Impaired decision-making ability in functional heartburn patients

Rats with visceral hypersensitivity often exhibit impaired decision-making abilities. Functional heartburn (FH) is a functional esophageal disease that belongs to the category of gut-brain interaction disorders, associated with visceral hypersensitivity. However, the decision-making ability of patients with FH remains unclear.

We recruited 30 patients diagnosed with FH based on the Rome IV criteria and 30 healthy controls (HCs). All patients were evaluated using the Hamilton Anxiety Scale and the 17-item Hamilton Depression Scale-17. Patients with FH also completed the gastroesophageal reflux disease and modified gastrointestinal symptom score questionnaires. We employed the Iowa Gambling Task (IGT) and Game of Dice Task (GDT) to evaluate decision making.

In the IGT, patients with FH exhibited a lower total net score and made more unfavorable choices compared to healthy controls (HCs). Specifically, statistically significant differences were observed in the net scores of the last three blocks, the differences were of large effect sizes. In the GDT, patients with FH demonstrated a lower total net score, higher risk score, and lower utilization of negative feedback than the HCs, the differences were of middle-large effect sizes. Even after controlling for the effects of anxiety, depression, and the coexistence of functional dyspepsia, patients with FH exhibited lower net scores than HCs, in both the IGT and GDTs.

Our findings suggest that patients with FH showed worse decision-making abilities than HCs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).