Department of Communication and Psychology, Aalborg University, Rendsburggade 14, 9000 Aalborg, Denmark; Center of Functionally Integrative Neuroscience/MINDLab, Danish Neuroscience Center, Aarhus University Hospital, Nørrebrogade 44, Building 1A, 8000 Aarhus C, Denmark; Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Indgang J, Plan 2, J220, 8200 Aarhus N, Denmark; Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, United Kingdom.
Center of Functionally Integrative Neuroscience/MINDLab, Danish Neuroscience Center, Aarhus University Hospital, Nørrebrogade 44, Building 1A, 8000 Aarhus C, Denmark; Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Indgang J, Plan 2, J220, 8200 Aarhus N, Denmark.
Brain Res. 2021 Aug 1;1764:147479. doi: 10.1016/j.brainres.2021.147479. Epub 2021 Apr 17.
Disorders of substance and behavioral addiction are believed to be associated with a myopic bias towards the incentive salience of addiction-related cues away from general rewards in the environment. In non-treatment seeking gambling disorder patients, neural activity to anticipation of monetary rewards is enhanced relative to erotic rewards. Here we focus on the balance between anticipation of reward types in active treatment gamblers relative to healthy volunteers.
Fifty-three (25 gambling disorder males, 28 age-matched male healthy volunteers) were scanned with fMRI performing a Monetary Incentive Delay task with monetary and erotic outcomes.
During reward anticipation, gambling disorder was associated with greater left orbitofrontal cortex and ventral striatal activity to erotic relative to monetary reward anticipation compared to healthy volunteers. Lower impulsivity correlated with greater activity in the dorsal striatum and dorsal anterior cingulate cortex to erotic anticipation in gambling disorder subjects. In the outcome phase, gambling disorder subjects showed greater activity in the ventral striatum, ventromedial and dorsolateral prefrontal cortex and anterior cingulate cortex to both reward types relative to healthy volunteers.
These findings contrast directly with previous findings in non-treatment seeking gambling disorder. Our observations highlight the role of treatment state in active treatment gambling disorder, emphasizing a potential influence of treatment status, gambling abstinence or cognitive behavioral therapy on increasing the salience of general rewards beyond that of gambling-related cues. These findings support a potential therapeutic role for targeting the salience of non-gambling related rewards and potential biomarkers for treatment efficacy.
物质和行为成瘾障碍被认为与对成瘾相关线索的激励显著性的近视偏差有关，而对环境中的一般奖励则忽视。在未经治疗的赌博障碍患者中，对金钱奖励的预期的神经活动相对于性奖励增强。在这里，我们关注的是积极治疗的赌徒与健康志愿者之间对奖励类型的预期之间的平衡。
53 名（25 名男性赌博障碍患者，28 名年龄匹配的男性健康志愿者）在 fMRI 扫描下进行了一项带有金钱和性奖励的金钱激励延迟任务。
在奖励预期期间，赌博障碍患者与健康志愿者相比，对性奖励的左眶额皮层和腹侧纹状体的活动更大，而对金钱奖励的预期则更小。冲动性越低，与赌博障碍患者对性奖励的预期相关的背侧纹状体和背侧前扣带皮层的活动就越大。在结果阶段，赌博障碍患者在腹侧纹状体、腹内侧和背外侧前额叶皮层以及前扣带皮层对两种奖励类型的活动都大于健康志愿者。
这些发现与未经治疗的赌博障碍患者的先前发现直接形成对比。我们的观察结果强调了治疗状态在积极治疗的赌博障碍中的作用，强调了治疗状态、赌博戒断或认知行为治疗对增加一般奖励的显著性的潜在影响，超过了与赌博相关的线索。这些发现支持了针对非赌博相关奖励的显著性和潜在治疗效果的生物标志物的治疗作用。
