Fellows Lesley K
Montreal Neurological Institute, Room 276, 3801 rue Université, Montréal, QC H3A 2B4, Canada.
Brain. 2006 Apr;129(Pt 4):944-52. doi: 10.1093/brain/awl017. Epub 2006 Feb 2.
Ventromedial frontal lobe (VMF) damage is associated with impaired decision making. Recent efforts to understand the functions of this brain region have focused on its role in tracking reward, punishment and risk. However, decision making is complex, and frontal lobe damage might be expected to affect it at other levels. This study used process-tracing techniques to explore the effect of VMF damage on multi-attribute decision making under certainty. Thirteen subjects with focal VMF damage were compared with 11 subjects with frontal damage that spared the VMF and 21 demographically matched healthy control subjects. Participants chose rental apartments in a standard information board task drawn from the literature on normal decision making. VMF subjects performed the decision making task in a way that differed markedly from all other groups, favouring an 'alternative-based' information acquisition strategy (i.e. they organized their information search around individual apartments). In contrast, both healthy control subjects and subjects with damage predominantly involving dorsal and/or lateral prefrontal cortex pursued primarily 'attribute-based' search strategies (in which information was acquired about categories such as rent and noise level across several apartments). This difference in the pattern of information acquisition argues for systematic differences in the underlying decision heuristics and strategies employed by subjects with VMF damage, which in turn may affect the quality of their choices. These findings suggest that the processes supported by ventral and medial prefrontal cortex need to be conceptualized more broadly, to account for changes in decision making under conditions of certainty, as well as uncertainty, following damage to these areas.
腹内侧额叶(VMF)损伤与决策能力受损有关。最近为了解该脑区功能所做的努力主要集中在其在追踪奖励、惩罚和风险方面的作用。然而,决策过程很复杂,额叶损伤可能会在其他层面影响决策。本研究采用过程追踪技术,探讨VMF损伤对确定性条件下多属性决策的影响。将13名患有局灶性VMF损伤的受试者与11名额叶损伤但VMF未受损的受试者以及21名人口统计学匹配的健康对照受试者进行比较。参与者在一项从正常决策文献中选取的标准信息板任务中选择出租公寓。VMF损伤组受试者在执行决策任务时采用的方式与所有其他组明显不同,他们倾向于一种“基于选项”的信息获取策略(即他们围绕各个公寓来组织信息搜索)。相比之下,健康对照受试者以及主要涉及背侧和/或外侧前额叶皮层损伤组的受试者主要采用“基于属性”的搜索策略(即获取有关几个公寓的租金和噪音水平等类别的信息)。信息获取模式的这种差异表明,VMF损伤组受试者所采用的潜在决策启发法和策略存在系统性差异,这反过来可能会影响他们选择的质量。这些发现表明,腹侧和内侧前额叶皮层所支持的过程需要更广泛地进行概念化,以解释这些区域受损后在确定性以及不确定性条件下决策的变化。