It is well established that the ventromedial prefrontal cortex (vmPFC) plays a critical role in memory consolidation and the retrieval of remote long-term memories. Recent evidence suggests that the vmPFC also supports rapid neocortical learning and consolidation over shorter timescales, particularly when novel events align with stored knowledge. One mechanism by which the vmPFC has been proposed to support this learning is by integrating congruent information into existing neocortical knowledge during memory encoding. An important outstanding question is whether the vmPFC also plays a critical role in linking congruent information with existing knowledge before storage in long-term memory. The current study investigated this question by testing whether lesions to the vmPFC disrupt the ability to leverage stored knowledge in support of short-term memory. Specifically, we investigated the visuospatial bootstrapping effect, the phenomenon whereby immediate verbal recall of visually presented stimuli is better when stimuli appear in a familiar visuospatial array that is congruent with prior knowledge compared with an unfamiliar visuospatial array. We found that the overall magnitude of the bootstrapping effect did not differ between patients with vmPFC lesions and controls. However, a reliable bootstrapping effect was not present in the patient group alone. Post hoc analysis of individual patient performance revealed that the bootstrapping effect did not differ from controls in nine patients but was reduced in two patients. Although mixed, these results suggest that vmPFC lesions do not uniformly disrupt the ability to leverage stored knowledge in support of short-term memory.
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