Decision-Making impairment on the Iowa gambling task after endovascular coiling or neurosurgical clipping for ruptured anterior communicating artery aneurysmArtículo de Revista
Autores: Gemma escartin; Carme junqué; Montserrat Juncadella; Andreu Gabarrós; María Angels de Miquel; Francisco Rubio.
Resumen
Objective: to investigate decision-making deficits after anterior communicating artery aneurysm (ACoA) rupture and to compare the effects of two treatments. Method: the sample included 40 patients with subarachoid hemorrhagesecondary to reptured ACoA with a favorable neurological outcome and control group of 31 subjects matched by age, sex and years of education. Twenty patients had surgical interventions (clipping) and 20 had received endovascular tratment. Decision-making was assesed by the Iowa Gambling Task (IGT). We used the expectancy Valence model to examine the different components associated with the IGT. Results: ACoA patients performed significlanty worse onthe IGT than controls, we observed poorly performance on IGT in 70% of the patients. Comparing the groups according to type of invertion. We found that clipped patients performedsignificantly worse on the IGT than controls, we observed poorly performance on IGT in 70% of tha patients. Comparing the groups according to type of intervention, we found that clipped patients performed significantly worse than controls on ths IGT, whereas coiled patients did not differ significantly from controls or clipped patients; however, coiled patients performed worse than controls on the last block of the task. Patients with frontal lesions selected significantly more cards from tha disadvantegous deck. IGT performance correlated with other tests of executive functions such as the perseverative errors and non perseverative errors of Wisconsin Card Scorting Tests, and verbal fluency test, but not with working memory tests.
