Changes in decision-making function in patients with subacute mild traumatic brain injury.

Although awareness regarding patients with mild traumatic brain injury has increased, they have not received sufficient attention in clinics; hence, many patients still experience only partial recovery. Deficits in decision-making function are frequently experienced by these patients. Accurate identification of impairment in the early stages after brain injury is particularly crucial for timely intervention and the prevention of long-term cognitive consequences. Therefore, we investigated the changes in decision-making ability under tasks of ambiguity and risk in patients with mild traumatic brain injury with a rule-based neuropsychological paradigm. In this study, patients (n = 39) and matched healthy controls (n = 38) completed general neuropsychological background tests and decision-making tasks (Iowa Gambling Task and Game of Dice Task). We found that patients had extensive cognitive impairment in general attention, memory and information processing speed in the subacute phase, and confirmed that patients had different degrees of impairment in decision-making abilities under ambiguity and risk. Furthermore, the decline of memory and executive function may be related to decision-making dysfunction.

Structural correlates underlying accelerated magnetic stimulation in Parkinson's disease.

Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neuromodulation technique with great potential in the treatment of Parkinson's disease (PD). This study aimed to investigate the clinical efficacy of accelerated rTMS and to understand the underlying neural mechanism. In a double-blinded way, a total of 42 patients with PD were randomized to receive real (n = 22) or sham (n = 20) continuous theta-burst stimulation (cTBS) on the left supplementary motor area (SMA) for 14 consecutive days. Patients treated with real cTBS, but not with sham cTBS, showed a significant improvement in Part III of the Unified PD Rating Scale (p < .0001). This improvement was observed as early as 1 week after the start of cTBS treatment, and maintained 8 weeks after the end of the treatment. These findings indicated that the treatment response was swift with a long-lasting effect. Imaging analyses showed that volume of the left globus pallidus (GP) increased after cTBS treatment. Furthermore, the volume change of GP was mildly correlated with symptom improvement and associated with the baseline fractional anisotropy of SMA-GP tracts. Together, these findings implicated that the accelerated cTBS could effectively alleviate motor symptoms of PD, maybe by modulating the motor circuitry involving the SMA-GP pathway.

Pre-supplementary motor network connectivity and clinical outcome of magnetic stimulation in obsessive-compulsive disorder.

A large proportion of patients with obsessive-compulsive disorder (OCD) respond unsatisfactorily to pharmacological and psychological treatments. An alternative novel treatment for these patients is repetitive transcranial magnetic stimulation (rTMS). This study aimed to investigate the underlying neural mechanism of rTMS treatment in OCD patients. A total of 37 patients with OCD were randomized to receive real or sham 1-Hz rTMS (14 days, 30 min/day) over the right pre-supplementary motor area (preSMA). Resting-state functional magnetic resonance imaging data were collected before and after rTMS treatment. The individualized target was defined by a personalized functional connectivity map of the subthalamic nucleus. After treatment, patients in the real group showed a better improvement in the Yale-Brown Obsessive Compulsive Scale than the sham group (F1,35  = 6.0, p = .019). To show the neural mechanism involved, we identified an "ideal target connectivity" before treatment. Leave-one-out cross-validation indicated that this connectivity pattern can significantly predict patients' symptom improvements (r = .60, p = .009). After real treatment, the average connectivity strength of the target network significantly decreased in the real but not in the sham group. This network-level change was cross-validated in three independent datasets. Altogether, these findings suggest that personalized magnetic stimulation on preSMA may alleviate obsessive-compulsive symptoms by decreasing the connectivity strength of the target network.

Better modulation for risk decision-making after optimized magnetic stimulation.

Traditional repetitive transcranial magnetic stimulation can only produce a significant but weak effect on the cortex while theta burst stimulation (TBS), a patterned accelerated form of stimulation, can produce a stronger poststimulation effect, which may improve decision-making abilities. We designed a comparative assessment of the effect of intermittent TBS (iTBS), 20 Hz, in two risk decision-making tasks on healthy controls. Participants were randomized and assigned to the iTBS (n = 29), 20 Hz (n = 29), or sham (n = 29) groups. The effects of the different methods of left dorsolateral prefrontal cortex stimulation on risk decision-making functions were compared based on subjects' performance in the Game of Dice Task (GDT) and Risky Gains Task (RGT). The main indicators were positive and negative feedback utilization rates of GDT and RGT. Both iTBS and 20 Hz stimulation resulted in significant improvements upon negative feedback in the GDT, with increases in safe options and reductions in risky options; iTBS stimulation increased subjects' use of positive feedback in the GDT and RGT (all p < 0.05). Furthermore, the iTBS group had a stronger feedback risk reduction effect than the 20 Hz or sham group following RGT negative feedback (p < 0.05). Individuals would integrate positive and negative information more efficiently, leading to them making rational choices after excitatory transcranial magnetic stimulation. Moreover, iTBS has a stronger risk reduction effect following negative feedback than the 20Hz stimulation did. In summary, iTBS might have clinical value in decision promotion.

