Decision-malting deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers
Decision-malting deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers
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DOI：
10.1016/s0028-3932(00)00136-6
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发表时间：
2001-01-01
期刊：
影响因子：
2.6
通讯作者：
Nathan, PE
中科院分区：
文献类型：
--
作者：
Bechara, A;Dolan, S;Nathan, PE
被称为“赌博任务”的决策工具，已被证明是敏感的决策障碍的患者双侧病变的腹内侧前额叶皮层（VM）。测试了三组受试者，物质依赖个体（SD）（n = 41）、正常对照（n = 40）和VM患者（n = 5）。所有SD都符合DSM-IV的依赖性标准，酒精或兴奋剂（甲基苯丙胺或可卡因）作为首选物质。结果显示，SD的性能相对于正常对照组有显着损害。显著高比例的SD（61 vs.仅32.5%的正常对照）在VM患者的范围内进行，而其余的在正常对照的范围内进行。一般的人口统计学因素，如年龄，性别和教育水平不能解释这些差异的表现。同样，智力（IQ）、记忆力或标准执行功能/额叶测试的表现也不能解释表现上的差异。赌博任务的表现最好通过多种因素的组合来预测，包括禁欲的持续时间，滥用的年份，复发和治疗的时间，以及从事有报酬工作的能力。这些结果支持了这样的假设，即与功能障碍的VM皮层相关的决策障碍与至少一个SD亚组相关。(C)2001爱思唯尔科技有限公司版权所有。
A decision-making instrument known as the 'gambling task' was used, which has been shown to be sensitive to the decision-making impairment of patients with bilateral lesions of the ventromedial prefrontal cortex (VM). Three groups of subjects were tested, substance dependent individuals (SD) (n = 41), normal controls (n = 40), and VM patients (n = 5). All SD met the DSM-IV criteria for dependence, with either alcohol or stimulants (metamphetamine or cocaine) as the primary substance of choice. The results revealed a significant impairment in the performance of SD relative to normal controls. A significantly high proportion of SD (61 vs. only 32.5% of normal controls) performed within the range of the VM patients, while the rest performed within the range of normal controls. General demographic Factors such as age, sex, and level of education could not explain these differences in performance. As well, differences in performance were not explained by intelligence (IQ), memory, or performance on standard executive function/frontal lobe tests. Performance on the gambling task was best predicted by a combination of factors; including duration of abstinence, years of abuse, relapses and limes in treatment, and the ability to hold gainful employment. The results support the hypothesis that impairment in decision-making linked to a dysfunctional VM cortex is associated with at least a sub-group of SD. (C) 2001 Elsevier Science Ltd. All rights reserved.