奖励引起的反应的变化，类似于情绪和焦虑症中看到的反应？发现区域14过度激活会引起对不确定性的高度响应，低危威胁，同时使心血管和行为预期唤起对高价值食物的奖励。相反，失活增强了对高价值奖励线索的唤醒，同时抑制了对巴甫洛夫威胁线索的心血管和行为反应的获得。基础性心血管活动，包括心率变异性和交感神经平衡，在情绪和焦虑症中功能失调，对14区活动的变化不敏感，因为条件性威胁反应已消失。与邻近区域25相比，失调的独特模式突显了vmPFC内功能的异质性，并揭示了区域14过度活化对正反应和负反应的影响如何反映出通常在情绪障碍中常见的快感和焦虑症状。