Orbitofrontal cortex output pathways: cingulate cortex, basal ganglia, and dopamine

The medial orbitofrontal cortex projects reward-related information to the pregenual cingulate cortex, and the lateral orbitofrontal cortex projects punishment and non-reward information to the supracallosal anterior cingulate cortex. These projections provide the reward outcome information needed for action-outcome goal value dependent instrumental learning by the cingulate cortex. The orbitofrontal cortex also projects reward-related information to the striatum for stimulus-response habit learning. Via the striatal route, and further in part via the habenula, the orbitofrontal cortex provides information about rewards and non-rewards that reached the brainstem dopamine neurons, some of which respond to positive reward prediction error, and the serotonin (5HT) neurons. The orbitofrontal cortex is therefore perhaps the key brain region involved in reward processing in the brain. The orbitofrontal cortex also has projections that can influence autonomic function, in part via the insula.