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Background  Although human beings regularly experience fictional worlds through activities such as reading novels and watching movies, little is known about what mechanisms underlie our implicit knowledge of the distinction between reality and fiction. The first neuroimaging study to address this issue revealed that the mere exposure to contexts involving real entities compared to fictional characters led to engagement of regions in the anterior medial prefrontal and posterior cingulate cortices (amPFC, PCC). As these core regions of the brain's default network are involved during self-referential processing and autobiographical memory retrieval, it was hypothesized that real entities may be conceptually coded as being more personally relevant to us than fictional characters.    Methodology/Principal Findings  In the present functional magnetic resonance imaging (fMRI) study, we directly test the hypothesis that entity-associated personal relevance is the critical factor underlying the differential engagement of these brain regions by comparing the brain's response when processing contexts involving family or friends (high relevance), famous people (medium relevance), or fictional characters (low relevance). In line with predictions, a gradient pattern of activation was observed such that higher entity-associated personal relevance was associated with stronger activation in the amPFC and the PCC.    Conclusions/Significance  The results of the study have several important implications. Firstly, they provide informed grounds for characterizing the dynamics of reality-fiction distinction. Secondly, they provide further insights into the functions of the amPFC and the PCC. Thirdly, in view of the current debate related to the functional relevance and specificity of brain's default network, they reveal a novel approach by which the functions of this network can be further explored.

Reality = Relevance? Insights from Spontaneous Modulations of the Brain's Default Network when Telling Apart Reality from Fiction