期刊名称：Revue de Neuropsychologie Neurosciences Cognitives et Cliniques
印刷版ISSN：2101-6739
电子版ISSN：2102-6025
出版年度：2013
卷号：5
期号：2
页码：93-105
DOI：10.1684/nrp.2013.0259
出版社：John Libbey Eurotext
摘要：Authors Jean-Pierre Jacus , Sophie Bayard , Stéphane Raffard , Marie-Christine Gély-Nargeot Centre hospitalier du Val-d’Ariège, laboratoire Epsylon, EA 4556, consultation mémoire, Foix, France, CHU Gui-de-Chauliac, service universitaire de neurologie, Inserm U 1061, laboratoire Epsylon, EA 4556, Montpellier, France, Université Paul-Valéry, Montpellier III, CHU La Colombière, service universitaire de psychiatrie, laboratoire Epsylon, EA 4556, Montpellier, France, Université Paul-Valéry, Montpellier III, laboratoire Epsylon, EA 4556, site Saint-Charles, route de Mende, 34999 Montpellier cedex 5, France Key words: decision-making, normal aging, pathological aging, Iowa Gambling Task, Game of Dice Task DOI : 10.1684/nrp.2013.0259 Page(s) : 93-105 Published in: 2013 Taking relevant decisions (in his interest or that of his relatives) is necessary for our adaptation, our autonomy and our survival. However, decision-making is a complex and composite ability, which is particularly sensitive to the effects of aging. Two decision-making conditions are usually distinguished: decision under ambiguity in which the probability of the result is ignored and decision under risk in which the consequences and the probabilities of these consequences are known. This review outlines the major age-related changes in decision-making processes. In normal aging, impaired decision-making is mainly related to executive function decline. In normal aging, decision under risk seems to be better preserved than decision under ambiguity. During pathological aging, the location of the cerebral lesions plays an important role on the type of decision-making problems encountered. Thus, frontal and/or sub-cortical frontal lesions lead to greater risk-taking, especially in ambiguous conditions. In this condition, reinforcements have a prevalent role. Frontal and/or sub-cortical frontal lesions make theses reinforcements particularly inefficient, hindering the ability to anticipate the probability of the outcome. Impaired decision making under risk is related to executive dysfunctions and damage of the expected reward system. The patients become unable to recognize and anticipate the consequences and their probabilities on the outcome. Temporal or temporofrontal lesions affect decision-making under ambiguity and decision making under risk. Impairment of risky decisions is due to the inability to accurately estimate the probabilities of the consequences. Decision-making disorders under ambiguity are linked with difficulties to learn by “feedback” and to anticipate the likelihood of the outcome. These results highlight the complexity and variety of mechanisms and processes of decision-making activities. These data also help to explain the dissociation observed, depending on the type of brain damage identified in the context of normal and pathological aging.
关键词：decision-making; normal aging; pathological aging; Iowa Gambling Task; Game of Dice Task
