[Deficit in risk-taking decision-making of patients with lesions of prefrontal cortex].
OBJECTIVE
To investigate the influence of injury of prefrontal cortex on the risk-taking decision-making and to test the hypothesis that the orbitofrontal area is involved in the special network of risk-taking decision-making.


METHODS
47 patients with lesions in the prefrontal lobe, 21 in the orbitofrontal area (OBF) and 19 in the dorsolateral prefrontal cortex (DLF), and 40 healthy controls (HC group) were administered with a risk-taking task.


RESULTS
The risky response rate after punishment of the HC group was 0.54 +/- 0.23, significantly fewer than before punishment (t = -3.82, P < 0.01), and the risky response rate after punishment of the DLF injury group was 0.68 +/- 0.16, significantly fewer than before punishment too (t = -2.32, P < 0.05). The risky response rate after reward of the patients with lesions in OBF areas was 0.79 +/- 0.19, significantly higher than that of the HC group (0.68 +/- 0.16, P < 0.05), and the risky response rate after punishment of the patients with lesions in OBF areas was 0.82 +/- 0.18, significantly higher than that of the HC group (0.54 +/- 0.23, P < 0.05). The risky response rates after reward and after punishment of the DLP group were 0.72 +/- 0.22 and 0.63 +/- 0.25 respectively, both not significantly different from those of the HC group (both P > 0.05).


CONCLUSIONS
The patients with lesions in the orbitofrontal area, not in the dorsolateral prefrontal cortex, have a specific deficit in risk-taking decision-making, i.e. an inhibition effect of punishment, reduced sensitivity to punishment but increased sensitivity to reward. The orbitofrontal areas play an important role in risk-taking decision-making processes.
Xi
Chun-hua
CH
Neuropsychological Laboratory, Department of Neurology, First Hospital of Anhui Medical University, Hefei 230022, China.
Fu
Xian-ming
XM
Wang
Kai
K
Niu
Chao-shi
CS
Lee
Tatia M C
TM
Meng
Yu
Y
Zhu
Chun-yan
CY
Du
Jing
J
D000223:Adaptation, Psychological; D000328:Adult; D001927:Brain Diseases / Q000150:complications / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D003657:Decision Making; D005260:Female; D006801:Humans; D020647:Lateral Thalamic Nuclei / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000473:pathology* / Q000503:physiopathology; D012309:Risk-Taking