Clark Luke, Manes Facundo, Antoun Nagui, Sahakian Barbara J, Robbins Trevor W
Department of Experimental Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK.
Neuropsychologia. 2003;41(11):1474-83. doi: 10.1016/s0028-3932(03)00081-2.
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 preferred 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.
人类前额叶皮质（PFC）受损会严重扰乱日常决策，并对社会和职业功能产生相应影响。对46例单侧前额叶皮质损伤患者和21名健康对照者进行了三项决策方面的神经心理学测试：爱荷华赌博任务、剑桥赌博任务和风险任务。对40例患者进行了磁共振成像（MRI）扫描，并对前额叶亚区域进行了感兴趣区域（ROI）映射。额叶损伤患者在内侧和眶额前额叶皮质仅表现出有限的损伤，但在感兴趣的外侧前额叶区域损伤更大。右侧额叶损伤患者在爱荷华赌博任务中更喜欢风险较大的牌组，与左侧额叶损伤患者及对照组有显著差异。在右侧额叶损伤组中，对风险较大牌组的偏好与总损伤体积及腹内侧前额叶区域外的损伤体积相关。右侧和左侧额叶损伤组在剑桥赌博任务或风险任务上没有显著差异，且表现与损伤体积无关。结果表明在爱荷华赌博任务上存在偏侧性效应，以及腹内侧区域以外的前额叶区域对任务表现的作用。剑桥赌博任务和风险任务对单侧额叶损伤的影响较不敏感，可能更有选择性地与腹侧前额叶损伤相关。
