Center for Dementia and Alzheimer’s Care, Department of Neurology, HealthPartners, St. Paul, MN, USA.
J Neuropsychiatry Clin Neurosci. 2012 Summer;24(3):266-77. doi: 10.1176/appi.neuropsych.11060139.
Decision-making is a complex executive function that draws on past experience, present goals, and anticipation of outcome, and which is influenced by prevailing and predicted emotional tone and cultural context. Functional imaging investigations and focal lesion studies identify the orbitofrontal, anterior cingulate, and dorsolateral prefrontal cortices as critical to decision-making. The authors review the connections of these prefrontal regions with the neocortex, limbic system, basal ganglia, and cerebellum, highlight current ideas regarding the cognitive processes of decision-making that these networks subserve, and present a novel integrated neuroanatomical model for decision-making. Finally, clinical relevance of this circuitry is illustrated through a discussion of frontotemporal dementia, traumatic brain injury, and sociopathy.
决策是一种复杂的执行功能，它利用过去的经验、当前的目标和对结果的预期，并受到当前和预测的情绪基调以及文化背景的影响。功能成像研究和焦点损伤研究确定眶额、前扣带和背外侧前额皮质对决策至关重要。作者回顾了这些前额区域与新皮质、边缘系统、基底神经节和小脑的连接，强调了这些网络所支持的决策认知过程的当前观点，并提出了一个新的决策的综合神经解剖模型。最后，通过讨论额颞叶痴呆、创伤性脑损伤和反社会行为，说明了该回路的临床相关性。
