The contributions of lesion laterality and lesion volume to decision-making impairment following frontal lobe damage
The contributions of lesion laterality and lesion volume to decision-making impairment following frontal lobe damage
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DOI：
10.1016/s0028-3932(03)00081-2
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发表时间：
2003-01-01
期刊：
影响因子：
2.6
通讯作者：
Robbins, TW
中科院分区：
文献类型：
--
作者：
Clark, L;Manes, F;Robbins, TW
人类前额叶皮质(PFC)的损害可以严重扰乱日常决策，并伴随着对社会和职业功能的影响。46名单侧前额叶损害患者和21名健康对照受试者接受了三种神经心理学的决策测量：爱荷华州赌博任务、剑桥赌博任务和风险任务。40名患者接受了磁共振成像(MRI)扫描，并绘制了前额叶区域的感兴趣区(ROI)图。额叶患者仅表现出内侧和眼眶前额叶皮质的有限损害，但在感兴趣的外侧前额叶区域损害更大。患有右额叶病变的患者更喜欢在爱荷华州赌博任务中选择有风险的牌子，并且与左额叶和对照组受试者有显著差异。在右额叶组中，对危险平台的偏好与总病变体积和前额腹内侧区外的病变体积相关。右侧和左侧额叶组在剑桥赌博任务或风险任务上没有显著差异，而且表现与病变体积无关。结果表明，爱荷华州赌博任务存在偏侧性效应，前额叶腹内侧区外区域对任务绩效的贡献显著。剑桥Gamble任务和Risk任务对单侧额叶损伤的影响不那么敏感，可能更有选择性地与腹侧前额叶损伤相关。(C)2003爱思唯尔科学有限公司。保留所有权利。
Lesions to prefrontal cortex (PFC) in humans can severely disrupt everyday decision-making, with concomitant effects on social and occupational functioning. Forty-six patients with unilateral lesions to prefrontal cortex and 21 healthy control subjects were administered three neuropsychological measures of decision-making: the Iowa Gambling Task, the Cambridge Gamble Task, and the Risk Task. Magnetic resonance imaging (MRI) scans were acquired from 40 patients, with region of interest (ROI) mapping of prefrontal subregions. The frontal patients showed only limited damage in medial and orbital prefrontal cortex, but greater damage in lateral prefrontal regions of interest. Patients with right frontal lesions prefer-red the risky decks on the Iowa Gambling Task, and differed significantly from left frontal and control subjects. Within the right frontal group, the preference for the risky decks was correlated with the total lesion volume and the volume of damage outside of the ventromedial prefrontal region. Right and left frontal groups did not differ significantly on the Cambridge Gamble Task or the Risk Task, and performance was not associated with lesion volume. The results indicate a laterality effect on the Iowa Gambling Task, and the contribution of prefrontal regions outside the ventromedial region to task performance. The Cambridge Gamble Task and Risk Task were less sensitive to the effects of unilateral frontal lobe lesions, and may be more selectively associated with ventral prefrontal damage. (C) 2003 Elsevier Science Ltd. All rights reserved.