Problem gamblers exhibit reward hypersensitivity in medial frontal cortex during gambling

Oberg, Scott; Christie, Gregory J.; Tata, Matthew S.

doi:10.1016/j.neuropsychologia.2011.09.037

Cited by 87 publications

(74 citation statements)

References 30 publications

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“…This observation bears relevance in the context of the recent debate questioning whether or not pathological gamblers have a hypo-active reward system (Leyton and Vezina, 2012). Whereas some studies have reported blunted brain responses to monetary rewards in pathological gamblers (Balodis et al, 2012;de Ruiter et al, 2009;Reuter et al, 2005), others have reported normal to exaggerated responses (Hewig et al, 2010;Oberg et al, 2011;Sescousse et al, 2013). Importantly, we employed an ecologically valid slot machine task with relatively high amounts of money that were delivered for real, raising confidence that our observations do not reflect a lack of behavioral relevance as has been suggested for previous studies Vezina, 2012, 2013).…”

Section: Discussionmentioning

confidence: 76%

Amplified Striatal Responses to Near-Miss Outcomes in Pathological Gamblers

Sescousse

Janssen

Hashemi

et al. 2016

Neuropsychopharmacol

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Near-misses in gambling games are losing events that come close to a win. Near-misses were previously shown to recruit reward-related brain regions including the ventral striatum, and to invigorate gambling behavior, supposedly by fostering an illusion of control. Given that pathological gamblers are particularly vulnerable to such cognitive illusions, their persistent gambling behavior might result from an amplified striatal sensitivity to near-misses. In addition, animal studies have shown that behavioral responses to near-miss-like events are sensitive to dopamine, but this dopaminergic influence has not been tested in humans. To investigate these hypotheses, we recruited 22 pathological gamblers and 22 healthy controls who played a slot machine task delivering wins, near-misses and full-misses, inside an fMRI scanner. Each participant played the task twice, once under placebo and once under a dopamine D2 receptor antagonist (sulpiride 400 mg), in a doubleblind, counter-balanced design. Participants were asked about their motivation to continue gambling throughout the task. Across all participants, near-misses elicited higher motivation to continue gambling and increased striatal responses compared with full-misses. Crucially, pathological gamblers showed amplified striatal responses to near-misses compared with controls. These group differences were not observed following win outcomes. In contrast to our hypothesis, sulpiride did not induce any reliable modulation of brain responses to near-misses. Together, our results demonstrate that pathological gamblers have amplified brain responses to near-misses, which likely contribute to their persistent gambling behavior. However, there is no evidence that these responses are influenced by dopamine. These results have implications for treatment and gambling regulation. INTRODUCTIONPathological gambling is a behavioral addiction with dramatic consequences including bankruptcy, unemployment, and relationship problems. The prevalence among college students has risen sharply in the past 10 years (Nowak and Aloe, 2014), while the rate of attempted suicide, approaching 20%, is higher than for any other addictive disorder (Bischof et al, 2015). Central to pathological gambling is the loss of control over gambling behavior and the inability to stop playing. This compulsive behavior is postulated to be fueled by cognitive distortions regarding the game structure. One example is the misappraisal of nearmiss events-losing outcomes that come close to a winwhich invigorate ongoing gambling behavior, conceivably by fostering an illusion of control (Clark, 2010). Although the behavioral vulnerability of pathological gamblers to such cognitive distortions is well established (Michalczuk et al, 2011), the underlying neural and neurochemical mechanisms remain elusive. We aimed to address this question using a combination of fMRI and pharmacological manipulation.Near-miss events are a hallmark of many gambling games and are particularly frequent in slot machines, which are recogniz...

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Section: Discussionmentioning

confidence: 76%

Amplified Striatal Responses to Near-Miss Outcomes in Pathological Gamblers

Sescousse

Janssen

Hashemi

et al. 2016

Neuropsychopharmacol

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“…Within the autonomic realm, research has examined electrodermal and cardiac data in real club settings when patrons bet with their own money (e.g., Coventry and Constable, 1999;Diskin and Hodgins, 2003;Griffiths, 1993;Krueger et al, 2005;Meyer et al, 2000). In a similar context, the implications of ERP findings for problem gambling have been alluded to in most laboratory studies, although we found no more than two studies that compared ERPs in response to reward and punishment sensitivity between problem and non-problem gamblers (Hewig et al, 2010;Oberg et al, 2011). The application of such information in the applied domain is clearly warranted and an urgent priority, although ethical and technical issues (e.g., challenges of recording reliable ERPs in a live-gambling environment) remain major challenges.…”

Section: Limitations and Future Directionsmentioning

confidence: 91%

“…For example, problem gamblers may be hyposensitive to non-reward/punishment (e.g., Reuter et al, 2005) and thus, the repeated detrimental losses experienced are not perceived to be averse; they may be hypersensitive to reward (e.g., Hewig et al, 2010;Oberg et al, 2011) and pursue wins at the expense of high costs; or they may be hyposensitive to reward (e.g., Blum et al, 2000) and engage in thrill-seeking behaviour (such as trying to obtain large wins) in order to reach the same level of excitement associated with smaller wins in non-problem gamblers.…”

Section: Introductionmentioning

confidence: 99%

Can event-related potentials serve as neural markers for wins, losses, and near-wins in a gambling task? A principal components analysis

Lole

Gonsalvez

Barry

et al. 2013

International Journal of Psychophysiology

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Originally, the feedback related negativity (FRN) event-related potential (ERP) component was considered to be a robust neural correlate of non-reward/punishment processing, with greater negative deflections observed following unfavourable outcomes. More recently, it has been suggested that this component is better conceptualised as a positive deflection following rewarding outcomes. The current study sought to elucidate the nature of the FRN, as well as another component associated with incentive-value processing, the P3b, through application of a spatiotemporal principal components analysis (PCA). Seventeen healthy controls played a computer electronic gaming machine (EGM) task and received feedback on credits won or lost on each trial, and ERPs were recorded. The distribution of reward/non-reward outcomes closely matched that of a real EGM, with frequent losses, and infrequent wins and near-wins. The PCA revealed that feedback elicited both a frontally maximal negative deflection to losses, and a positive deflection to wins (which was also sensitive to reward magnitude), implying that the neural generator/s of the FRN are differentially activated following these outcomes. As expected, greater P3b amplitudes were found for wins compared to losses. Interestingly, near-wins elicited significantly smaller FRN amplitudes than losses (with no differences in P3b amplitude), and may contribute to the maintenance of gambling behaviours on EGMs. The results of the current study are integrated into a response profile of healthy controls to outcomes of varying incentive value. This may provide a foundation for the future examination of individuals who exhibit abnormalities in reward/ punishment processing, such as problem gamblers. The PCA revealed that feedback elicited both a frontally maximal negative deflection to losses, and a positive deflection to wins (which was also sensitive to reward magnitude), implying that the neural generator/s of the FRN are differentially activated following these outcomes. As expected, greater P3b amplitudes were found for wins compared to losses.Interestingly, near-wins elicited significantly smaller FRN amplitudes than losses (with no differences in P3b amplitude), and may contribute to the maintenance of gambling behaviours on EGMs. The results of the current study are integrated into a response profile of healthy controls to outcomes of varying incentive value. This may provide a foundation for the future examination of individuals who exhibit abnormalities in reward/punishment processing, such as problem gamblers.

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“…If the total score for the block was less than 100, no remuneration was given. Our previous work indicates this threshold to be a reliable discriminant of non-random choice and is used to incentivize subjects to solve the task [28]. Scores were reset to 0 at the end of each block.…”

Section: Gambling Taskmentioning

confidence: 99%