Decision Making assessed by the Iowa Gambling Task and Major Depressive Disorder: a systematic review / Tomada de decisão avaliada pela Iowa Gambling Task e pelo Transtorno Depressivo Maior: uma revisão sistemática

Abstract Major Depressive Disorder (MDD) can occur in parallel with cognitive impairment. The search for a neuropsychological profile of depression has been pursued in the last two decades. However, scant research has been done on executive functions and decision-making ability (DM). Objective: To perform a systematic review of the evidence of DM performance evaluated using the Iowa Gambling Task (IGT) in adults with MDD. Methods: A systematic search according to the PRISMA statement was performed on MEDLINE for studies in English using the following keywords: 'depression', 'depressive', 'depressive symptoms' AND 'decision making' OR 'game task'. Results: Five articles that met the inclusion and exclusion criteria were identified. Three reported significant differences between depressed and non-depressed individuals. The results indicated that young adults with MDD exhibited lower performance on all or almost all stages of the IGT. One study that evaluated DM in older adults with MDD showed that depressed non-apathetic participants failed to adopt any advantageous strategy and continued to make risky decisions during the task. Conclusion: Results suggest that performance on the DM task by young and old adults with MDD differed in comparison to non-depressed participants. Given the small number of articles, further studies should be performed.

Resumo O Transtorno Depressivo Maior (TDM) pode ocorrer em paralelo com o comprometimento cognitivo. A busca por um perfil neuropsicológico da depressão tem sido perseguida nas últimas duas décadas. No entanto, poucas pesquisas foram feitas sobre funções executivas e capacidade de decisão (DM). Objetivo: Realizar uma revisão sistemática das evidências do desempenho do DM avaliado pela Iowa Gambling Task (IGT) em adultos com TDM. Métodos: Uma pesquisa sistemática de acordo com a declaração PRISMA foi realizada na MEDLINE para estudos em inglês usando as seguintes palavras-chave: "depressão", "depressivo", "sintomas depressivos" e "tomada de decisão" OU "tarefa de jogo". Resultados: Foram identificados 5 artigos que atenderam aos critérios de inclusão e exclusão. Três relataram diferenças significativas entre indivíduos deprimidos e não deprimidos. Os resultados indicaram que os jovens adultos com TDM exibiram menor desempenho em todos ou quase todos os estágios da IGT. Um estudo que avaliou o DM em idosos com TDM mostrou que os participantes deprimidos não apáticos não adotaram nenhuma estratégia vantajosa e continuaram tomando decisões arriscadas durante a tarefa. Conclusão: Os resultados sugerem que o desempenho na tarefa de DM por jovens e adultos idosos com TDM diferiu em comparação com os participantes não deprimidos. Dado o pequeno número de artigos, mais estudos devem ser realizados.

Bases neurales de la toma de decisiones e implicación de las emociones en el proceso / The neural basis of the decision-making and emotional processes involved / Bases neurais da tomada de decisão e implicação das emoções neste processo

Este artículo se ha propuesto como una revisión de las investigaciones que han surgido en la última década en el campo de la neurociencia, y que se hayan relacionadas con la actividad neurobiológica y funcional de la toma de decisiones por parte del ser humano. Así, ha sido posible identificar y dar cuenta de las estructuras del sistema nervioso central que son claves en la comprensión de los procesos relacionados con la toma de decisiones, y a su vez han permitido establecer el rol de las emociones como influencia determinante en este proceso. De igual forma, las investigaciones han posibilitado conocer cómo se lleva a cabo la actividad de tomar decisiones en el cerebro, las relaciones entre las diversas regiones y cómo las emociones guían el resultado.Además, se ha llegado a destacar dos sistemas que explicarían el proceso de la toma de decisiones, uno asociado a la intuición (sistema práctico), donde se destaca la actividad metabólica de la amígdala cerebral y sus redes neuronales; otro que corresponde al razonamiento (sistema analítico), en el cual resalta la participación de las conexiones neuronales de la porción ventromedial del córtex prefrontal.

This paper has proposedas a review of the researchthat has been appearing in the last decade in the field of neuroscience, and the relationship with the neurobiological and functional activity of the human decision making. Therefore, it has been possible to identify and inform the key structures of the central nervous system in the comprehension of the related processes, and it has allowed to stablish the important influence of the emotion in this process. Also, the research hasallowed to know how the decision-making process has been referred in the brain, the relationship between the different brain regions and the emotion who led the outcome. Thus, there are two systems involved in the decision makingprocess; one related with the intuition (practical system), where the metabolic activity of the cerebral amygdala is remarked with their neural networks, and other related with reasoning (analytical system), in which, is important to note the involvement of the ventromedial portion of the prefrontal cortex.

