Bechara Antoine
Department of Neurology, University of Iowa, Iowa City, IA 52242, USA.
Brain Cogn. 2004 Jun;55(1):30-40. doi: 10.1016/j.bandc.2003.04.001.
Most theories of choice assume that decisions derive from an assessment of the future outcomes of various options and alternatives through some type of cost-benefit analyses. The influence of emotions on decision-making is largely ignored. The studies of decision-making in neurological patients who can no longer process emotional information normally suggest that people make judgments not only by evaluating the consequences and their probability of occurring, but also and even sometimes primarily at a gut or emotional level. Lesions of the ventromedial (which includes the orbitofrontal) sector of the prefrontal cortex interfere with the normal processing of "somatic" or emotional signals, while sparing most basic cognitive functions. Such damage leads to impairments in the decision-making process, which seriously compromise the quality of decisions in daily life. The aim of this paper is to review evidence in support of "The Somatic Marker Hypothesis," which provides a systems-level neuroanatomical and cognitive framework for decision-making and suggests that the process of decision-making depends in many important ways on neural substrates that regulate homeostasis, emotion, and feeling. The implications of this theoretical framework for the normal and abnormal development of the orbitofrontal cortex are also discussed.
大多数选择理论都假定，决策源自通过某种成本效益分析对各种选项和替代方案的未来结果进行评估。情绪对决策的影响在很大程度上被忽视了。对那些无法正常处理情绪信息的神经疾病患者的决策研究表明，人们不仅通过评估后果及其发生的可能性来做出判断，而且有时甚至主要是在直觉或情感层面做出判断。前额叶皮层腹内侧（包括眶额）区域的损伤会干扰“躯体”或情感信号的正常处理，同时保留大多数基本认知功能。这种损伤会导致决策过程受损，严重影响日常生活中的决策质量。本文的目的是综述支持“躯体标记假说”的证据，该假说为决策提供了一个系统层面的神经解剖学和认知框架，并表明决策过程在许多重要方面依赖于调节内稳态、情绪和感觉的神经基质。本文还讨论了这一理论框架对眶额皮层正常和异常发育的影响。
