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中文摘要：
目的探讨前额叶眶部（OBF）和背外侧（DLF）损伤对风险决策认知加工的影响，验证OBF参与风险决策认知加工过程的假说。方法OBF损伤患者21例，DLF损伤患者19例以及健康对照组（HC）40名，采用风险决策任务，比较各组执行风险决策的能力。结果组内与奖赏后相比，惩罚后HC组的风险选择频率显著下降（分别为0．68±0．16和0．54±0．23，P〈0．01），表现为惩罚后风险选择的抑制效应；DLF损伤组患者在惩罚后的风险选择频率亦有显著下降（分别为0．72±0．22和0．63±0．25，P〈0．05）；而OBF损伤组患者在惩罚后风险选择的抑制效应消失（分别为0．79±0．19和0．82±0．18，P〉0．05）。与HC组比较，OBF损伤组患者在奖赏后和惩罚后的风险选择频率均显著升高（奖赏后分别为0．68±0．16和0．79±0．19，惩罚后分别为0．54±0．23和0．82±0．18：P〈0．05），而DLF损伤组患者无显著变化（奖赏后分别为0．68±0．16和0．72±0．22，惩罚后分别为0．54±0．23和0．63±0．25；P〉0．05）。结论OBF和DLF在人类的风险决策认知加工过程存在分离。OBF损伤后的患者追求高奖赏，惩罚后风险选择的抑制效应消失，而DLF损伤组患者的风险决策能力正常。OBF可能参与了奖赏／惩罚认知加工过程，是风险决策认知加工和处理的重要脑区。
英文摘要：
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 ）. Conclusion 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.
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