Este artigo foi proposto como uma revisão das pesquisas que surgiram na última década no campo da neurociência, e que tem sido relacionada à atividade neurobiológica e funcional da tomada de decisão pelo ser humano. Assim, foi possível identificar e explicar as estruturas do sistema nervoso central que são fundamentais na compreensão dos processos relacionados à tomada de decisões e, por sua vez, permitiram estabelecer o papel das emoções como influência determinante nesse processo. Da mesma forma, a pesquisa permitiu saber como é a atividade de tomada de decisão no cérebro, as relações entre diferentes regiões e como as emoções orientam o resultado. Ademais, foram destacados dois sistemas que explicam o processo de tomada de decisão, um associado à intuição (sistema prático), que enfatiza a atividade metabólica da amígdala cerebral e suas redes neurais; outro correspondente ao raciocínio (sistema analítico), no qual as conexões neuronais da porção ventromedial do córtex pré-frontal são destacadas.

Neural mechanism and evaluation of decision-making function in obsessive-compulsive disorder / 上海交通大学学报（医学版）

Obsessive-compulsive disorder (OCD) is a chronic,disabling,mental disorder,which has been linked to significant abnormalities in certain brain areas,including the orbital frontal cortex and the anterior cingulate cortex.Neuroimaging studies have also shown that brain areas related to the decision-making function include the orbital frontal cortex and the dorsal prefrontal lobes.Furthermore,the association between OCD and decision-making function has been consistently demonstrated from a neurobiological perspective.Clinically,impaired decision-making ability is commonly observed in OCD patients,and there is a correlation between OCD and abnormal decision function.Decision-making tasks are typically divided into two types,decision-making under risk and decision-making under ambiguity,with the former commonly evaluated using the Iowa Gambling Task (IGT) and the latter using the Game of Dice Task (GDT).In this article the neural mechanism and evaluation methods of decision making in OCD were reviewed.

Maximal strength and endurance scores of the tongue, lip, and cheek in healthy, normal Koreans

OBJECTIVES: The purpose of this study was to establish normative data for healthy Korean adults by measuring the maximal strength and endurance scores of the tongue, lip, and cheek, and to examine correlations between these measurements. MATERIALS AND METHODS: This study included 120 subjects that were divided into three groups according to age: young (20-39 years), middle-aged (40-59 years), and older (over 60 years); and by gender. Measurements were taken using the Iowa Oral Performance Instrument (IOPI). RESULTS: The mean maximal tongue strengths were as follows: young men (46.7±10.2 kPa) and women (32.1±7.9 kPa), middle-aged men (40.9±9.3 kPa) and women (36.9±8.6 kPa), and older men (35.2±9.0 kPa) and women (34.5±6.9 kPa). The mean tongue endurance scores were: young men (28.8±12.6 seconds) and women (20.8±13.5 seconds), middle-aged men (17.0±8.5 seconds) and women (15.3±5.2 seconds), and older men (15.8±6.7 seconds) and women (17.9±8.1 seconds). The mean maximal lip strengths were: young men (11.6±3.0 kPa) and women (11.4±3.8 kPa), middle-aged men (11.4±4.2 kPa) and women (11.1±5.1 kPa), and older men (14.5±3.9 kPa) and women (11.7±2.6 kPa). The mean lip endurance scores were: young men (41.1±23.9 seconds) and women (22.4±21.7 seconds), middle-aged men (24.3±10.3 seconds) and women (30.5±13.4 seconds), and older men (24.9±11.0 seconds) and women (12.8±7.6 seconds). The mean maximal cheek strengths were: young men (24.5±4.6 kPa) and women (20.5±4.3 kPa), middle-aged men (25.2±6.4 kPa) and women (21.2±5.5 kPa), and older men (22.4±5.3 kPa) and women (18.0±4.8 kPa). The mean cheek endurance scores were: young men (47.8±24.4 seconds) and women (43.9±25.0 seconds), middle-aged men (27.3±11.3 seconds) and women (20.0±14.6 seconds), and older men (21.7±14.5 seconds) and women (17.2±11.4 seconds). CONCLUSION: The data collected in this study will provide an important database of standardized measurements for maximal strength and endurance scores of the tongue, lip and cheek in healthy, normal Koreans.

