Department of Neurology, Columbia University Medical Center, 710 W 168(th) St, New York, NY 10032, USA; Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, 710 W 168(th) St, New York, NY 10032, USA.
Department of Neurology, Baylor College of Medicine, 7200 Cambridge Street, Houston, TX 77030, USA.
J Neurol Sci. 2024 Jun 15;461:123060. doi: 10.1016/j.jns.2024.123060. Epub 2024 May 23.
Previous research has identified that people with cerebellar ataxia (CA) showed impaired reward-related decision-making in the Iowa Gambling Task (IGT). To investigate the mechanisms underlying this impairment, we examined CA participants' combination of performance in the IGT, which predominantly tests reward seeking, and the modified IGT (mIGT), which mainly assesses punishment avoidance.
Fifty participants with CA and one hundred controls completed the IGT and mIGT. Task performance in each of the five twenty-trial blocks was compared between groups and the learning rates were assessed with simple linear regressions. Each participant's IGT score and mIGT score were compared.
CA participants performed worse than controls in both the IGT and the mIGT, especially in the last block (IGT: -0.24 ± 10.05 vs. 3.88 ± 10.31, p = 0.041; mIGT: 2.72 ± 7.62 vs. 8.65 ± 8.64, p < 0.001). In contrast to the controls, those with CA did not significantly improve their scores over time in either task. Controls performed better in the mIGT than the IGT, while CA participants' scores in the two tasks showed no significant difference. IGT and mIGT performance did not correlate with ataxia severity or depressive symptoms.
Individuals with CA showed impaired performance in both the IGT and mIGT, which indicates disruption in both short-term reward seeking and short-term punishment avoidance. Therefore, these results suggest that reduced sensitivity to long-term consequences drives the risky decision-making in CA.
先前的研究表明,小脑性共济失调(CA)患者在爱荷华赌博任务(IGT)中表现出受损的奖励相关决策。为了探究这种损伤的机制,我们研究了 CA 患者在 IGT 和改良 IGT(mIGT)中的表现组合,前者主要测试奖励寻求,后者主要评估惩罚回避。
50 名 CA 患者和 100 名对照者完成了 IGT 和 mIGT。比较了两组在每个 20 轮试验块中的任务表现,并使用简单线性回归评估了学习率。比较了每个参与者的 IGT 得分和 mIGT 得分。
CA 患者在 IGT 和 mIGT 中的表现均差于对照组,尤其是在最后一个块(IGT:-0.24±10.05 与 3.88±10.31,p=0.041;mIGT:2.72±7.62 与 8.65±8.64,p<0.001)。与对照组不同的是,CA 患者在两个任务中都没有随着时间的推移显著提高他们的分数。对照组在 mIGT 中的表现优于 IGT,而 CA 患者在两个任务中的得分没有显著差异。IGT 和 mIGT 表现与共济失调严重程度或抑郁症状无关。
CA 患者在 IGT 和 mIGT 中表现出受损的表现,这表明他们在短期奖励寻求和短期惩罚回避方面都受到了干扰。因此,这些结果表明,对长期后果的敏感性降低导致 CA 中的风险决策。