Subjects may apply an implicit strategy to cope with the uncertain game, therefore they favored high-frequency gains over high-frequency losses in the experiment. This "gain-stay, lose-randomize" strategy (Figure 3)  has been observed in human and animal appetitive and avoidance experiments in which human or animal encounter reward or punishment [42–48]. These pioneer behavior studies with the concurrent schedules of reinforcement have displayed the frequency effect for choice pattern [45–49]. Additionally, these concepts have also been applied to examine the behavioral model of neuropsychological deficit [50, 51].
The SGT possessed the variant frequency, magnitude and delay of reinforcement/punishment depending on each subject's choice. Most part of these set-ups may be similar to the consideration of the traditional behavior-analysis studies [45–49, 52], therefore, the gain-loss frequency can successfully serve as a predictor for choice behavior under these uncertain situations.
The effect of gain-loss frequency is not an isolated finding in similar settings. A reexamination of the bad decks (A and B) in the original IGT  indicated that bad deck B (9 gains and 1 loss) was also chosen more frequently than deck A (5 gains and 5 losses). Other studies obtained similar findings but did not explore them further [18–28, 33, 34]. Furthermore, some research groups even showed that normal subjects chose the disadvantageous deck B more frequently than the advantageous deck C or D [18–28]. Dunn et al.  sampled 38 IGT related studies to demonstrate that only five studies [18, 19, 23, 25, 53] utilized the "four-deck format" to display their findings (i.e., the number of card turnings for each deck over a total of 100 trials being shown separately). These studies all demonstrated that deck B was chosen more frequently than deck A. It is worth noting that four out of five studies [18, 19, 23, 25, 53] also demonstrated that deck B was chosen more than deck C or D.
Furthermore, in Peters and Slovic study , the modified IGT study also demonstrated that deck B ($ -250) and D ($ +250) possessed the inversed expected values, but with nearly equal attraction to subjects. This may imply that the expected value does not guide decision makers to approach the beneficial choice in these dynamic games. On the other hand, in the modified IGT, deck C contained high-frequency gain (8 out of 10 trials) over deck D (5 out of 10 trials), but with nearly equal expected value ($ +300 for C vs. $ +250 for D). However, subjects preferred deck C rather than deck D significantly. The gain-loss frequency seems to be more reasonable than EV in explaining these observations. Ahn et al.  confirmed the present finding by comparing the decision learning models for IGT and SGT respectively.
Questionnaire data in this study also indicate a novel phenomenon, namely, the "money account illusion". Subjects ignored the EV dimension and miscounted the money amount in terms of the strength of frequency, specifically, frequently receiving gains will leave an overall impression of large accumulated monetary outcome for a deck than when gains are infrequently received.
In the IGT, normal subjects shifted their choices to good decks during the latter part of the game, such that a learning curve was evident [7–9, 36, 37, 39]. We propose that this shift is not due to better EV but rather an effect resulting from more frequent gains than losses. The Somatic Marker Hypothesis stresses that somatic markers (or peripheral feedback) predispose normal subjects to behave in accordance with perceived future consequences over the long run. This study demonstrated that even subjects with intact somatic markers cannot behave accordingly to a search for EV in the SGT. Immediate reinforcement will override EV in the SGT. Decision makers may have been guided by immediate gain and, as such, their behavioral results are consistent with the prediction of gain-loss frequency. Based on the present observation, three possible interpretations exist for SMH: 1) somatic marker system may guide decision making behavior via rough-estimation processing (gain-loss frequency), not a precise calculation (EV: probability × value); 2) somatic marker system may only contribute to generating subjective feelings (consciousness), and may not be immediately related to decision guidance; 3) the operation of the somatic marker may be involved in gathering the long-term memory, but may not globally direct choice behavior in situations of high uncertainty.
The Somatic Marker Hypothesis also posits that somatic markers guide advantageous behavior in a non-conscious manner. However, questionnaire results suggest further that subjects can have a clear knowledge of gain and loss frequency by the end of the game. This perception eventually determines their choice patterns. A similar finding was obtained by Maia and McClelland , demonstrating a possible "conscious" knowledge of EV in the IGT.
In the SGT, normal subjects were stuck with the influence of gain-loss frequency without shifting to EV throughout the entire session. If normal subjects cannot resist the influence of gain-loss frequency, ventromedial prefrontal patients would have increased vulnerability to the effect of immediate gains and losses. This prediction seems to be in line with disinhibition theory that suggests that socially dysfunctional patients with prefrontal damage have difficulty avoiding a punishment-associated stimulus when that stimulus was previously associated with a reward [13, 15, 16, 56]. If this is true, then both normal subjects and ventromedial prefrontal patients will not be responsive to the long-term dimension.
Supposing this is the case, the facilitative effect of somatic markers did not induce a learning effect or an advantageous shifting behavior in the long run in the SGT, as consistently proposed by IGT researchers. Careful analysis of experimental results obtained in this study identified a subordinate phenomenon in that deck A was chosen more often than deck B, despite both decks possessing the same gain-loss frequency. The immediate value of gain and loss can also alter slightly decision-makers' choices and is worthy of further exploration.
EV and gain-loss frequency were seriously confounded in the administration of the IGT. Selection of good decks by normal subjects cannot only be attributed to the effect of EV, but must also be explained in terms of gain-loss frequency. The Somatic Marker Hypothesis was further reinforced by adopting the principal findings from the IGT experiment as important supporting data, i.e., somatic markers predispose normal subjects to search for EV in the long run. This study explored separately the relative contribution of EV and gain-loss frequency in the SGT, a modified gambling task. Experimental results indicated that immediate reinforcement overrides the effect of EV. Crone et al.  also identified a local preference for gain-loss frequency; however, EV dominated gain-loss frequency in their modified IGT. In contrast to the predictions based on Somatic Marker Hypothesis, experimental data in this study indicate that normal subjects were primarily guided by the effect of gain-loss frequency rather than EV. This finding, although differing from the simple explanation provided by the Somatic Marker Hypothesis, is consistent with the view of behavioral [1–5] and affective [5, 20, 58–62] decision literature, indicating that normal individuals are often short-sighted when making decisions in stock market or real life [41, 63, 64].