title: Interactions between affective and cognitive processing systems in problematic gamblers: a functional connectivity study.
abstract: BACKGROUND
  Motivational and cognitive abnormalities are frequently reported in pathological gambling. However, studies simultaneously investigating motivational and cognitive processing in problematic gamblers are lacking, limiting our understanding of the interplay between these systems in problematic gambling. Studies in non-clinical samples indicate that interactions between dorsal "executive" and ventral "affective" processing systems are necessary for adequate responses in various emotive situations.
  
  
  METHODS
  We conducted a generalized Psycho-Physiological Interaction (gPPI) analysis to assess the influence of affective stimuli on changes in functional connectivity associated with response inhibition in 16 treatment seeking problematic gamblers (PRGs) and 15 healthy controls (HCs) using an affective Go-NoGo fMRI paradigm including neutral, gambling-related, positive and negative pictures as neutral and affective conditions.
  
  
  RESULTS
  Across groups, task performance accuracy during neutral inhibition trials was positively correlated with functional connectivity between the left caudate and the right middle frontal cortex. During inhibition in the gambling condition, only in PRGs accuracy of task performance was positively correlated with functional connectivity within sub-regions of the dorsal executive system. Group interactions showed that during neutral inhibition, HCs exhibited greater functional connectivity between the left caudate and occipital cortex than PRGs. In contrast, during inhibition in the positive condition, PRGs compared to HCs showed greater functional connectivity between the left caudate and occipital cortex. During inhibition trials in the negative condition, a stronger functional connectivity between the left caudate and the right anterior cingulate cortex in PRGs compared to HCs was present. There were no group interactions during inhibition in the gambling condition.
  
  
  CONCLUSIONS
  During gamble inhibition PRGs seem to benefit more from functional connectivity within the dorsal executive system than HCs, because task accuracy in this condition in PRGs is positively correlated with functional connectivity, although the groups show similar connectivity patterns during gamble inhibition. Greater functional connectivity between the ventral affective system and the dorsal executive system in PRGs in the affective conditions compared to HCs, suggests facilitation of the dorsal executive system when affective stimuli are present specifically in PRGs.
authors.affiliation: Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands. ruthvan.holst@gmail.com
authors.forename: Ruth J
authors.initials: RJ
authors.lastname: van Holst
authors.forename: Johan N
authors.initials: JN
authors.lastname: van der Meer
authors.forename: Donald G
authors.initials: DG
authors.lastname: McLaren
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.forename: Anna E
authors.initials: AE
authors.lastname: Goudriaan
mesh_terms: D000328:Adult; D000339:Affect; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D003071:Cognition; D005715:Gambling / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011930:Reaction Time; D055815:Young Adult