Classification of schizophrenia by intersubject correlation in functional connectome.

Functional connectomes have been suggested as fingerprinting for individual identification. Accordingly, we hypothesized that subjects in the same phenotypic group have similar functional connectome features, which could help to discriminate schizophrenia (SCH) patients from healthy controls (HCs) and from depression patients. To this end, we included resting-state functional magnetic resonance imaging data of SCH, depression patients, and HCs from three centers. We first investigated the characteristics of connectome similarity between individuals, and found higher similarity between subjects belonging to the same group (i.e., SCH-SCH) than different groups (i.e., HC-SCH). These findings suggest that the average connectome within group (termed as group-specific functional connectome [GFC]) may help in individual classification. Consistently, significant accuracy (75-77%) and area under curve (81-86%) were found in discriminating SCH from HC or depression patients by GFC-based leave-one-out cross-validation. Cross-center classification further suggests a good generalizability of the GFC classification. We additionally included normal aging data (255 young and 242 old subjects with different scanning sequences) to show factors could be improved for better classification performance, and the findings emphasized the importance of increasing sample size but not temporal resolution during scanning. In conclusion, our findings suggest that the average functional connectome across subjects contained group-specific biological features and may be helpful in clinical diagnosis for schizophrenia.

Functional Connectivity of the Corticobasal Ganglia-Thalamocortical Network in Parkinson Disease: A Systematic Review and Meta-Analysis with Cross-Validation.

Purpose To quantitatively summarize the functional connectivity (FC) feature of the corticobasal ganglia-thalamocortical (CBTC) network in patients with Parkinson disease (PD) by means of a meta-analysis with cross-validation. Materials and Methods For this prospective study, a systematic literature search in the PubMed and EMBASE databases was performed for resting-state functional magnetic resonance (MR) imaging studies of PD published between January 2000 and May 2017. Then, a coordinate-based meta-analysis was conducted by Effect Size-Signed Differential Mapping. A cross-validation analysis was performed by using an independent resting-state functional MR imaging data set that contained 25 patients with PD and 19 age-, sex-, and education-matched healthy control participants. Two-sample t test was performed on FC maps between PD and control groups. Results Thirty studies with 854 patients with PD and 831 control participants were included in this meta-analysis. The main meta-analysis found increased FC in the left pre- and postcentral gyrus in patients with PD compared with healthy control participants (z = 2.6; P < .001). The abnormality of the postcentral gyrus was further confirmed by subgroup meta-analyses on medication-naive (n = 25; z = 2.2; P < .001) and medication-off (n = 11; z = 1.5; P < .001) experiments, which suggested that the finding was unaffected by medication. The abnormality of the postcentral gyrus was cross-validated by the independent data set (t = 5.0; P < .05), which suggested a high reproducibility and generalizability. Conclusion This meta-analysis emphasizes the left postcentral gyrus as a critical region in PD, which may become a potential target for clinical intervention. © RSNA, 2018 Online supplemental material is available for this article.

The Working Memory and Dorsolateral Prefrontal-Hippocampal Functional Connectivity Changes in Long-Term Survival Breast Cancer Patients Treated with Tamoxifen.

