Brain Imaging in Gambling Disorder

Abstract

Gambling disorder recently was reclassified under the category “substance-related and addictive disorders.” With regard to the diagnostic criteria, it overlaps a great deal with substance use disorder, i.e., loss of control, craving/withdrawal, and neglect of other areas of life. However, the gambling disorder symptom “chasing one’s losses” is the only criterion absent from substance use disorder. Therefore, special forms of reward (i.e., gain/loss) processing, such as the processing of loss avoidance and loss aversion, have just recently attracted attention among gambling disorder researchers. Because gambling disorder might be considered an addiction in its “pure” form, i.e., without the influence of a drug of abuse, investigating brain volume changes in people with this behavioral addiction is an important task for neuroimaging researchers in exploring the neural signatures of addiction. Because the brain is a complex network, investigation of alterations in functional connectivity has gained interest among gambling disorder researchers in order to get a more complete picture of functional brain changes in people with gambling disorder. However, only a few studies on brain structure and functional connectivity in gambling disorder have been performed so far. This review focuses on brain imaging studies of reward and loss processing, with an emphasis on loss avoidance and aversion as well as brain volume and functional connectivity in gambling disorder.

Reduced loss aversion in pathological gambling and alcohol dependence is associated with differential alterations in amygdala and prefrontal functioning

“…However, our study is innovative because we have directly compared an SUD and a behavioral addictive disorder and we have used an extensive set of tools to investigate the neural correlates of reduced LA in PG and AD. Disentangling the psychological from the neurotoxic factors of addiction is one of the great challenges of current neurobehavioral research 73 . Further comparative and transdiagnostical studies like ours are needed to find neurobehavioral markers for etiology research, for better diagnosis and better measurement of treatment success 3 , 74 – 77 .…”

To chase or not to chase: A study on the role of mentalization and alcohol consumption in chasing behavior

“…The extant literature has shown that chasing represents an important step in the development and maintenance of gambling disorder (Breen & Zuckerman, 1999;Goudriaan, Yücel, & van Holst, 2014;Lesieur, 1984; see also Corless & Dickerson, 1989;Sharpe, 2002; for a review, see Nigro, Ciccarelli, & Cosenza, 2018b), and is one of the few observable signs for disordered gambling (Gainsbury, Suhonen, & Saaststamoinen, 2014), and the only criterion of gambling addiction absent in substance use disorder (Quester & Romanczuk-Seiferth, 2015). Prior research found that chasing is associated, among others, with impulsivity (Breen & Zuckerman, 1999), sensation seeking (Linnet, Røjskjaer, Nygaard, & Maher, 2006), increased activation in brain regions related to reward expectation (Campbell-Meiklejohn et al, 2008), low sensitivity to punishment (Kim & Lee, 2011), poor decision-making (Nigro et al, 2018a), disinhibition (Nigro et al, 2018b), alexithymia (Bibby, 2016), and shortened time horizon .…”

Gambling with Rose-Tinted Glasses on: Use of Emotion-Regulation Strategies Correlates with Dysfunctional Cognitions in Gambling Disorder Patients

“…Indeed, the involvement of undersensitivity to losses in potentially problematic gambling behaviors is already well known. Abnormal reaction to losses discriminates between gamblers and other addicted patients ( Torres et al., 2013 ), and some studies have also shown pathological and frequent gamblers to have lower scores in punishment sensitivity as measured by self-reports ( Goudriaan, Oosterlaan, de Beurs, & van den Brink, 2004 ; Navas et al., 2014 ) and an abnormal brain response to monetary losses (see Quester & Romanczuk-Seiferth, 2015 , for a review). Relatedly, loss processing has also been shown to be involved in gambling-related distorted cognitions ( Billieux, Van der Linden, Khazaal, Zullino, & Clark, 2012 ; Michalczuk, Bowden-Jones, Verdejo-Garcia, & Clark, 2011 ; Worhunsky, Malison, Rogers, & Potenza, 2014 ).…”