Prefrontal cortex activity is reduced in gambling and nongambling substance users during decision-making

Department of Radiology, University of Colorado at Denver and Health Sciences Center, Denver, CO 80262, USA.
Human Brain Mapping (Impact Factor: 5.97). 12/2007; 28(12):1276-86. DOI: 10.1002/hbm.20344
Source: PubMed


Poor decision-making is a hallmark of addiction, whether to substances or activities. Performance on a widely used test of decision-making, the Iowa Gambling Task (IGT), can discriminate controls from persons with ventral medial frontal lesions, substance-dependence, and pathological gambling. Positron emission tomography (PET) studies indicate that substance-dependent individuals show altered prefrontal activity on the task. Here we adapted the IGT to an fMRI setting to test the hypothesis that defects in ventral medial and prefrontal processing are associated with impaired decisions that involve risk but may differ depending on whether substance dependence is comorbid with gambling problems.
18 controls, 14 substance-dependent individuals (SD), and 16 SD with gambling problems (SDPG) underwent fMRI while performing a modified version of the IGT.
Group differences were observed in ventral medial frontal, right frontopolar, and superior frontal cortex during decision-making. Controls showed the greatest activity, followed by SDPG, followed by SD.
Our results support a hypothesis that defects in ventral medial frontal processing lead to impaired decisions that involve risk. Reductions in right prefrontal activity during decision-making appear to be modulated by the presence of gambling problems and may reflect impaired working memory, stimulus reward valuation, or cue reactivity in substance-dependent individuals.

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Available from: Eric Claus, Oct 06, 2015
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    • "Within-group images were thresholded using cluster detection statistics, with a height threshold of z > 2.3 and a cluster probability of P < 0.05, corrected for wholebrain multiple comparisons based on Gaussian random field theory. Between-group images were thresholded using cluster detection statistics, with a height threshold of z > 2.3 and a cluster probability of P < 0.05, using a priori region of interest (ROI) constructed as spheres ranging from 5 to 10 mm and centered based on peak coordinates from previous brain imaging studies on the IGT (Bolla et al. 2003; Tanabe et al. 2007; Christakou et al. 2009; Li et al. 2010; Power et al. 2012). ROIs comprised the DLPFC (10 mm spheres, coordinates: ±40, 28, 30), "
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    Addiction Biology 03/2015; DOI:10.1111/adb.12239 · 5.36 Impact Factor
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    • "Crockford et al., 2005; Potenza et al., 2003b; van Holst et al., 2012a; Goudriaan et al., 2010); risky decision making (e.g. Tanabe et al., 2007); inhibitory control (Potenza et al., 2003a); presentation of non-monetary reward , such as personally relevant stimuli (e.g. de Greck et al., 2010); probability and delay discounting of monetary reward (e.g. Miedl et al., 2012) as well as processing of monetary gains and losses (Miedl et al., 2012; Sescousse et al., 2013; Miedl et al., 2010; Reuter et al., 2005). "
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    • "In each of these tasks, participants are required to choose between " safe " and " risky " monetary gambles. Many studies fail to report performance differences between individuals with substance use disorders and control participants (e.g., Acheson et al., 2009; Adinoff et al., 2003; Bjork et al., 2008; Bolla et al., 2003; Cousijn et al., 2013; Ersche et al., 2005; Tanabe et al., 2007; Vaidya et al., 2012); but see (Bolla et al., 2005; Fein et al., 2004; Fishbein et al., 2005; Lane et al., 2010). These mixed results in risk-taking behavior have been replicated by our own group, which investigated risk-taking behavior in treatment-seeking alcoholic patients compared to controls and found no behavioral differences (e.g., Gilman et al., 2014). "
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