Treatment of Late-Onset Legg-Calve-Perthes Disease by Arthrodiastasis

BACKGROUND: To evaluate the efficacy of arthrodiastasis for Legg-Calve-Perthes disease. METHODS: Arthrodiastasis was conducted using external fixator devices (Orthofix) in 7 patients at least 8 years of age with a diagnosis of Legg-Calve-Perthes disease. The average follow-up was 80 months (range, 32 to 149 months), and their average age was 9.1 years (range, 8 to 12 years). The results of treatment were evaluated by measuring the degree of hip pain and the range of motion of the hip at 6 months after the operation and comparing the values with preoperative measurements. Radiological recovery was evaluated by the epiphyseal index and compared with the preoperative values. At the final follow-up, clinical and radiological results were evaluated using the Iowa hip score and the Stulberg classification. RESULTS: On the clinical evaluation performed at 6 months after arthrodiastasis, the degree of pain decreased by 1.8 points on average, and the average flexion, internal rotation, and abduction increased by 35°, 16°, and 11°, respectively. Based on radiological findings, the epiphyseal index showed a remarkable increase of 6.6 on average (from 19 preoperatively to 26 postoperatively). At the final follow-up, the average Iowa hip score improved from 65 points preoperatively to 84 points. There were 1 Stulberg class I hip, 2 Stulberg class II hips, 3 Stulberg class III hips, 1 Stulberg class IV hip, and no Stulberg class V hip. CONCLUSIONS: We conclude that arthrodiastasis using an external fixator can be a relatively promising surgical procedure for the treatment of late-onset Legg-Calve-Perthes disease.

The Relationship Between Tongue Pressure and Oral Dysphagia in Stroke Patients

OBJECTIVE: To evaluate the relationships between tongue pressure and different aspects of the oral-phase swallowing function. METHODS: We included 96 stroke patients with dysphagia, ranging in age from 40 to 88 years (mean, 63.7 years). Measurements of tongue pressure were obtained with the Iowa Oral Performance Instrument, a device with established normative data. Three trials of maximum performance were performed for lip closure pressure (LP), anterior hard palate-to-tongue pressure (AP), and posterior hard palate-to-tongue pressure (PP); buccal-to-tongue pressures on both sides were also recorded (buccal-to-tongue pressure, on the weak side [BW]; buccal-to-tongue pressure, on the healthy side [BH]). The average pressure in each result was compared between the groups. Clinical evaluation of the swallowing function was performed with a videofluoroscopic swallowing study. RESULTS: The average maximum AP and PP values in the intact LC group were significantly higher than those in the inadequate lip closure group (AP, p=0.003; PP, p<0.001). AP and PP showed significant relationships with bolus formation (BF), mastication, premature bolus loss (PBL), tongue to palate contact (TP), and oral transit time (OTT). Furthermore, LP, BW, and BH values were significantly higher in the groups with intact mastication, without PBL and intact TP. CONCLUSION: These findings indicate that the tongue pressure appears to be closely related to the oral-phase swallowing function in post-stroke patients, especially BF, mastication, PBL, TP and OTT.

Effects of approach and withdrawal motivation on risk decision making / 中华行为医学与脑科学杂志

Objective To explore the role of emotional valence and motivational direction avoidance on risk taking behavior.Methods In the experiment,300 healthy young adults were randomly assigned to a control and four emotion condition groups(60 per group),which induced by four short movie clips of 100～140 seconds' duration.To keep participants from suspecting a link between the emotional induction and the Iowa gambling task (IGT),participants were told that they would complete two experiments.The first experiment was to evaluate whether the movie clips were suitable for materials of the memory test,and the second was to complete a poke gambling task,and then they were required to read the instructions about the IGT.Immediately after reading the instructions and watching one of four movie clips and completing the scales of emotional appraisals,participants were asked to perform the IGT.At the end of the procedure,the experimenter asked the participants for their opinion about the experiments.They all answered that the two experiments were independent of each other.Results With approach-based emotion (amusement and anger) prompting more advantageous card selection along with the time course of the decision making relative to withdrawal-based emotion (serenity and disgust) (0.75±0.01 vs 0.67±0.01).Furthermore,compared with the latter(block 1-5:-5.85±0.66 vs-1.36±0.62 vs 2.78±0.57 vs 1.93±0.52 vs 2.90±0.61),the participants with approach-based emotion(block1-5:-6.28±0.66 vs-1.67±0.63 vs 7.63±0.57 vs 6.43±0.52 vs 8.03±0.61) preferred to transform the direction of card selection after getting negative feedback to avoid potentially high risks.Additionally,the main effect of the motivation direction mentioned above was more and more significant along with the increase of the intensity of the emotion.Conclusion A main effect of motivational direction,but not valence is observed in the present study,the results suggest that motivation dimension,relative to emotional valence,may be a more useful research perspective to study such decisions.

