Is there a recovery of decision-making function after frontal lobe damage? A study using alternative versions of the Iowa Gambling Task

In a previous study, we examined whether frontal patients with impaired decision making on the Iowa Gambling Task (IGT) would recover over time if retested on the IGT. However, a major limitation of repeated administration of the IGT is practice effects, where control participants show improvement with retesting. Therefore, the primary goal of this study was to design two alternative versions of the IGT to eliminate practice effects. We found that control participants did not show improvement in performance across the different versions of the task, thus reflecting success in our attempt to design alternative versions of the IGT. Compared to control participants, patients with damage to the ventromedial prefrontal cortex (vmPFC) performed worse on all three versions of the IGT, even after controlling for age, sex, and education. The development of alternative versions of the IGT provides a valuable tool for clinicians and researchers to utilize the IGT as a way to track how the decision-making abilities of patients change over time. Additionally, these results are consistent with findings from the original studies using the IGT with patients with damage to the vmPFC, which showed that decision-making impairments do not recover over time.