• Chun-hua Xi, Xian-ming Fu, Kai Wang, Chao-shi Niu, Tatia M C Lee, Yu Meng, Chun-yan Zhu, and Jing Du.
• Neuropsychological Laboratory, Department of Neurology, First Hospital of Anhui Medical University, Hefei 230022, China.
• Zhonghua Yi Xue Za Zhi. 2006 Dec 5;86(45):3169-72.

ObjectiveTo 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.Methods47 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.ResultsThe 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).ConclusionThe 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.

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