People who tend to impulsively choose smaller, sooner rewards over larger, later rewards are at increased risk for addiction and psychiatric disorders. A neurobiological measure of the tendency to overvalue immediate gratification could facilitate the study of individuals who are susceptible to these mental disorders. The objective of this research was to develop a cortical assay of impulsive choice for immediate rewards.

A cortex-based assay of impulsive choice was developed using 1105 healthy adults from the Human Connectome Project, and then cross-validated in two independent samples of adults with elevated rates of psychiatric disorders.

Study 1: Cortical delay discounting (C-DD) was developed using a multivariate additive model of gray matter thickness across both hemispheres. Higher C-DD corresponded to thinner cortex and greater impulsive choice for immediate rewards. It also predicted cannabis use beyond established risk factors for drug use, including familial substance use, childhood conduct problems, personality traits, and cognitive functioning. Study 2: C-DD replicated the association with delay discounting performance from study 1. Structural equation modeling showed C-DD covaried with symptoms of externalizing, but not internalizing disorders. Study 3: C-DD positively predicted future delay discounting behavior (6–34 months later).

Across three studies, a cortical assay of impulsive choice evidenced consistent associations with drug use and delay discounting task performance. It was also uniquely associated with psychiatric disorders that share impulsivity as a core feature. Together, findings support the utility of C-DD as a neurobiological assay of impulsive decision-making and a possible biomarker of externalizing disorders.

那些倾向于冲动地选择较小、较早的奖励而不是较大、较晚的奖励的人，上瘾和精神疾病的风险会增加。对高估即时满足倾向的神经生物学测量可以促进对易患这些精神障碍的个体的研究。这项研究的目的是开发一种针对即时奖励的冲动选择的皮层分析方法。

使用人类连接组项目的 1105 名健康成年人开发了一种基于皮层的冲动选择测定法，然后在精神疾病发病率较高的两个独立成年人样本中进行交叉验证。

研究 1 ：皮质延迟贴现 (C-DD) 是使用两个半球灰质厚度的多元加性模型开发的。更高的 C-DD 对应于更薄的皮层和更大的立即奖励的冲动选择。它还预测大麻的使用超出了既定的吸毒风险因素，包括家庭药物使用、儿童行为问题、人格特征和认知功能。研究 2： C-DD 复制了研究 1 中与延迟贴现绩效的关联。结构方程模型显示，C-DD 与外化障碍症状共变，但与内化障碍症状无关。研究 3： C-DD 积极预测未来的延迟贴现行为（6-34 个月后）。

在三项研究中，冲动选择的皮质分析证明了与药物使用和延迟折扣任务表现之间存在一致的关联。它还与以冲动为核心特征的精神疾病有着独特的联系。总之，研究结果支持 C-DD 作为冲动决策的神经生物学测定和外化障碍的可能生物标志物的实用性。