Studies of neurological patients can be particularly useful in testing whether putative component processes are, in fact, distinct (by showing, for example, that one process is impaired, and another spared, after brain damage). Furthermore, when such work is carried out in patients with defined brain injuries, inferences can be drawn about the brain substrates of the process in question. Thus, a neurological approach provides a useful window on decision making. This chapter will review work on the brain substrates of value-based decision making from this perspective, concentrating particularly on component process approaches. As we shall see, at least some of this work has addressed how “value” relates to choice objects in the world, and as such can be framed as a linkage of sensation and reward. Experimental studies of patients with focal brain injury aimed at delineating the neuroanatomical substrates of decision making will be the primary focus, but I will also touch on work examining the neurochemical modulation of choice. As mentioned, this basic science research also offers an interesting perspective on the mechanisms underlying the everyday difficulties of patients with dysfunction of systems important to decision and reward processing. I will return to this at the end of the chapter.
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