Failure to respond autonomically to anticipated future outcomes following damage to prefrontal cortex
Failure to respond autonomically to anticipated future outcomes following damage to prefrontal cortex
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DOI：
10.1093/cercor/6.2.215
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发表时间：
1996-03-01
期刊：
影响因子：
3.7
通讯作者：
Damasio, AR
中科院分区：
文献类型：
--
作者：
Bechara, A;Tranel, D;Damasio, AR
在前额叶皮层的特定区域受损后，尽管人类的智力表现正常，但在现实生活中的决策能力会出现缺陷。受此影响的病人甚至可能意识到他们行为的后果，但没有采取相应的行动，从而表现出对未来的遗忘。这种缺陷的神经基础一直无法解释。在这里，我们确定了生理相关的缺陷，并讨论其可能的意义。我们测量了7名前额叶损伤患者和12名正常对照的皮肤电导反应（SCR），在执行一项新任务时，这是一种模拟现实生活中决策的纸牌游戏，其因素包括不确定性，奖励和惩罚。患者和对照组在选择卡片后都产生了SCR，随后是惩罚或奖励。然而，经过多次试验，对照组在选择卡片之前也开始产生SCR，同时他们考虑从哪副卡片中选择，但没有患者表现出这种预期的SCR。前额叶损伤患者缺乏预期性SCR与他们对未来结果不敏感有关。这与以下观点是一致的：这些患者未能激活偏见信号，这些信号将作为区分未来结果好坏的选择的价值标记;这些信号还参与增强与决策过程相关的表征的注意力和工作记忆;这些信号来自维持躯体内环境稳定的生物调节机制，并可以表达为情绪和感觉。
Following damage to specific sectors of the prefrontal cortex, humans develop a defect in real-life decision making, in spite of otherwise normal intellectual performance. The patients so affected may even realize the consequences of their actions but fail to act accordingly, thus appearing oblivious to the future. The neural basis of this defect has resisted explanation. Here we identify a physiological correlate for the defect and discuss its possible significance. We measured the skin conductance responses (SCRs) of 7 patients with prefrontal damage, and 12 normal controls, during the performance of a novel task, a card game that simulates real-life decision making in the way it factors uncertainty, rewards, and penalties. Both patients and controls generated SCRs after selecting cards that were followed by penalties or by reward. However, after a number of trials, controls also began to generate SCRs prior to their selection of a card, while they pondered from which deck to choose, but no patients showed such anticipatory SCRs. The absence of anticipatory SCRs in patients with prefrontal damage is a correlate of their insensitivity to future outcomes. It is compatible with the idea that these patients fail to activate biasing signals that would serve as value markers in the distinction between choices with good or bad future outcomes; that these signals also participate in the enhancement of attention and working memory relative to representations pertinent to the decision process; and that the signals hail from the bioregulatory machinery that sustains somatic homeostasis and can be expressed in emotion and feeling.