Background: Tamoxifen is the most widely used drug for treating patients with estrogen receptor-sensitive breast cancer. There is evidence that breast cancer patients treated with tamoxifen exhibit cognitive dysfunction. However, the underlying neural mechanism remains unclear. The present study aimed to investigate the neural mechanisms underlying working memory deficits in combination with functional connectivity changes in premenopausal women with breast cancer who received long-term tamoxifen treatment. Methods: A total of 31 premenopausal women with breast cancer who received tamoxifen and 32 matched healthy control participants were included. The participants completed n-back tasks and underwent resting-state functional magnetic resonance imaging, which measure working memory performance and brain functional connectivity, respectively. A seed-based functional connectivity analysis within the whole brain was conducted, for which the dorsolateral prefrontal cortex was chosen as the seed region. Results: Our results indicated that the tamoxifen group had significant deficits in working memory and general executive function performance and significantly lower functional connectivity of the right dorsolateral prefrontal cortex with the right hippocampus compared with the healthy controls. There were no significant changes in functional connectivity in the left dorsolateral prefrontal cortex within the whole brain between the tamoxifen group and healthy controls. Moreover, significant correlations were found in the tamoxifen group between the functional connectivity strength of the dorsolateral prefrontal cortex with the right hippocampus and decreased working memory performance. Conclusion: This study demonstrates that the prefrontal cortex and hippocampus may be affected by tamoxifen treatment, supporting an antagonistic role of tamoxifen in the long-term treatment of breast cancer patients.

Functional connectivity change of brain default mode network in breast cancer patients after chemotherapy.

INTRODUCTION: Complaint about attention disorders is common among breast cancer patients who have undergone chemotherapy, which may be associated with the default mode network (DMN). To validate this hypothesis, we investigated the DMN functional connectivity (FC) change and its relationship with the attention function in breast cancer patients (BC) using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS: Twenty-two BC treated with chemotherapy and 22 healthy controls (HC) were recruited into this study. The FC between the DMN's hubs and regions of the dorsal medial prefrontal cortex (dMPFC) and medial temporal lobe (MTL) subsystems was respectively calculated for each participant. RESULTS: The statistical result showed significantly lower connectivity in dMPFC and MTL subsystems in the BC group. In addition, the partial correlation analysis result indicated that the low connectivity of some brain regions in MTL subsystem was correlated with attention dysfunction following BC chemotherapy. CONCLUSION: These results suggest that the functional disconnection in MTL subsystem of the DMN may have association with attention function of BC after chemotherapy.

Decision-making impairments in breast cancer patients treated with tamoxifen.

The selective estrogen receptor modulator tamoxifen (TAM) is most commonly prescribed for patients with hormone-sensitive breast cancer. Although TAM can bind to estrogen receptors in the nervous system, it is unknown whether it acts as an estrogen agonist or antagonist in the human brain. Several studies have reported the negative effects of TAM on cognitive function; however, its effects on decision-making function have not been previously explored. The present study aimed to investigate the decision-making function under ambiguity and risk in breast cancer patients treated with TAM. Participants included breast cancer patients taking TAM (TAM, n=47) and breast cancer patients not taking TAM (non-TAM, n=45) as well as their matched healthy controls (HC, n=50). All participants were given the Iowa Gambling Task (IGT) to assess their decision-making under conditions involving ambiguity, the Game of Dice Task (GDT) to assess their decision-making under conditions involving risk, and a battery of neuropsychological tests. Our results indicated that patients in the TAM group were significantly impaired as assessed by both the IGT and GDT and performed significantly worse on some aspects of various tasks involving memory and information processing. Furthermore, we found that decreased performance on verbal memory testing significantly correlated with IGT performance, and executive dysfunction was associated with poor GDT performance in breast cancer patients undergoing TAM treatment. This study demonstrates that breast cancer patients taking TAM have several decision-making impairments. These findings may support the idea that TAM resulting in cognitive changes plays an antagonistic role in the areas of the brain where estrogen receptors are present, including the prefrontal cortex, hippocampus and amygdala.

Selective impairment of attention networks in breast cancer patients receiving chemotherapy treatment.

INTRODUCTION: Complaints about attention disorders are common among breast cancer survivors who have undergone chemotherapy treatment. However, it is not known whether these complaints indicate a global attention deficit or the selective impairment of attention networks. OBJECTIVE: This study sought to investigate the attentional abilities of breast cancer patients after chemotherapy treatment using the attention network test (ANT). METHODS: The participants included breast cancer patients who had undergone chemotherapy (CT, N = 58), patients who had not undergone chemotherapy (non-CT, N = 53), and matched healthy controls (HC, N = 55). All participants completed the ANT, which provides measures of three independent attention networks (alerting, orienting, and executive control) and neuropsychological background tests. RESULTS: Our results indicated that the chemotherapy-treated breast cancer patients had significant deficits in the alerting and executive control networks but not in the orienting network. The CT group scored significantly lower in several cognitive tasks, including attention, memory, and information processing tasks, relative to the other two groups. Additionally, significant correlations were found between information processing and the efficiency of the executive control network within the CT group. CONCLUSIONS: These results suggest that the three attention networks were selectively impaired following chemotherapy treatment, which affected different brain areas in the breast cancer survivors.