Normal aging and decision-making: a systematic review of the literature of the last 10 years / Envelhecimento normal e tomada de decisão: uma revisão sistemática da literatura dos 10 últimos anos

Objective Conduct a systematic review to investigate whether healthy elderly have deficits in the decision-making process when compared to the young. Methods We performed a systematic search on SciELO, Lilacs, PsycINFO, Scopus and PubMed database with keywords decision making and aging (according to the description of Mesh terms) at least 10 years. Results We found nine studies from different countries, who investigated 441 young and 377 elderly. All studies used the IOWA Gambling Task as a way of benchmarking the process of decision making. The analysis showed that 78% of the articles did not have significant differences between groups. However, 100% of the studies that assessed learning did find relevant differences. Furthermore, studies that observed the behavior of individuals in the face of losses and gains, 60% of articles showed that the elderly has more disadvantageous choices throughout the task. Conclusion: The consulted literature showed no consensus on the existence of differences in performance of the decision-making process between old and young, but it is observed that the elderly has deficits in learning and a tendency to fewer advantageous choices. .

Objetivo Realizar uma revisão sistemática para investigar se idosos saudáveis apresentam disfunções no processo de tomada de decisão quando comparados a jovens. Métodos Foi realizada uma busca sistemática nas bases de dados SciELO, Lilacs, PsycINFO, Scopus e PubMed, com as palavras-chave decision making and aging (de acordo com a descrição dos termos Mesh) dos últimos 10 anos. Resultados Foram encontrados nove estudos de diferentes países, que investigaram 441 jovens e 377 idosos. Como resultado, observou-se que 78% dos artigos não encontram diferenças significativas entre os grupos. Porém, 100% dos estudos que avaliaram o aprendizado encontram diferenças significativas. Além disso, dos estudos que observaram o comportamento dos indivíduos perante as perdas e ganhos, 60% mostraram que os idosos apresentam mais escolhas desvantajosas ao longo do teste. Conclusão Os artigos avaliados não apresentaram um consenso em relação à existência de diferenças no processo de tomada de decisão entre idosos e jovens, porém observa-se que os idosos apresentam dificuldade no aprendizado e tendência a escolhas menos vantajosas. .

O Iowa Gambling Task: uma revisão crítica / The Iowa Gambling Task: a critical revision

O Iowa Gambling Task (IGT) é uma tarefa amplamente utilizada na avaliação da capacidade de tomada de decisão. Neste artigo, procede-se à revisão da literatura, comparando-se as versões do IGT, as diferentes medidas de avaliação do desempenho e as alterações introduzidas nos procedimentos, nomeadamente no feedback, na aleatorização espacial dos baralhos, no número de ensaios e de cartas por baralho, nas instruções, na remuneração e na manipulação das recompensas e punições. Desta análise, conclui-se que as diversas versões da tarefa, as alterações nos procedimentos de aplicação e as diferentes medidas utilizadas na avaliação têm impacto no desempenho, prejudicam a comparação entre estudos e as generalizações dos resultados. Finalmente, apresentam-se sugestões para uma maior adequação dos procedimentos.

The Iowa Gambling Task (IGT) is a widely used task in the assessment of the decision-making ability. In this article, we conduct a literature review by comparing IGT versions, different performance assessment measures, and changes to procedures including feedback, spatial randomization of decks, number of trials, number of cards per deck, instructions, payment, and rewards and punishments. On basis of this analysis, we conclude that different versions of the task, changes in application procedures and different measures used to assess the task have an impact on performance, thereby affecting comparison among studies and generalization of results. Finally, we offer suggestions to define adequate procedures.

The Iowa Gambling Task (IGT) in Brazil: a systematic review / O Iowa Gambling Task (IGT) no Brasil: uma revisão sistemática

Background: Decision-making is a complex, multidimensional cognitive function that requires the choice between two or more options and also the predictive analysis of its consequences. One of the tools most widely used to assess decision-making in neuropsychological research is the Iowa Gambling Task (IGT). Objective: To conduct a systematic review of articles reporting empirical IGT studies based in Brazil. Method: Articles were obtained from multiple journal databases including ISI Web of Knowledge, Scopus, SciELO, LILACS, and Scholar Google. Results: Thirty-six studies were included in this review and divided into four categories according to main subject matter (psychiatry & personality; demographic & cultural variables; medical/clinic; and psychometric properties & test administration standardization). In general, there was a significant growth in research employing IGT (Χ² = 17.6, df = 5, p = 0.0003), but this growth was restricted to a few geographic areas of Brazil. The psychiatry & personality subject matter was the most abundant, accounting for 14 publications (39% of the total sample). Conclusion: Since its first adaptation to Brazilian Portuguese in 2006, a growing interest in decision-making as measured by the IGT can be observed, with psychiatry & personality topics representing a large portion of the scientific inquiry to date. Nevertheless, in order to extend the initial results of Brazilian IGT decision-making research, more studies are necessary - across a more diverse range of topics, including demographic & cultural variables, and psychometric properties & test administration standardization, the areas least studied -, as is the dissemination of the IGT to more regions of the country.

