The role of prefrontal cortex sub-circuits in impulse control and preference consistency: Behavioural analyses in patients with focal prefrontal cortex lesions.

人们通常更喜欢大奖励而不是小奖励，更喜欢即时奖励而不是延迟奖励。然而，在大多数情况下，奖励的差异不止一个维度（即在跨时间选择中，人们在较小但较早的奖励和较大但较晚的奖励之间进行选择）。这些情况需要在等待时间和奖励大小之间进行权衡，人们通常会根据延迟的近似双曲线函数（延迟或时间贴现）来贴现未来奖励的价值。这样的决定是高度相关的，因为许多冲动控制障碍（如成瘾、注意力缺陷多动障碍）都与这些任务中的冲动反应有关。功能性磁共振成像和经颅磁刺激研究表明，在这种情况下，额顶叶控制网络参与实施冲动控制（即支持选择具有较大长期回报的选项，同时抵制选择即时满足的诱惑）。在这种情况下，腹内侧前额叶皮层损伤会减少冲动控制，并可能额外增加偏好不一致。相比之下，目前缺乏通过人体病变研究直接证明外侧前额叶皮层参与的证据。本项目旨在直接评估局灶性前额皮质病变患者样本的冲动控制和偏好一致性（在测试期间和测试期间）。这种结合的方法将允许比较外侧和腹内侧前额叶皮层对基于价值的决策和冲动控制的不同组成部分的贡献。

People typically prefer large rewards over small rewards and immediate rewards over delayed rewards. Yet, in most scenarios rewards differ on more than one dimension (i.e. in inter-temporal choice, people are choosing between smaller-but-sooner and larger-but-later reward). These situations require a trade-off between waiting time and reward magnitude, and people typically discount the value of a future reward following an approximately hyperbolic function of the delay (delay or temporal discounting). Such decisions are highly relevant because many impulse control disorders (e.g. addiction, attention-deficit hyperactivity disorder) are associated with impulsive responses in these tasks. Functional magnetic resonance imaging and transcranial magnetic stimulation studies have suggested that a fronto-parietal control network is involved in implementing impulse control in such scenarios (i.e. supporting choices of options with larger long-term payoff, while resisting the temptation to opt for immediate gratification). Ventro-medial prefrontal cortex damage reduces impulse control in such scenarios, and may additionally increase preference inconsistency. In contrast, direct evidence for an involvement of the lateral prefrontal cortex via human lesion studies is currently lacking. The present project aims to directly assess impulse control and preference consistency (both within- and between testing sessions) in a sample of patients with focal prefrontal cortex lesions. This combined approach will allow the comparison of lateral and ventro-medial prefrontal cortex contributions to distinct components of value-based decision-making and impulse control.