Scientific approaches to understand the neural processes underlying how we make decisions have used a variety of methods in their quest to describe how the brain makes decisions, including functional neuroimaging, and work with brain damaged patients. We studied the decision-making capabilities of patients who had suffered injury to the ventromedial sector of their prefrontal cortex. At the time, the decision-making deficit seen in these patients presented a puzzling defect because their impairment was obvious in their real life, but there was no laboratory probe to detect and measure this decision-making impairment in the clinic. Many of these challenges were overcome with the development of what became known as the Iowa Gambling Task (IGT). The development of this task enabled investigators to detect these patients' elusive impairment in the laboratory, measure it, and investigate its possible causes. There have been many application of this research on decision-making to understanding the neurobiology of addiction. We have linked substance addiction behaviors to impaired decision-making and a dysfunctional ventromedial prefrontal cortex. Another key research area relates to the finding that the insula is critical for smoking addiction (and potentially other substances of abuse). This finding brought to light the potential role of a new neural region, the insular cortex, which was completely ignored in the past in the psychopathology of addiction. There is currently an extension of this decision neuroscience research to behavioral addictions where attempts are being made to understand the brain mechanisms that underlie human choice, particularly in the areas of making healthy food choices, gambling behaviors, and problematic Internet use. InvestigatorsAntoine Bechara, PhD Ofir Turel, PhD Damien Brevers, PhD Quinhua He, PhD Tasha Poppa |