Regional brain atrophy and impaired decision making on the Balloon Analog Risk Task in behavioral variant frontotemporal dementia

Maren Strenziok, Sarah Pulaski, Frank Krueger, Giovanna Zamboni, Deborah Clawson, Jordan Grafman*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Objective:: The goal of this study was 2-fold, first, to compare decision making in behavioral variant frontotemporal dementia (bvFTD) patients and healthy adults using the Balloon Analog Risk Task (BART), and, second, to identify the regions of gray matter atrophy associated with bvFTD patients' BART performance. Background:: Stimulus-reinforcement learning is required to evaluate the results of previously chosen actions to improve future decisions. Although there is a well established literature suggesting altered decision making in FTD patients and data from lesion studies suggest orbitofrontal cortex (OFC) involvement in decision making, there is very little research looking at the brain correlates of decision making in FTD populations specifically. Method:: Twenty-seven bvFTD patients and 19 age-matched and education-matched normal controls completed the BART. Voxel-based morphometry analysis was performed on the magnetic resonance imaging scans of a subset of patients. Results:: Compared with healthy controls, the bvFTD patients did not learn and pumped less to inflate a balloon to receive a reward, indicating altered stimulus-reinforcement learning. The voxel-based morphometry analysis indicated that bvFTD patients' impaired BART performance was related to atrophy in the right lateral OFC. Conclusions: The right lateral OFC is crucial for stimulus-reinforcement learning required for the adjustment of behavior under changing reward contingencies.

Original languageEnglish (US)
Pages (from-to)59-67
Number of pages9
JournalCognitive and Behavioral Neurology
Issue number2
StatePublished - Jun 2011


  • BART
  • decision making
  • frontotemporal dementia
  • orbitofrontal cortex
  • stimulus-reinforcement learning

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Psychiatry and Mental health


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