Contexto: A tomada de decisão é uma função cognitiva complexa e multidimensional que envolve a escolha entre duas ou mais opções, bem como a análise preditiva das suas consequências. Um dos instrumentos de pesquisa mais amplamente utilizados para avaliar a tomada de decisão em neurociência é o Iowa Gambling Task (IGT). Objetivo: Realizar uma revisão sistemática de artigos empíricos conduzidos com o IGT no Brasil. Método: Os artigos foram obtidos através de busca nos bancos de dados ISI Web of Knowledge, Scopus, SciELO, LILACS e Scholar Google. Resultados: Trinta e seis estudos foram incluídos e divididos em quatro categorias de acordo com o tema principal (variáveis demográficas e culturais; psiquiatria e personalidade; variáveis médico-genéticas e saúde geral; e propriedades psicométricas e padronização de aplicação). Em geral, houve um crescimento significativo da pesquisa utilizando o IGT (Χ² = 17,6, gl = 5, p = 0,0003), porém restrito a algumas áreas geográficas brasileiras. O eixo temático de psiquiatria e personalidade foi o que mais produziu estudos, contabilizando 14 publicações (39% da amostra total). Conclusão: Desde sua primeira adaptação para o português brasileiro em 2006, pode-se observar um crescente interesse pela tomada de decisão medida pelo IGT, sendo assuntos relacionados ao tema psiquiatria e personalidade responsáveis por grande parte dos estudos realizados até o momento. No entanto, para ampliar os resultados iniciais da pesquisa nacional com o IGT, mais estudos são necessários - com uma amplitude maior de áreas temáticas, incluindo as categorias menos estudadas até o momento: variáveis demográficas e culturais e propriedades psicométricas e padronização de aplicação - bem como uma maior disseminação do IGT em outros centros regionais do país.

Tomada de decisão e outras funções executivas: um estudo correlacional / Decision-making and other executive functions: a correlational study

O construto Funções Executivas (FE) é um grupo de processos composto por múltiplos componentes, porém ainda é insuficiente definido e operacionalizado. Podem ser considerados, pela participação de processamentos emocionais, “frios” e “quentes”. O objetivo deste estudo foi correlacionar o construto Tomada de Decisão (TD), considerado uma FE “quente”, avaliado pelo Iowa Gambling Task (IGT), com outros componentes executivos avaliados pelos Teste Wisconsin de Classificação de Cartas (WSCT), do Trail Making Test (TMT) e do Hayling Test. Em relação ao desempenho global do IGT, somente foi encontrada relação inversa com o tempo da parte B do Hayling Test, sugerindo que a velocidade de inibição pode se relacionar diretamente com uma TD vantajosa. Foram encontradas correlações inversas entre o desempenho no primeiro bloco do IGT e outros escores dos três instrumentos de FE, indicando um processamento distinto no início deste paradigma. Uma possível hipótese é que mecanismos explícitos mais necessários nas outras tarefas executivas poderiam ter uma associação negativa com o desempenho no início do IGT, em que um processamento implícito e emocional é privilegiado. Sugerem-se estudos sobre a relação do construto mensurado pelo IGT com outras FE consideradas “quentes”

Impulsive behavior in heroin addicts:a P00 ERP study / 中华行为医学与脑科学杂志

Objective To investigate the characteristic of P30o event-related potentials(ERP) of impulsive behavior in heroin addicts.Methods The Iowa gambling task (IGT) were performed by using the paradigm for psychological experiment both in heroin addiction group (HA group) and health control group (HC group),the inspection of electroencephalography were underwent in all the subjects concurrently.Following the collection of data of ERP,amplitude and latency of P300 were compared between the two groups,and then the relationship betweenamplitude or latency of P300 and the results of Barratt impulsiveness scale were analyzed separately.Results Compared to HC group,BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group ( HA:75.12 ± 12.49,91.14 ± 21.35 ; HC:66.54 ± 8.61,73.71 ± 18.91 ; P ＜ 0.05 ),while the both two groups had visible waveforms of P30o,and the amplitude and latency were markedly lower ( HA:4.92 ± 1.14,293.43 ± 36.21 ; HC:7.65 ± 1.59,332.68 ± 40.15 ; P ＜ 0.05 ) and were negatively associated with BIS score in HA group( r =-0.76,-0.52,P＜ 0.05).Logistic regression results showed that the scores of BIS-11 were related to amplitude of P30o merely( P ＜ 0.05 ).Conclusion Impulsive behavior can be observed from the abnormal characteristic of the P300 event-related potential of impulsive behavior in heroin addicts,which may partly contribute to both addiction and relapse of heroin addict.

