Altered neural correlates of reward and loss processing during simulated slot-machine fMRI in pathological gambling and cocaine dependence

Drug Alcohol Depend. 2014 Dec 1:145:77-86. doi: 10.1016/j.drugalcdep.2014.09.013. Epub 2014 Nov 4.

Abstract

Background: Individuals with gambling or substance-use disorders exhibit similar functional alterations in reward circuitry suggestive of a shared underlying vulnerability in addictive disorders. Additional research into common and unique alterations in reward-processing in substance-related and non-substance-related addictions may identify neural factors that could be targeted in treatment development for these disorders.

Methods: To investigate contextual reward-processing in pathological gambling, a slot-machine fMRI task was performed by three groups (with pathological gambling, cocaine dependence and neither disorder; N = 24 each) to determine the extent to which two groups with addictions (non-substance-related and substance-related) showed similarities and differences with respect to each other and a non-addicted group during anticipatory periods and following the delivery of winning, losing and 'near-miss' outcomes.

Results: Individuals with pathological gambling or cocaine dependence compared to those with neither disorder exhibited exaggerated anticipatory activity in mesolimbic and ventrocortical regions, with pathological-gambling participants displaying greater positive possible-reward anticipation and cocaine-dependent participants displaying more negative certain-loss anticipation. Neither clinical sample exhibited medial frontal or striatal responses that were observed following near-miss outcomes in healthy comparison participants.

Conclusions: Alterations in anticipatory processing may be sensitive to the valence of rewards and content-disorder-specific. Common and unique findings in pathological gambling and cocaine dependence with respect to anticipatory reward and near-miss loss processing suggest shared and unique elements that might be targeted through behavioral or pharmacological interventions in the treatment of addictions.

Keywords: Addiction; Cocaine dependence; Near-miss; Pathological gambling; fMRI.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Behavior, Addictive / diagnosis
  • Behavior, Addictive / metabolism
  • Behavior, Addictive / psychology
  • Cocaine-Related Disorders / diagnosis
  • Cocaine-Related Disorders / metabolism*
  • Cocaine-Related Disorders / psychology
  • Computer Simulation*
  • Corpus Striatum / metabolism*
  • Female
  • Gambling / diagnosis
  • Gambling / metabolism*
  • Gambling / psychology
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Photic Stimulation / methods
  • Reward*
  • Young Adult