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Impulsivity, reward sensitivity, and decision-making in subarachnoid hemorrhage survivors

Published online by Cambridge University Press:  08 September 2006

CLAIRE H. SALMOND ,
ELISE E. DEVITO ,
LUKE CLARK ,
DAVID K. MENON ,
DORIS A. CHATFIELD ,
JOHN D. PICKARD ,
PETER J. KIRKPATRICK  and
BARBARA J. SAHAKIAN
CLAIRE H. SALMOND
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
ELISE E. DEVITO
Affiliation:
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
LUKE CLARK
Affiliation:
Experimental Psychology, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
DAVID K. MENON
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Anaesthetics, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
DORIS A. CHATFIELD
Affiliation:
Department of Anaesthetics, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
JOHN D. PICKARD
Affiliation:
Wolfson Brain Imaging Centre, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
PETER J. KIRKPATRICK
Affiliation:
Department of Neurosurgery, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
BARBARA J. SAHAKIAN
Affiliation:
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom
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Abstract

Subarachnoid hemorrhage (SAH) survivors often report psychosocial and emotional changes, including a diminished capacity for decision making. However, systematic investigations into the nature of the changes have been limited to those patients surviving SAH secondary to aneurysms of the anterior communicating artery. This study aimed to explore the nature of decision making in survivors of SAH secondary to aneurysms of the middle cerebral or posterior communicating artery using a series of computerized tasks. Twenty SAH survivors and 20 matched controls completed a battery of computerized decision-making tasks. These included tasks examining an individual's ability to make probabilistic choices and risk-taking behavior, as well as tasks examining aspects of impulsivity. The results revealed two key patterns of abnormal decision-making behavior in the SAH survivors: altered sensitivity to both reward and punishment, and impulsive responding. These complex deficits may contribute to difficulties in daily living resulting from apathy, poor judgment, or inhibition in SAH survivors. (JINS, 2006, 12, 697–706.)

Keywords

Intracranial aneurysmCognitionAffective symptomsRisk takingImpulsive behaviorMotivation
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 5 , September 2006 , pp. 697 - 706
Copyright
© 2006 The International Neuropsychological Society

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