Meng Ya-jing, Deng Wei, Wang Hui-yao, Guo Wan-jun, Li Tao, Lam Chaw, Lin Xia
Mental Health Center, West China Hospital, Sichuan University, PR China; State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
Mental Health Center, West China Hospital, Sichuan University, PR China.
Behav Brain Res. 2014 Dec 15;275:243-51. doi: 10.1016/j.bbr.2014.08.057. Epub 2014 Sep 6.
Recent emerging functional magnetic resonance imaging (fMRI) studies have identified many brain regions in which gambling cues or rewards elicit activation and may shed light upon the ongoing disputes regarding the diagnostic and neuroscientific issues of gambling disorder (GD). However, no studies to date have systemically reviewed fMRI studies of GD to analyze the brain areas activated by gambling-related cues and examine whether these areas were differentially activated between cases and healthy controls (HC). This study reviewed 62 candidate articles and ultimately selected 13 qualified voxel-wise whole brain analysis studies to perform a comprehensive series of meta-analyses using the effect size-signed differential mapping approach. Compared with HC, GD patients showed significant activation in right lentiform nucleus and left middle occipital gyrus. The increased activities in the lentiform nucleus compared to HC were also found in both GD subgroups, regardless of excluding or not excluding any kind of substance use disorder. In addition, the South Oaks Gambling Screen scores were associated with hyperactivity in right lentiform nucleus and bilateral parahippocampus, but negatively related to right middle frontal gyrus. These results suggest dysfunction within the frontostriatal cortical pathway in GD, which could contribute to our understanding of the categories and definition of GD and provide evidence for the reclassification of GD as a behavioral addiction in the DSM-5.
近期新兴的功能磁共振成像（fMRI）研究已经确定了许多脑区，在这些脑区中，赌博线索或奖励会引发激活，这可能有助于阐明目前关于赌博障碍（GD）的诊断和神经科学问题的争议。然而，迄今为止，尚无研究系统回顾GD的fMRI研究，以分析由赌博相关线索激活的脑区，并检查这些区域在病例组和健康对照（HC）之间是否存在差异激活。本研究回顾了62篇候选文章，最终选择了13项合格的基于体素的全脑分析研究，采用效应大小符号差异映射方法进行了一系列全面的荟萃分析。与HC相比，GD患者在右侧豆状核和左侧枕中回显示出显著激活。在两个GD亚组中，无论是否排除任何类型的物质使用障碍，与HC相比，豆状核的活动均增加。此外，南橡树赌博筛查分数与右侧豆状核和双侧海马旁回的多动有关，但与右侧额中回呈负相关。这些结果表明GD患者额纹状体皮质通路存在功能障碍，这有助于我们理解GD的类别和定义，并为将GD重新分类为《精神疾病诊断与统计手册》第5版中的行为成瘾提供证据。
