title: Differential cardiovascular and hypothalamic pituitary response to amphetamine in male pathological gamblers versus healthy controls.
abstract: Cardiovascular and hypothalamic pituitary axis (HPA) disturbances have been observed in individuals who are pathological gamblers (PGs). These may partly derive from chronic exposure to gambling. Response to amphetamine (AMPH) may reveal such disturbances while controlling for differential conditioned responses to gambling in PGs vs healthy controls (HCs). This study assessed heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) and plasma cortisol following oral AMPH (0.4 mg/kg) in male PGs (n=12) and HCs (n=11) who underwent a positron emission tomography (PET) scan. The Stop Signal Task enabled assessment of the link between physiological and behavioral dysregulation. Trait moderating effects were explored. The responses of PGs to AMPH differed from those of HCs on every index. PGs displayed persistent elevation in DBP and concomitant reduction in HR (i.e. baroreflex) compared to HCs beyond 90 min post-dose. PGs displayed deficits in cortisol compared to HCs that were partially reversed by AMPH. Impairment on the Stop Signal Task correlated positively with HR in controls, but negatively with HR in PGs, suggesting that strong initial and compensatory cardiac responses to a stimulant may each predict disinhibition. Extraversion predicted greater disinhibition in PGs. Noradrenergic disturbances may contribute to sensitized responses to stimulant challenge and disinhibition in PGs.
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada martin.zack@camh.ca.
authors.forename: Martin
authors.initials: M
authors.lastname: Zack
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Boileau
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Doris
authors.initials: D
authors.lastname: Payer
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Bindiya
authors.initials: B
authors.lastname: Chugani
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Daniela S
authors.initials: DS
authors.lastname: Lobo
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Houle
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Alan A
authors.initials: AA
authors.lastname: Wilson
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Jerry J
authors.initials: JJ
authors.lastname: Warsh
authors.affiliation: Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kish
mesh_terms: D000328:Adult; D000661:Amphetamine / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects*; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D005715:Gambling / Q000097:blood / Q000139:chemically induced*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007031:Hypothalamus / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D010902:Pituitary Gland / Q000187:drug effects*; D049268:Positron-Emission Tomography / Q000379:methods
chemical_list: D000697:Central Nervous System Stimulants; D000661:Amphetamine; D006854:Hydrocortisone
keywords: Amphetamine; cardiovascular; cortisol; pathological gambling