It has been brought to popular attention by Antonio Damasio (proponent of the somatic marker hypothesis) in his best-selling book Descartes' Error.
[2] The IGT is thought to measure an individual's approach to risk-taking, impulsivity, and ability to delay short-term gratification to achieve long-term rewards.
Patients with orbitofrontal cortex (OFC) dysfunction, however, continue to persevere with the bad decks, sometimes even though they know that they are losing money overall.
[6] By contrast, patients with amygdala lesions never develop this physiological reaction to impending punishment.
In another test, patients with ventromedial prefrontal cortex (vmPFC) dysfunction were shown to choose outcomes that yield high immediate gains in spite of higher losses in the future.