Attention dysfunction of postoperative patients with glioma.

BACKGROUND: Attention dysfunction has been observed among many kinds of nervous system diseases, including glioma. This study aimed to investigate the correlation between glioma localization, malignancy, postoperative recovery time and attention deficit. METHODS: A total of 45 patients with glioma who underwent surgical resection and 18 healthy volunteers were enrolled. The attention network test, digital span test, color trail test II and Stroop test were used to detect the characteristics of attention deficit. RESULTS: Orientation network dysfunction was detected in the parietal lobe tumor group, and execution network deficit was detected in both the frontal and parietal lobe groups, while no significant difference was detected in the temporal lobe group compared to healthy controls. The high-grade glioma group (grade III-IV) exhibited more serious functional impairment than the low-grade group (grade I-II). No significant correlation was observed between postoperative recovery time and attention impairment. CONCLUSIONS: High-grade glioma patients suffer more severe attention impairment. In addition, the frontal and parietal lobe glioma patients suffer attention dysfunction in dissimilar manner. These findings will provide important guidance on the care of glioma patients after therapy.

[Cognitive function in breast cancer patients on chemotherapy: a longitudinal study].

OBJECTIVE: To explore whether cognitive impairment in breast cancer patients after the completion of chemotherapy treatment in comparisons with breast cancer patients without chemotherapy treatment and matched healthy controls. METHODS: A neuropsychology battery was applied in all breast cancer patients at our hospital from January 2012 to February 2013. Forty-two breast cancer patients with chemotherapy treatment (CT) underwent neuropsychologic testing before the start of chemotherapy (T1) and after treatment (T2). And 37 patients without chemotherapy treatment (non-CT) and matched healthy controls (HC) underwent the same assessment at matched intervals. RESULTS: The CT group performed significantly worse on attention, memory and executive function tests at T2 versus T1 (P < 0.05). As compared with HC and non-CT groups, the correct numbers of backward, digit symbol, delayed recall and recognition were lower in the CT group (P < 0.05). The reacting time of TMT test B, Stroop test B and Stroop test C were longer in the CT group (P < 0.05). There was significant time interaction in three groups (P < 0.05). CONCLUSION: There are longitudinal changes in cognitive functioning of memory, attention and executive functions in breast cancer patients on Chemotherapy.

Orienting network impairment of attention in patients with mild traumatic brain injury.

The incomplete understanding of mild traumatic brain injury (MTBI)-related cognitive impairment in the acute stage and the low cognitive needs of patients in the later stage might be the main reasons for the neglect of clinical symptoms in patients with MTBI. Patients often experience attention deficits; however, it is unclear whether these patients suffer from general deficits or selective impairment of the brain attention network. Therefore, we investigated deficits in the attention function of patients with mild brain traumatic injury. Patients (n = 50) and matched healthy controls (n = 49) completed a general neuropsychological background test and the Attention Network Test, which provided an independent assessment of the three attention networks (alerting, orienting, and executive control). We found that patients had significant deficits in the orienting network but none in the alerting and executive control networks. Furthermore, patients' cognitive task scores in attention, memory, and information processing tasks were significantly lower than the scores of the controls. Our results demonstrated that patients with MTBI had selective impairment in the orienting network and extensive cognitive impairments, including those related to general attention, memory, and information processing speed.

Depression and Anxiety During the COVID-19 Pandemic: Epidemiology, Mechanism, and Treatment.

The Coronavirus Disease 2019 (COVID-19) pandemic has had an adverse impact on the physical and mental health of the public worldwide. In addition to illness in patients with COVID-19, isolated people and the general population have experienced mental health problems due to social distancing policies, mandatory lockdown, and other psychosocial factors, and the prevalence of depression and anxiety significantly increased during the pandemic. The purpose of this review is to elucidate the epidemiology, contributing factors, and pathogenesis of depression and anxiety. during the pandemic. These findings indicate that physicians and psychiatrists should pay more attention to and identify those with a high risk for mental problems, such as females, younger people, unmarried people, and those with a low educational level. In addition, researchers should focus on identifying the neural and neuroimmune mechanisms involved in depression and anxiety, and assess the intestinal microbiome to identify effective biomarkers. We also provide an overview of various intervention methods, including pharmacological treatment, psychological therapy, and physiotherapy, to provide a reference for different populations to guide the development of optimized intervention methods.

