abusers). The Iowa gambling task is a computerized test in which participants are presented with four decks of cards from which they repeatedly choose. Each deck contains various amounts of rewards of either $50 or $100, and occasional losses that are greater in the decks with higher rewards. The participants do not know where the penalty cards are located, and are told to pick cards that will maximize their winnings. The most profitable strategy turns out to be to choose cards only from the small reward/small penalty decks, because although the reward is smaller, the penalty is proportionally much smaller than in the high reward/high penalty decks. Over the course of a session, most healthy participants come to adopt the profitable low-penalty deck strategy. Participants with brain damage, however, are unable to determine the better deck to choose from, and continue to choose from the high reward/high penalty decks. Since the Iowa gambling task measures participants' quickness in "developing anticipatory emotional responses to guide advantageous choices", it is helpful in testing the somatic marker hypothesis. According to the hypothesis, somatic markers give rise to anticipation of the emotional consequences of a decision being made. Consequently, persons who perform well on the task are thought to be aware of the penalty cards and of the negative emotions associated with drawing such cards, and to realize which deck is less likely to yield a penalty. This experiment has been used to analyze the impairments of people with damage to the ventromedial prefrontal cortex, which has been known to affect neural signaling of prospective rewards or punishments. Such persons perform less well on the task. Functional magnetic resonance imaging (fMRI) has been used to analyze the brain during the Iowa gambling task. The brain regions that were activated during the Iowa gambling task were also the ones hypothesized to be triggered by somatic markers during decision-making. Evolutionary significance Damasio has posited that the ability of humans to perform abstract thinking quickly and efficiently coincides with both the development of the ventromedial (VM) cortex and with the use of somatic markers to guide human behavior during evolution. Patients with damage to the VM cortices are more likely to engage in behaviors that negatively impact personal relationships in the distant future, but they never engage in actions that would lead to immediate harm to themselves or others. The evolution of the prefrontal cortex was associated