Avaliação neuropsicológica do processo de tomada de decisões em crianças e adolescentes: uma revisão integrativa da literatura / Neuropsychological assessment of the decision making process in children and adolescents: an integrative review of the literature

OBJETIVO: Atualmente, tem havido um interesse crescente nos aspectos "quentes" das funções executivas relacionados ao córtex orbitofrontal, em particular na tomada de decisão afetiva em crianças e adolescentes. Revisamos a literatura sobre a avaliação da tomada de decisão em crianças e adolescentes utilizando o paradigma do Iowa Gambling Task e derivados. MÉTODO: Pesquisamos artigos publicados de 2000 a 2009, indexados no Lilacs e no PubMed e que estudaram crianças e/ou adolescentes até 16 anos. Os artigos foram analisados de acordo com os paradigmas utilizados nos estudos, as conclusões sobre o desenvolvimento no processo de tomada de decisão e a capacidade de distinção entre a população clínica e os controles. RESULTADOS: Trinta e seis artigos foram selecionados. Os estudos envolvendo crianças e adolescentes ainda são poucos quando comparados àqueles realizados com população adulta. Foram desenvolvidas diversas versões derivadas do paradigma IGT a fim de estudar a tomada de decisão em crianças e adolescentes. CONCLUSÃO: O IGT é o instrumento mais utilizado. Em pré-escolares, versões simplificadas têm sido utilizadas com maior frequência. Os diferentes paradigmas se mostram úteis na diferenciação entre sujeitos normais e com transtornos psiquiátricos. Os resultados se relacionam de forma positiva e significativa com a frequência de comportamentos impulsivos em populações não clínicas.

OBJECTIVE: Nowadays there has been growing interest in the "hot" aspects of the executive functions related to the orbitofrontal cortex (OFC), in particular in the affective decision-making process in children and adolescents. We reviewed the available literature about the evaluation of decision making in children and adolescents. METHOD: We searched for papers published from 2000 to 2009 that studied children and/or adolescents until the age of 16 in the Lilacs and PubMed index. The papers were analyzed according to the paradigms used in the studies, the conclusions about the development of the decision-making process, and the ability to distinguish between the clinical population and the controls. RESULTS: Thirty-six papers were selected. Compared to the amount of studies of adults, there are still few studies focusing on children and adolescents. Several versions derived from the IGT were developed in order to study decision-making processes in children and adolescents. DISCUSSION: The IGT is the most used instrument. In preschoolers, simplified versions have been used with greater frequency. The different paradigms are useful in differentiating between normal and psychiatric disorder patients. The results are positively and significantly related to the frequency of impulsive behaviors in nonclinical populations.

A cultural study on decision making: performance differences on the Iowa gambling task between selected groups of brazilians and americans

This study compared the performance of selected groups of Brazilian and American individuals on the Iowa Gambling Task (IGT). The sample was composed of 70 Brazilian and American individuals of both genders, divided into two groups of young and older adults. The two groups of Brazilians were composed of 10 young adults, aged 25 to 41 years, and 25 older adults, aged 60 to 75 years. The two groups of Americans were composed of 10 young adults, aged 28 to 39 years, and 25 older adults, aged 60 to 76 years. A two-way analysis of variance revealed differences in performance between Brazilian and American participants, regardless of age group (country, p = .001; age group, p = .134; country vs. age group, p = .291). Analyses of variance using age group and country as main factors did not reveal any difference between the two national groups with regard to the learning achieved during the task (block, p < .001; age group, p = .063; country, p = .086). The results suggest that culture, represented by the country of origin, influences the performance of individuals on the IGT, demonstrating the importance of validating an instrument for each cultural group on which it is used.

Estudo de fidedignidade do instrumento neuropsicológico Iowa Gambling Task / Reliability study of the neuropsychological test Iowa Gambling Task

OBJETIVO: O objetivo do presente estudo foi verificar evidências de fidedignidade do instrumento neuropsicológico Iowa Gambling Task (IGT) a partir do método teste-reteste. MÉTODO: Participaram 50 indivíduos saudáveis, de 19 a 75 anos de idade, com no mínimo cinco anos de educação formal. A aplicação foi realizada de forma individual, em dois encontros, com intervalo de um a seis meses entre teste e reteste. RESULTADOS: Os resultados evidenciaram uma correlação positiva moderada significativa entre teste-reteste no cálculo global. Na análise por segmentos, os blocos 4 e 5 apresentaram uma correlação positiva moderada, mas não foram observadas correlações significativas nos blocos 1, 2 e 3. CONCLUSÃO: Esses dados corroboram estudos atuais que encontraram correlações moderadas entre teste-reteste em medidas de funções executivas e sugerem que o IGT pode ser empregado para avaliar o processo de tomada de decisão de forma confiável ao longo do tempo, desde que sejam considerados estudos de fidedignidade com populações saudáveis mais amplas e com populações clínicas.