High-Definition Transcranial Direct Current Stimulation Improves Decision-Making Ability: A Study Based on EEG.

High-definition transcranial direct current stimulation (HD-tDCS) has been shown to modulate decision-making; however, the neurophysiological mechanisms underlying this effect remain unclear. To further explore the neurophysiological processes of decision-making modulated by HD-tDCS, health participants underwent ten anodal (n = 16)/sham (n = 17) HD-tDCS sessions targeting the left DLPFC. Iowa gambling task was performed simultaneously with electroencephalography (EEG) before and after HD-tDCS. Iowa gambling task performance, the P300 amplitude, and the power of theta oscillation as an index of decision-making were compared. Behavioral changes were found that showed anodal HD-tDCS could improve the decision-making function, in which participants could make more advantageous choices. The electrophysiological results showed that the P300 amplitude significantly increased in CZ, CPZ electrode placement site and theta oscillation power significantly activated in FCZ, CZ electrode placement site after anodal HD-tDCS. Significant positive correlations were observed between the changes in the percent use of negative feedback and the changes in theta oscillation power before and after anodal HD-tDCS. This study showed that HD-tDCS is a promising technology in improving decision-making and theta oscillation induced by may be a predictor of improved decision-making.

Changing trends in the global burden of mental disorders from 1990 to 2019 and predicted levels in 25 years.

AIMS: The burden of mental disorders is increasing worldwide, thus, affecting society and healthcare systems. This study investigated the independent influences of age, period and cohort on the global prevalence of mental disorders from 1990 to 2019; compared them by sex; and predicted the future burden of mental disorders in the next 25 years. METHODS: The age-specific and sex-specific incidence of mental disorders worldwide was analysed according to the general analysis strategy used in the Global Burden of Disease Study in 2019. The incidence and mortality trends of mental disorders from 1990 to 2019 were evaluated through joinpoint regression analysis. The influences of age, period and cohort on the incidence of mental disorders were evaluated with an age-period-cohort model. RESULTS: From 1990 to 2019, the sex-specific age-standardized incidence and disability-adjusted life years (DALY) rate decreased slightly. Joinpoint regression analysis from 1990 to 2019 indicated four turning points in the male DALY rate and five turning points in the female DALY rate. In analysis of age effects, the relative risk (RR) of incidence and the DALY rate in mental disorders in men and women generally showed an inverted U-shaped pattern with increasing age. In analysis of period effects, the incidence of mental disorders increased gradually over time, and showed a sub-peak in 2004 (RR, 1.006 for males; 95% CI, 1.000-1.012; 1.002 for women, 0.997-1.008). Analysis of cohort effects showed that the incidence and DALY rate decreased in successive birth cohorts. The incidence of mental disorders is expected to decline slightly over the next 25 years, but the number of cases is expected to increase. CONCLUSIONS: Although the age-standardized burden of mental disorders has declined in the past 30 years, the number of new cases and deaths of mental disorders worldwide has increased, and will continue to increase in the near future. Therefore, relevant policies should be used to promote the prevention and management of known risk factors and strengthen the understanding of risk profiles and incidence modes of mental disorders, to help guide future research on control and prevention strategies.

Linking Personalized Brain Atrophy to Schizophrenia Network and Treatment Response.

BACKGROUND AND HYPOTHESIS: Schizophrenia manifests with marked heterogeneity in both clinical presentation and underlying biology. Modeling individual differences within clinical cohorts is critical to translate knowledge reliably into clinical practice. We hypothesized that individualized brain atrophy in patients with schizophrenia may explain the heterogeneous outcomes of repetitive transcranial magnetic stimulation (rTMS). STUDY DESIGN: The magnetic resonance imaging (MRI) data of 797 healthy subjects and 91 schizophrenia patients (between January 1, 2015, and December 31, 2020) were retrospectively selected from our hospital database. The healthy subjects were used to establish normative reference ranges for cortical thickness as a function of age and sex. Then, a schizophrenia patient's personalized atrophy map was computed as vertex-wise deviations from the normative model. Each patient's atrophy network was mapped using resting-state functional connectivity MRI from a subgroup of healthy subjects (n = 652). In total 52 of the 91 schizophrenia patients received rTMS in a randomized clinical trial (RCT). Their longitudinal symptom changes were adopted to test the clinical utility of the personalized atrophy map. RESULTS: The personalized atrophy maps were highly heterogeneous across patients, but functionally converged to a putative schizophrenia network that comprised regions implicated by previous group-level findings. More importantly, retrospective analysis of rTMS-RCT data indicated that functional connectivity of the personalized atrophy maps with rTMS targets was significantly associated with the symptom outcomes of schizophrenia patients. CONCLUSIONS: Normative modeling can aid in mapping the personalized atrophy network associated with treatment outcomes of patients with schizophrenia.

