Freinhofer Daniel, Schwartenbeck Philipp, Thon Natasha, Eigenberger Tina, Aichhorn Wolfgang, Lenger Melanie, Wurst Friedrich M, Kronbichler Martin
Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
Neuroscience Institute, Christian-Doppler Medical Centre, Paracelsus Medical University Salzburg, Salzburg, Austria.
Front Psychiatry. 2020 Mar 4;11:109. doi: 10.3389/fpsyt.2020.00109. eCollection 2020.
Individuals suffering from pathological gambling (PG) show impaired decision making, but it is still not clear how this impairment is related to other traits and neuroanatomical characteristics. In this study, we investigated how the influence of PG on decision making (1) is connected to different impulsivity facets and (2) how it is related to gray matter volume (GMV) in various brain regions. Twenty-eight diagnosed PG patients and 23 healthy controls completed the cups task to measure decision making. In this task, participants had to decide between safe and risky options, which varied in expected value (EV) between risk advantageous, equal EV, and risk disadvantageous choices. A delay discounting task and the Barrant Impulsiveness Scale were applied to assess multiple impulsivity facets. In addition, structural magnetic resonance images were acquired. In comparison to the control group PG patients demonstrated more deficits in decision making, indicated by less EV sensitivity, but there was no significant difference in number of overall risky choices. Also, PG patients showed increased impulsivity in nearly every dimension. Results revealed (1) a positive correlation between decision making impairments and non-planning impulsivity but no significant relation to other impulsivity facets. Although we found no GMV differences between PG patients and controls, (2) a regions of interest analysis showed a correlation between medial orbitofrontal GMV and EV sensitivity in PG patients. Our findings showed that (1) the association between decision making and impulsivity can also be found in PG patients, but only for certain impulsivity facets. This suggests that it is essential to consider measuring different dimensions, when investigating impulsivity in a PG sample. Secondly, our findings revealed that (2) dysfunctional decision making-particularly the component of risk evaluation-is related to decreased GMV in the medial orbitofrontal cortex, a brain region concerned with processing of rewards. Interestingly, we did not find more risky choices for PG patients, and thus, we assume that decision making deficits in PG are primarily related to risk evaluation, not risk seeking, which is in line with our GMV findings.
患有病态赌博（PG）的个体表现出决策能力受损，但这种损伤与其他特质和神经解剖特征之间的关系仍不清楚。在本研究中，我们调查了PG对决策的影响（1）如何与不同的冲动性方面相关联，以及（2）它如何与各个脑区的灰质体积（GMV）相关。28名被诊断为PG的患者和23名健康对照完成了杯子任务以测量决策。在这个任务中，参与者必须在安全和有风险的选项之间做出决定，这些选项在预期价值（EV）上在风险有利、EV相等和风险不利的选择之间变化。应用延迟折扣任务和巴兰特冲动性量表来评估多个冲动性方面。此外，采集了结构磁共振图像。与对照组相比，PG患者在决策方面表现出更多缺陷，表现为EV敏感性较低，但总体风险选择数量没有显著差异。此外，PG患者在几乎每个维度上都表现出冲动性增加。结果显示（1）决策损伤与非计划性冲动性之间存在正相关，但与其他冲动性方面无显著关系。虽然我们在PG患者和对照组之间未发现GMV差异，但（2）感兴趣区域分析显示PG患者内侧眶额GMV与EV敏感性之间存在相关性。我们的研究结果表明，（1）在PG患者中也可以发现决策与冲动性之间的关联，但仅针对某些冲动性方面。这表明在研究PG样本中的冲动性时，考虑测量不同维度至关重要。其次，我们的研究结果表明，（2）功能失调的决策——特别是风险评估成分——与内侧眶额皮质GMV减少有关，内侧眶额皮质是一个与奖励处理有关的脑区。有趣的是，我们没有发现PG患者有更多的风险选择，因此，我们假设PG中的决策缺陷主要与风险评估有关，而不是风险寻求，这与我们的GMV研究结果一致。
