Contextual Modulation of Semantic Coherence in vmPFC Patients’ Mental Constructions

Previous evidence has identified the ventromedial prefrontal cortex (vmPFC) as crucial for implementing high-level semantic memory structures (schemas) during event construction. If this is the case, one would expect reduced semantic coherence in events mentally constructed by vmPFC patients compared to healthy and brain-damaged controls. We tested this prediction by having participants mentally construct events using objects as cues and reanalyzing a published dataset using sentences as cues. In both cases, we measured the semantic coherence of patients’ mental constructions and their semantic coherence with the cue, using transformer-based sentence embeddings (S-BERT), and further corroborated the findings with E5 Multilingual and E5 Italian embedding models. Our results reveal that the hypothesized impairment in semantic coherence following vmPFC damage is, in fact, task-dependent. With minimal (object) cues, vmPFC patients’ reports exhibited reduced local coherence, increased connectedness to the cues, and reduced lexical diversity. In contrast, with extended (sentence) cues, they showed preserved- or even enhanced-local and global coherence. We suggest that vmPFC integrity is necessary to trigger schema activation under minimal cue conditions. Although extended cues may facilitate schema activation, schemas are degraded and essentialized following vmPFC damage, thereby constraining patients’ mental constructions within a narrower—hence overly coherent—semantic space.