Goulet-Kennedy Julie, Labbe Sara, Fecteau Shirley
Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada.
Dialogues Clin Neurosci. 2016 Mar;18(1):55-63. doi: 10.31887/DCNS.2016.18.1/sfecteau.
Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives.
决策制定在经济学背景下以及从群体角度已得到广泛研究，但对于个体决策制定仍知之甚少。在此，我们讨论决策制定过程中涉及的不同认知过程及其相关的神经基础。决策制定中假定的主导者似乎是前额叶皮层和纹状体。各种临床人群中决策技能受损与前额叶皮层和纹状体的活动有关。我们强调加强认知和神经基础整合程度的重要性，以便进一步理解决策技能。在认知范式方面，有必要提高评估不同情境下和有奖励情况下决策的实验任务的生态效度；这将有助于将实验室所学转化为实际生活中的益处。在神经基础方面，神经成像技术的使用有助于描绘与决策制定相关的神经网络；最近，通过非侵入性脑刺激来调节大脑活动（如在前额叶皮层和相关区域，如纹状体）的方法也为决策制定的神经和认知基础提供了线索。总之，这些认知和神经方法可能对决策技能受损的患者有用。这一系列工作背后的驱动力在于，决策能力是我们日常生活中健康、安全以及财务和社会选择等重要方面的基础。
