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Frontotemporal dementia and Iowa Gambling Task: a literature review on decision-making process

Background: Frontotemporal dementia (FDT) is related to memory and behavioral changes. There are variants in which the damage is more pronounced in one cognitive domain. Among the behavioral changes is the decision-making process. To evaluate this skill executive function tests are used, such as the Iowa Gambling Task (IGT). Objectives: Analyze the correlation between Iowa Gambling Task and decision- making process in patients with FDT. Methods: A review was conducted on PubMed, using the key words “Iowa Gambling Task AND Frontotemporal Dementia”, resulting in 4 papers. From those, 3 were included. Results: In Gleichgerrcht et al. (2012) IGT was used as a parameter to investigate risk taking on the decision-making process in patients with Primary Progressive Aphasia (PPA) and its subtypes (PPA is frequently associated with FTD) versus subjects with behavioral variant from FTD (bvFTD). PPA subjects had no improvement throughout the task, proving that there is an impairment in decision-making. The bvFTD group progression showed that this group has a tendency to choose risky behaviors, suggesting an inability to foresee negative outcomes. In Girardi, MacPherson & Abrahams (2011) the frontal variant was analyzed in subjects with ALS and had similar results, showing also a failure to learn how to avoid disadvantageous choices. Torralva et al. (2017) analyzed the results on subjects with the frontal variant in which the results were consistent with the previous studies analyzed in this review. Conclusion: In patients with FTD, the IGT proves that a cognitive impairment in the decision-making and risk-taking process is present.