OBJECTIVE: This study aimed at evaluating reliability evidence of neuropsychological instrument Iowa Gambling Task (IGT) by the means of the test-retest method. METHOD: The sample was comprised of 50 healthy subjects, 19-75 years of age, with at least five years of formal education. The assessment was done individually, in two meetings with an interval from 1 to 6 months between test and retest. RESULTS: The findings showed a significant moderate positive correlation between test-retest in the overall calculation. In the analysis by segments, a significant moderate positive correlation was found for blocks 4 and 5, whereas there were no significant correlations for blocks 1, 2 and 3. CONCLUSION: These data corroborate recent studies that found moderate correlations between test-retest measures of executive functions, and suggest that the IGT can be used to assess decision making over time if specific analyses are taken into account.

O Desempenho de idosos quanto a tomada de decisão em duas variações do Iowa Gambling Test / Performance of older adults in two versions of the Iowa Gambling Task

O Iowa Gambling Test é utilizado na avaliação da tomada de decisão. O objetivo do presente estudo foi investigar se alterações nos procedimentos de aplicação do instrumento interferem na tarefa. Foi realizado um estudo transversal comparando dois grupos de idosos saudáveis em duas variações do instrumento. Vinte e sete participantes executaram a tarefa sem pista de reforço visual, enquanto 17 participantes foram submetidos à tarefa com pista. Os dados foram analisados por meio dos testes t de Student para amostras independentes e ANOVA para medidas repetidas. Houve diferença estatisticamente significativa entre os grupos quanto à aversão ao risco. Os resultados indicam que uma pista de reforço visual permite a alocação de recursos atencionais e de memória de trabalho, possibilitando decisões menos arriscadas.

The Iowa Gambling Test is used in decision making assessment. The aim of this study was to investigate if changes in the instrument application procedures interfere in the task execution.Across sectional study was carried out comparing two groups of healthy elderly in two variations of the instrument. Twenty seven participants executed the task without visual reinforcement clues, while 17 participants were submitted to the task with clues. Statistically significant difference was found between the two groups in relation to risk aversion. Results indicate that a clue of visual reinforcement permits the allocation of attention resources and working memory, allowing less risky decisions.

O desempenho de idosos com e sem declínio cognitivo leve nos Testes Wisconsin de Classificação de Cartas e Iowa Gambling Test / Desempeño de ancianos con y sin Deterioro Cognitivo Ligero (DCL) en el Test de Ordenamiento de Cartas de Wisconsin y en el Iowa Gambling Test / Performance of elderly with and without mild cognitive impairment in the Wisconsin Card Sorting Test and Iowa Gambling Test

Estudos recentes sugerem a existência de disfunções executivas no Declínio Cognitivo Leve (DCL), além das de memória. O objetivo deste trabalho foi verificar a presença de disfunções executivas em pacientes com DCL. Os instrumentos utilizados foram o Teste Wisconsin de Classificação de Cartas (WCST) e o Iowa Gambling Test (IGT). Foram estudados dez pacientes com e 27 sem DCL. Os dados foram analisados através do teste t de Student para amostras independentes e da análise de variância (ANOVA) para medidas repetidas. Os resultados não evidenciaram diferença significativa entre os grupos nos índices de resposta do WCST e no número de cartas retiradas de cada baralho no IGT. O estudo da evolução do desempenho no IGT revelou diferença qualitativa entre os grupos. Idosos sem DCL aprendem ao longo da tarefa, enquanto idosos com DCL não o fazem, sugerindo uma interferência dos sistemas de memória na tomada de decisão.

Recent studies suggest the existence of executive dysfunctions in Mild Cognitive Impairment (MCI). The aim of this work was to verify the presence of executive dysfunctions in patients with MCI. The instruments used were the Wisconsin Card Sorting Test (WCST) and the Iowa Gambling Test (IGT). Ten patients with and 27 without MCI were assessed. The data were analyzed through Student t test for independent samples and analysis of variance (ANOVA) for repeated measures. The results did not show significant difference between groups in the answer rates of WCST and in the number of cards with drawn from each pack of cards in the IGT. The study of the performance evolution in the IGT revealed a qualitative difference between the groups. Elderly without MCI learn along the task, while elderly with MCI did not, suggesting an interference of memory systems in decision making.

