Decision-making and impulse control after frontal lobe injuries.
OBJECTIVE
For a long time, the prefrontal cortex has been considered a 'nonfunctional' brain area, and understanding its function has lagged behind other areas. This is no longer true since appreciation of the vital role that this brain region plays in adaptive behaviors, and especially decision-making, is now evident more than ever. The present review highlights recent progress made in this area of research.


RESULTS
Decision-making is a term often referred to in the psychological literature as one of the 'executive functions' that play a role in managing (like an executive) other cognitive functions, such as memory, attention, and language. Considerable research efforts have been directed towards differentiating various processes of executive functions, but much of this effort in the past has focused on the dorsolateral prefrontal cortex sector. Here we will review findings that address decision-making and its link to the ventromedial prefrontal cortex.


CONCLUSIONS
Decision-making impairments as encountered in neurological and psychiatric patients are costly in terms of individual human suffering and in financial terms. In addition to its obvious value in advancing fundamental knowledge in neuroscience, understanding the neural mechanisms of decision-making is likely to have important practical consequences, including the understanding and management of neuropsychiatric disorders such as addiction, as well as the management of a considerable number of elderly people suffering from a decline in cognitive functions critical for decision-making, in spite of relatively intact memory and general intellect, which impact real-life matters that are important to themselves and their family.
Bechara
Antoine
A
Division of Cognitive Neuroscience, Department of Neurology, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA. antoine-bechara@uiowa.edu
Van Der Linden
Martial
M
D001930:Brain Injuries / Q000150:complications*; D003657:Decision Making / Q000502:physiology*; D004644:Emotions / Q000502:physiology; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007175:Impulsive Behavior / Q000209:etiology*; D009483:Neuropsychological Tests