Case report: Anti-GAD65 antibody-associated autoimmune encephalitis following HPV vaccination.

Human papillomavirus (HPV) infection is a sexually transmitted disease that may lead to cervical cancer. HPV vaccines have been implemented widely to prevent this. While generally few complications of vaccination are reported, there have been occasional reports of adverse reactions post-vaccination. The safety profile of the HPV vaccine is reassuring. However, since its introduction, several serious post-vaccination central nervous system complications have been reported; however, causality has not been established. Herein, we describe a 39-year-old woman who developed seizures and experienced a rapid decline in memory shortly after her first dose of the HPV vaccine. Cranial magnetic resonance imaging and cerebrospinal fluid analysis were performed, and the patient was diagnosed with anti-glutamic acid decarboxylase 65 (anti-GAD65) antibody-associated autoimmune encephalitis. She responded well to high-dose glucocorticoids. Four-month follow-up revealed full recovery and absence of recurrence. Since the HPV vaccine is administered worldwide, this case should raise clinicians' awareness regarding the possible CNS complications related to vaccinations, such as anti-GAD65 antibody-associated AE.

Intermittent theta burst stimulation improved visual-spatial working memory in treatment-resistant schizophrenia: A pilot study.

BACKGROUND: Visual-spatial working memory (vsWM) impairment in treatment-resistant schizophrenia (TRS) currently has no satisfactory treatment. Our study aimed to improve vsWM function in TRS through intermittent theta burst stimulation (iTBS) using neuronavigation equipment to target the left dorsolateral prefrontal cortex. METHOD: TRS patients (n = 59) were randomly allocated to receive iTBS (n = 33) or a sham treatment (n = 26) over 2 weeks. The participants including TRS patients and healthy controls (HCs) performed the vsWM n-back task, and TRS patients' neuroimaging data were acquired before and after treatment. All patients also underwent a battery of symptom measures to assess the severity of illness. The main outcome measure was the accuracy (ACC) of n-back target responses, particularly 3-back ACC. RESULTS: The iTBS group showed considerable improvement in n-back ACC compared to the sham group, especially 3-back ACC. After iTBS, performance on the n-back task was comparable to that of HCs. The interaction (group × time) results showed increased fractional amplitude of low frequency fluctuations (fALFF) in the right occipital areas and decreased fALFF in the right precuneus. However, there was a negative correlation between the 3-back ACC and improved clinical symptoms scores. Improvements in 3-back ACC were positively correlated with activity in the right visual cortex. CONCLUSIONS: Our study suggested that 2 weeks of iTBS intervention may be a novel, efficacious treatment for vsWM deficits in TRS, which can modulate the activity of local brain regions. iTBS can provide a solution for clinical treatment of TRS and may help patients approach normalcy.

Decision-making impairments under ambiguous and risky situations in patients with prefrontal tumor: A neuropsychological study.

INTRODUCTION: The neural mechanism underlying decision-making, which is an important component of executive function, is complex and not fully understood. Few studies have directly investigated the two types of decision-making functions - under ambiguity and under risk - in patients with brain tumors in different brain regions. METHODS: Participants were classified into the ventral prefrontal cortex tumor group (VPFC, n = 27), the dorsolateral prefrontal cortex tumor group (DLPFC, n = 29), and matched healthy controls (HCs, n = 32). All participants were given a battery of neuropsychological tests, and they then performed the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT) to assess their decision-making under ambiguity and under risk, respectively. RESULTS: The two patient groups performed significantly worse on attention, memory, information processing, and executive function. Additionally, patients in the DLPFC group performed significantly worse on the memory and information processing tests compared with the VPFC and HC groups. CONCLUSION: This study found that the decision-making functions of participants in the VPFC and DLPFC tumor groups were impaired to varying degrees. Among them, there was decision-making impairment under ambiguity and under risk in the VPFC group, and there was decision-making impairment under risk in the DLPFC group.