Recientes estudios hacen sugerencia a la existencia de disfunciones ejecutivas, más allá de las de la memoria, en el Deterioro Cognitivo Ligero (DCL). El objetivo de ese trabajo fue verificar la presencia de disfunciones ejecutivas en ancianos con DCL en comparación a un grupo control. Los instrumentos utilizados fueran el Test de Ordenamiento de Cartas de Winsconsin (WCST) y el Iowa Gambling Test (IGT). Fueran estudiados diez pacientes con DCL y 27 controles. Los datos fueran analizados a través del test t de Student para muestras independientes y de la ANOVA para medidas repetidas. Los resultados no traen evidencia de significativa distinción entre los grupos en los índices de respuesta del WCST en el número de cartas tiradas de cada baraja en IGT. El estudio de la evolución del desempeño en el IGT revelo diferencia cualitativa entre los grupos. Ancianos sin DCL aprenden a lo longo de la tarea, mientras ancianos con DCL no lo hacen, haciendo sugerencia de una interferencia de los sistemas de memoria en la tomada de decisión.

Sequential Involvement of Distinct Portions of the Medial Prefrontal Cortex in Different Stages of Decision Making Using the Iowa Gambling Task

Functional magnetic resonance imaging (fMRI) was used to assess the temporal response of neural activation in healthy subjects while they performed the Iowa Gambling Test (IGT), which utilizes decisions involving ambiguity and risk. The IGT was divided into five blocks of 20 trials; analysis showed that activity in the medial prefrontal cortex (mPFC) moves gradually from the dorsal to the ventral mPFC over the course of the IGT. These findings suggest that cognitive division of the mPFC, including the dorsal portion of the anterior cingulated cortex (ACC), plays a major role in ambiguous decision making and that the aspect of the IGT corresponding to risky decision making is associated with significant activity within the corticolimbic network strongly implicated in emotion and reinforcement. Our results also suggest that decisions made under ambiguity and decisions made under risk situations can be further divided into sub-phases based on the neural network involved.

The Impact of Executive Function on Emotion Recognition and Emotion Experience in Patients with Schizophrenia

OBJECTIVE: This study investigated the impact of executive function on the performance of two different affective tasks, the Facial Affect Identification Task (FAIT) and the Iowa Gambling Task (IGT), in patients with schizophrenia. METHODS: Thirty-nine patients with schizophrenia and 33 healthy controls completed the FAIT and the IGT, followed by the Wisconsin Card Sorting Test (WCST) and the intelligence quotient (IQ) test. In addition to correlation analysis, regression analysis was used to determine the extent to which the performance of the WCST, in particular, perseverative error (PE), accounted for the variation in both the FAIT and the IGT. RESULTS: Relative to normal controls, patients with schizophrenia showed significant impairments in the IGT, the FAIT and the WCST even after controlling for IQ. While normal controls did not show any relationships between the WCST and two affective tasks, patients with schizophrenia showed that variables in the WCST correlated not only with the FAIT total correct score (r=-0.503, p=0.001 for PE) but also with the IGT net score (r=0.385, p=0.016 for PE). The PE score was a better predictor of the performance on the FAIT (R2=0.25) than that of the performance on the IGT (R2=0.15). CONCLUSION: Our findings imply that deficits in executive function in schizophrenia can affect performance on facial emotion recognition task more than performance on task based on emotion experience, that is, the feedback from the body. Therefore, more consideration is needed of the impact of executive function when interpreting the result of "conventional" facial affect recognition tests as opposed to interpreting the IGT.

Current Trends of Reconstructive Surgery for the 173 Cases of Korean Duplicated Thumbs Based on the Iowa System

PURPOSE: To report the current trends of Korean duplicated thumbs and their reconstructive surgery based on Iowa system performed during the last five years. MATERIALS AND METHODS: We performed retrospective review of all (164) patients who had performed operations between 2003 and 2007. Out of all, 109 were male and 55 were female. The age at the time of surgery ranged from six months to 46 years. Data analysis was done by using information from preoperative radiographs and patients'chart including operative records, etc. RESULTS: Wassel type IV was the most common one, and type II was the next. The thumbs were involved as follows: bilateral in nine patients; right, 100; left, 55. In right duplicated thumb, males had about 2.45 more times than females. Eighty five percent of all were 24 months or less: their average body weight was 2.72 kg; average body weight at surgery, 9.07 kg (7.7~10.3 kg); average age at surgery, 9.98months (6~19months). In age distribution of their parents, each average age of fathers and mothers was 34.3 and 32.5 years old. And 10.1 percent of all had combined anomalies. Though there could be some discrimination between radiological types and intraoperative findings on cartilaginous epiphyseal portions, surgical procedures were simple ablation, central resection followed by reconstruction, and combination with radial remnant tissue portions after resection of radial extradigital bone through preoperative findings including radiographs based on Iowa system. CONCLUSIONS: Surgical procedures for duplicated thumb are not ablation but reconstruction. At the appropriate time and optimal procedures are needed for satisfactory postoperative results.