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OBJECTIVE: The goal of this study was 2-fold, first, to compare decision making in behavioral variant frontotemporal dementia (bvFTD) patients and healthy adults using the Balloon Analog Risk Task (BART), and, second, to identify the regions of gray matter atrophy associated with bvFTD patients' BART performance. BACKGROUND: Stimulus-reinforcement learning is required to evaluate the results of previously chosen actions to improve future decisions. Although there is a well established literature suggesting altered decision making in FTD patients and data from lesion studies suggest orbitofrontal cortex (OFC) involvement in decision making, there is very little research looking at the brain correlates of decision making in FTD populations specifically. METHOD: Twenty-seven bvFTD patients and 19 age-matched and education-matched normal controls completed the BART. Voxel-based morphometry analysis was performed on the magnetic resonance imaging scans of a subset of patients. RESULTS: Compared with healthy controls, the bvFTD patients did not learn and pumped less to inflate a balloon to receive a reward, indicating altered stimulus-reinforcement learning. The voxel-based morphometry analysis indicated that bvFTD patients' impaired BART performance was related to atrophy in the right lateral OFC. CONCLUSIONS: The right lateral OFC is crucial for stimulus-reinforcement learning required for the adjustment of behavior under changing reward contingencies.

Original publication

DOI

10.1097/WNN.0b013e3182255a7c

Type

Journal article

Journal

Cogn Behav Neurol

Publication Date

06/2011

Volume

24

Pages

59 - 67

Keywords

Aged, Atrophy, Cerebral Cortex, Decision Making, Female, Frontotemporal Dementia, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Reinforcement (Psychology)