본문 바로가기
KERD
논문KCI 등재

의사결정의 신경생물학

Neurobiology of Decision-Making

김양태|이승재
대한생물치료정신의학회 (Korean Society Of Biological Therapies In Psychiatry)|2004.06|생물치료정신의학 (Journal of the Korean Society of Biological Therapies in Psychiatry)|제10권 제1호|pp. 96-103

0

조회

0

다운로드

7

인용

0

참고문헌

키워드

Decision-makingVentromedial prefrontal cortex의사결정·복내측 전두엽·신체 표지자.Somatic marker
주제분류정신과학

초록

Damasio와 그의 동료들은 감정과 느낌이 의사결정의 과정에 중요한 역할을 한다는 것을 신체 표지자 가설을 통해서 제시하고, 복내측 전전두엽이 감정, 느낌, 그리고 의사결정에 중요한 해부학적 구조임을 주장하고 있다. 의사결정능력의 장애는 복내측 전전두엽이 손상된 환자뿐만 아니라 정신과 영역의 환자들에서도 보고되고 있다. 물질의존, 강박장애, 병적도박, 간헐적 폭발성장애, 그리고 주의력결핍과잉행동장애 환자들이 정상 대조군에 비해 유의하게 도박과제 수행정도가 낮음이 알려져 있다. 이러한 정신과장애 환자들에서 보이는 조절되지 않는 행동양상은 의사결정능력의 장애뿐만 아니라 손상된 충동조절에 의해서도 기인하는 것으로 보인다. 도파민과 세로토닌이 의사결정의 과정에 관여하는 신경전달물질로 거론되고 있으나, 그 구체적인 기전은 향후 더 많은 연구가 필요하다고 생각된다. 의사결정의 신경생물학적인 이해는 정신과 영역의 많은 환자들의 행동양상을 이해하고, 그들의 치료와 재활에 도움을 줄 것이라고 기대된다.

Abstract

While patients with bilateral lesions of the ventromedial prefrontal cortex did have normal intellect, there were abnormalities in emotion and feeling, along with abnormalities in decision-making. Based on these observations, the somatic marker hypothesis was proposed by Damasio and his colleagues. The somatic marker hypothesis suggests that emotion and feeling provide the principal guide for decision-making. Understanding the neural mechanisms of decision-making has direct implication for understanding substance abuse. The application of decision-making also extends to several psychiatric disorders that include obsessive-compulsive disorder, pathological gambling, intermittent explosive disorder, and attention deficit hyperactivity disorder. In addition to decision-making, there are several other prefrontal mechanisms for impulsiveness that are important for behavioral control that could be impaired in these psychiatric disorders. It is believed that neurotransmitters such as dopamine and serotonin are involved in the process of decision-making. We expect that the neurobiological understanding of decision-making would serve as guide for treatment and rehabilitation of many psychiatric disorders.

참고문헌 (26)

  1. "Damasio AR. Descartes error and the future of hu-man life. Sci Am 1994", pp.144~
  2. "Da-masio AR. The return of Phineas Gage clues about the brain from the skull of a famous patient. Science 1994", pp.1102~5
  3. "Damasio AR. Severe disturbance of hig-her cognition after bilateral frontal lobe ablation", pp.1731~41
  4. "Dis-sociation of working memory from decision making within the human prefrontal cortex.", 18, pp.428~437 (1998)
  5. "Decision-making and addiction(part II): myopia for the future or hypersen-sitivity to reward?", 40, pp.1690~1705 (2002)
  6. "Different contributions of the human amygdala and ventrome-dial prefrontal cortex to decision-making.", 19, pp.5473~5481 (1999)
  7. "Subcortical and cortical brain activity during the feeling of self-generated emotions.", 3, pp.1049~1056 (2000)
  8. "Anderson SW. In-sensitivity to future consequences folowing damage to human prefrontal cortex. Cognition 1994", pp.7~15
  9. "Characterization of the decision-making deficit of patients with ventrome-dial prefrontal cortex lesions.", 123, pp.2189~202 (2000)
  10. "Functional magnetic reson-ance imaging of brain reward circuitry in the human.", 877, pp.523~547 (1999)
  11. "Functional imaging of neural responses to expectancy and experience of monetary gains and losses.", 30, pp.619~639 (2001), Kahneman D
  12. "Drug abusers show impaired performance in a laboratory test of decision making.", 38, pp.1180~1187 (2000)
  13. "Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers.", 39, pp.376~389 (2001)
  14. "Decision-making and addic-tion(part I): impaired activation of somatic states in substance dependent individuals when pondering de-cisions with negative future consequences.", 40, pp.1675~1689 (2002)
  15. "Risky busines: emotion, decision-making, and addiction", 19, pp.23~51 (2003)
  16. "Decision making performance in obsessive com-pulsive disorder.", 69, pp.257~260 (2002)
  17. "Decision-making heterogeneity in obsessive-compulsive disorder: ventromedial prefrontal cortex function predicts diferent treatment outcomes.", 40, pp.205~211 (2002)
  18. "Basal-corticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controled, double dissociation study.", 54, pp.437~443 (2003)
  19. "Frontal lobe Dysfunction in Pathological Gambling Patients.", 51, pp.334~341 (2002)
  20. "Evidence for a dys-functional prefrontal circuit in patients with an im-pulsive aggressive disorder.", 99, pp.8448~8453 (2002)
  21. "Decision making in adolescents with behavior disorders and adults with substance abuse.", 160, pp.33~40 (2003)
  22. "A neuropsycholo-gical investigation of prefrontal cortex involvement in acute mania.", 158, pp.1605~1 (2001)
  23. "Substance abuse, pathological gambling, and impulsiveness.", 63, pp.29~38 (2001)
  24. "Chemical neuromodulation of frontal-executive functions in humans and other animals", 133, pp.130~138 (2000)
  25. "Reward mechanisms in the brain and their role in dependence evidence from neurophysiological and neuroimaging studies.", 36, pp.139~149 (2001)
  26. "Manipulation of dopamine and serotonin causes different effects on covert and overt decision-making.", 27 (2001)

이 간행물의 다른 논문 (12건)

자살과 정신 장애제영묘pp. 3-10자살의 심리학적 측면이귀행pp. 11-14자살 환자의 치료이광헌pp. 15-24여성 성기능장애 평가를 위한 한국판 성기능 설문지의 개발 : 신뢰도와 타당도 연구박현숙, 구현영, 원승희pp. 25-25비정형 항정신병약물 치료 중 관찰된 체중의 변화신철진, 권영준, 이경규, 지익성pp. 36-44
원문 보기