Brain Activities Differ in Problem Gamblers

Imaging studies have identified unique brain activity changes in men with pathological gambling when they viewed videotapes about betting on cards or rolling dice at a casino, a Yale study has found.

The study, which is believed to be the first functional magnetic resonance imaging (fMRI) study of pathological gambling, also found that the men with gambling problems showed largely similar brain activity changes as did other men when viewing videos about sad events, such as a divorce or the death of a relative, and happy events, such as a wedding or an unexpected visit by a relative.

"The finding of distinct patterns of neural responses to gambling-related stimuli that are unique from those to other internal emotional states has direct clinical implications and provides a basis for future experimentation in the prevention and treatment of pathological gambling," said Marc Potenza, M.D., psychiatrist at Yale School of Medicine and principal investigator of the study published this month in the Archives of General Psychiatry.

The fMRI study showed that the men with gambling problems had a temporally dynamic pattern of brain activity when viewing gambling videotapes, with changes observed in frontal, paralimbic, and limbic brain structures. When viewing gambling cues, men with pathological gambling demonstrated relatively decreased activity in brain regions implicated in impulse regulation.

Another finding is that the pattern of brain activity changes more closely paralleled those observed in the cocaine cravings of cocaine addicts than the anticipatory urges in persons with OCD. Interestingly, the drugs that are effective in treating OCD also have been shown in some studies to be effective in treating pathological gambling, Potenza said.

Co-authors included Bruce Rounsaville, M.D., Bruce Wexler, M.D., and Mary Wilber, all of the Yale Department of Psychiatry; Pawel Skudlarski, Robert Fulbright, M.D., and Cheryl Lacadie, all of the Department of Diagnostic Radiology; Marvin Steinberg of the Connecticut Council on Problem Gambling, and John Gore of Vanderbilt University School of Medicine.

The study was funded by the National Alliance for Research in Schizophrenia and Depression; the American Psychiatric Association; the National Institute on Drug Abuse; the National Center for Responsible Gaming; the National Institute of Mental Health, and the New England Veterans Administration Mental Illness Research Educational and Clinical Center.