Altered Brain Activity during Reward Anticipation in Pathological Gambling and Obsessive-Compulsive Disorder

Choi, Jung Seok; Shin, Young June; Jung, Wi Hoon; Jang, Joon Hwan; Kang, Do‐Hyung; Choi, Chi-Hoon; Choi, Sam‐Wook; Lee, Jun-Young; Hwang, Jae Yeon; Kwon, Jun Soo

doi:10.1371/journal.pone.0045938

Cited by 99 publications

(83 citation statements)

References 41 publications

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“…As has been shown in SUD [34,36], activation in the ventral striatum during gain anticipation correlated negatively with impulsivity measures. In line with that, Choi et al [40] reported reduced activation of the ventromedial caudate nucleus both during anticipation of gain and loss in patients with GD. On the other hand, Miedl et al [27] reported an enhanced activity of ventral striatal and posterior cingulate during reward processing as derived from contrasting winning versus losing situations.…”

Section: Neglect Of Other Areas In Lifesupporting

confidence: 77%

From Symptoms to Neurobiology: Pathological Gambling in the Light of the New Classification in DSM-5

2014

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Pathological gambling (PG), as defined until recently in the DSM-IV, shares many clinical characteristics with substance use disorders (SUDs), such as craving and loss of control. Moreover, an increasing body of literature also revealed neurobiological similarities between PG and substance-related addictions. Further, specific treatments for SUD are also effective in pathological gamblers. These observations resulted in a recent change in the diagnostic classification of PG in DSM-5: maladaptive gambling behavior is now subsumed as ‘gambling disorder' (GD) under the category ‘substance-related and addictive disorders'. On the basis of similarities in clinical characteristics between GD and SUDs, this article proposes 3 main clusters of diagnostic criteria: ‘loss of control', ‘craving/withdrawal' and ‘neglect of other areas in life'. These symptom clusters can then be related to the experimental paradigms commonly used in the neuroscience of addiction, including neuropsychological, neurophysiological and neuroimaging studies. In this paper, we present the neurobiological evidence for PG by focusing on key functional magnetic resonance imaging studies related to these 3 symptom clusters. It is concluded that these symptom clusters provide a useful framework for systematic comparisons of new evidence in GD and SUDs in the future.

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Section: Neglect Of Other Areas In Lifesupporting

confidence: 77%

From Symptoms to Neurobiology: Pathological Gambling in the Light of the New Classification in DSM-5

2014

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“…In healthy participants, insula responsivity to near-miss outcomes correlated positively with their trait susceptibility to gambling distortions on a self-report scale (6,38). With a monetary incentive delay task in treatment-seeking pathological gamblers, overactivity of anterior insula during loss anticipation was correlated with gambling severity scores (39). These effects may be mediated by the established role of the insula in the representation of bodily states, i.e., interoception (40).…”

Section: Discussionmentioning

confidence: 99%

Damage to insula abolishes cognitive distortions during simulated gambling

Clark

Studer

Bruss³

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

108

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Gambling is a naturalistic example of risky decision-making. During gambling, players typically display an array of cognitive biases that create a distorted expectancy of winning. This study investigated brain regions underpinning gambling-related cognitive distortions, contrasting patients with focal brain lesions to the ventromedial prefrontal cortex (vmPFC), insula, or amygdala ("target patients") against healthy comparison participants and lesion comparison patients (i.e., with lesions that spare the target regions). A slot machine task was used to deliver near-miss outcomes (i.e., nonwins that fall spatially close to a jackpot), and a roulette game was used to examine the gambler's fallacy (color decisions following outcome runs). Comparison groups displayed a heightened motivation to play following near misses (compared with full misses), and manifested a classic gambler's fallacy effect. Both effects were also observed in patients with vmPFC and amygdala damage, but were absent in patients with insula damage. Our findings indicate that the distorted cognitive processing of near-miss outcomes and event sequences may be ordinarily supported by the recruitment of the insula. Interventions to reduce insula reactivity could show promise in the treatment of disordered gambling.G ambling is a widespread activity with a lifetime prevalence of 78% in the United States (1) and a past-year prevalence of 73% in the United Kingdom (2). The widespread recognition that "the house always wins," reflecting the negative expected value of gambling, makes gambling an enduring puzzle for psychological and economic models of choice behavior. Cognitive approaches to gambling explain this nonnormative behavior with reference to a number of cognitive distortions and irrational beliefs that occur during gambling play, which cause the gambler to overestimate his likelihood of winning (3, 4). The illusion of control refers to how superficial features of a game, such as a choice or instrumental response, promote erroneous perceptions of skill over outcomes that are determined only by chance (5). Near-miss outcomes (nonwins that fall close to the jackpot) increase motivations to play, plausibly by fueling beliefs about skill acquisition (6). The gambler's fallacy is a bias in the processing of randomness, whereby recent consecutive outcomes are considered less likely to repeat, and conversely, outcomes that have not occurred in the recent history are perceived as "due" (7).These distortions are reliably observed in field studies, e.g., casino environments (8), and are not confined to gambling; illusory control and the gambler's fallacy are observed in stock traders (9), and near misses influence decision-making in occupational settings (10). In the laboratory, these distortions can be elicited with gambling games, allowing the comparison of these biases between different clinical groups. The overall level of distorted thinking is elevated in people with gambling problems (11,12), and these cognitions can be targeted effectively in psy...

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“…Studies have found diminished, normal or even increased BOLD responses in disordered gamblers using a variety of fMRI tasks. For example, disordered gamblers showed attenuated ventral striatal responses during reward anticipation as well as in response to monetary wins (Balodis et al 2012;Choi et al 2012). A recent study found no abnormal processing in reward anticipation but higher ventral striatum activity during loss anticipation (Romanczuk-Seiferth et al 2014).…”

Section: Neurobiology Of Disordered Gamblingmentioning

confidence: 99%

Behavioural addiction—A rising tide?

Chamberlain

Löchner

Stein

et al. 2016

European Neuropsychopharmacology

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The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions.

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Altered Brain Activity during Reward Anticipation in Pathological Gambling and Obsessive-Compulsive Disorder

Cited by 99 publications

References 41 publications

From Symptoms to Neurobiology: Pathological Gambling in the Light of the New Classification in DSM-5

From Symptoms to Neurobiology: Pathological Gambling in the Light of the New Classification in DSM-5

Damage to insula abolishes cognitive distortions during simulated gambling

Behavioural addiction—A rising tide?

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