Koehler Saskia, Ovadia-Caro Smadar, van der Meer Elke, Villringer Arno, Heinz Andreas, Romanczuk-Seiferth Nina, Margulies Daniel S
Berlin School of Mind and Brain and the Mind-Brain Institute, Humboldt-Universität zu Berlin, Berlin, Germany ; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany ; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany ; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
Berlin School of Mind and Brain and the Mind-Brain Institute, Humboldt-Universität zu Berlin, Berlin, Germany ; Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany ; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
PLoS One. 2013 Dec 19;8(12):e84565. doi: 10.1371/journal.pone.0084565. eCollection 2013.
Pathological gambling (PG) shares clinical characteristics with substance-use disorders and is thus discussed as a behavioral addiction. Recent neuroimaging studies on PG report functional changes in prefrontal structures and the mesolimbic reward system. While an imbalance between these structures has been related to addictive behavior, whether their dysfunction in PG is reflected in the interaction between them remains unclear. We addressed this question using functional connectivity resting-state fMRI in male subjects with PG and controls. Seed-based functional connectivity was computed using two regions-of-interest, based on the results of a previous voxel-based morphometry study, located in the prefrontal cortex and the mesolimbic reward system (right middle frontal gyrus and right ventral striatum). PG patients demonstrated increased connectivity from the right middle frontal gyrus to the right striatum as compared to controls, which was also positively correlated with nonplanning aspect of impulsiveness, smoking and craving scores in the PG group. Moreover, PG patients demonstrated decreased connectivity from the right middle frontal gyrus to other prefrontal areas as compared to controls. The right ventral striatum demonstrated increased connectivity to the right superior and middle frontal gyrus and left cerebellum in PG patients as compared to controls. The increased connectivity to the cerebellum was positively correlated with smoking in the PG group. Our results provide further evidence for alterations in functional connectivity in PG with increased connectivity between prefrontal regions and the reward system, similar to connectivity changes reported in substance use disorder.
病理性赌博（PG）与物质使用障碍具有共同的临床特征，因此被视为一种行为成瘾。最近关于PG的神经影像学研究报告了前额叶结构和中脑边缘奖赏系统的功能变化。虽然这些结构之间的失衡与成瘾行为有关，但它们在PG中的功能障碍是否反映在它们之间的相互作用中仍不清楚。我们使用静息态功能磁共振成像（fMRI）的功能连接性来研究患有PG的男性受试者和对照组，以解决这个问题。基于之前一项基于体素的形态学研究结果，使用位于前额叶皮层和中脑边缘奖赏系统（右侧额中回和右侧腹侧纹状体）的两个感兴趣区域来计算基于种子的功能连接性。与对照组相比，PG患者从右侧额中回到右侧纹状体的连接性增加，这也与PG组冲动性的非计划性方面、吸烟和渴望评分呈正相关。此外，与对照组相比，PG患者从右侧额中回到其他前额叶区域的连接性降低。与对照组相比，PG患者右侧腹侧纹状体与右侧额上回、额中回和左侧小脑的连接性增加。与小脑连接性的增加与PG组的吸烟呈正相关。我们的结果为PG中功能连接性的改变提供了进一步的证据，即前额叶区域与奖赏系统之间的连接性增加，这与物质使用障碍中报道的连接性变化相似。
