Impulsivity, time perception, emotion and reinforcement sensitivity in patients with orbitofrontal cortex lesions
Impulsivity, time perception, emotion and reinforcement sensitivity in patients with orbitofrontal cortex lesions
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DOI：
10.1093/brain/awh135
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发表时间：
2004-05-01
期刊：
影响因子：
14.5
通讯作者：
Kischka, U
中科院分区：
文献类型：
--
作者：
Berlin, HA;Rolls, ET;Kischka, U
人类眶额皮质（OFC）的损伤与不受抑制或社交不当的行为和情绪变化有关。一些变化可能与对奖励和惩罚者做出正确反应的困难有关，因为当视觉刺激不再与奖励相关时，这些患者很难学习纠正他们对视觉刺激的选择。我们通过调查额叶功能障碍和冲动行为之间的关系，在前额叶皮层损伤患者中观察到的行为，情绪和个性变化，从而扩展了这种基本方法，从而进一步阐明了冲动人群中受损的认知和生物过程。OFC患者（n = 23）进行更冲动的自我报告和认知/行为测试的冲动，报告更多的不适当的“正面”的行为，并表现出更差的刺激强化关联逆转任务，比非OFC前额叶皮层病变的控制（n = 20）和正常对照组（n = 39）的参与者。此外，OFC患者比非OFC和正常参与者经历了更多的主观愤怒，比正常人更少的主观幸福感;并且比正常对照组有更快的主观时间感（高估和产生不足的时间间隔），而非OFC患者与正常人没有差异。最后，OFC和非OFC患者都比正常参与者更不开放。OFC患者、非OFC病变患者和正常对照组在所有其他人格特质上均无差异，最显著的是外向性。在空间工作记忆任务中，非OFC组，其中大多数人有背外侧前额叶皮层病变，受损的是，他们反复返回到以前选择的空位置（“内错误”），而OFC患者没有损害这项措施。因此，眶额皮层损伤的影响与背外侧前额叶皮层损伤的影响之间存在分离，眶额皮层损伤不影响空间工作记忆的测量，但影响冲动和不适当的行为、逆转、人格、时间知觉和情绪;背外侧前额叶皮层损伤影响空间工作记忆的测量，但不影响冲动和不适当的行为、逆转、人格、时间知觉和情绪。这里描述的OFC损伤对冲动行为和相关行为的影响对理解冲动行为有影响。
Damage to the orbitofrontal cortex (OFC) in humans has been associated with disinhibited or socially inappropriate behaviour and emotional changes. Some of the changes may be related to difficulty in responding correctly to rewards and punishers, in that these patients have difficulty in learning to correct their choice of a visual stimulus when it is no longer associated with reward. We extend this fundamental approach by investigating the relationship between frontal dysfunction and impulsive behaviour, the behavioural, emotional and personality changes seen in patients with prefrontal cortex damage, and thus in addition illuminate the cognitive and biological processes that are impaired in impulsive people. OFC patients (n = 23) performed more impulsively on both self-report and cognitive/behavioural tests of impulsivity, reported more inappropriate 'frontal' behaviours, and performed worse on a stimulus-reinforcement association reversal task, than non-OFC prefrontal cortex lesion control (n = 20) and normal control (n = 39) participants. Further, OFC patients experienced more subjective anger than non-OFC and normal participants, and less subjective happiness than normals; and had a faster subjective sense of time (overestimated and underproduced time intervals) than normal controls, while non-OFC patients did not differ from normals. Finally, both OFC and non-OFC patients were less open to experience than normal participants. There were no differences between OFC patients, non-OFC lesion patients and normal controls on all other personality traits, most notably extraversion. In a spatial working memory task, the non-OFC group, most of whom had dorsolateral prefrontal cortex lesions, were impaired in that they repeatedly returned to previously chosen empty locations ('within errors'), whereas OFC patients were not impaired on this measure. Thus there is a dissociation between the effects of OFC damage which does not affect this measure of spatial working memory but does affect impulsive and inappropriate behaviour, reversal, personality, time perception and emotion; and dorsolateral prefrontal cortex damage which does affect this measure of spatial working memory, but not impulsive and inappropriate behaviour, reversal, personality, time perception and emotion. The effects of OFC damage on impulsive and related behaviours described here have implications for understanding impulsive behaviour.