White matter integrity between left basal ganglia and left prefrontal cortex is compromised in gambling disorder.
Pathological gambling (PG) is a behavioral addiction characterized by an inability to stop gambling despite the negative consequences, which may be mediated by cognitive flexibility deficits. Indeed, impaired cognitive flexibility has previously been linked to PG and also to reduced integrity of white matter connections between the basal ganglia and the prefrontal cortex. It remains unclear, however, how white matter integrity problems relate to cognitive inflexibility seen in PG. We used a cognitive switch paradigm during functional magnetic resonance imaging in pathological gamblers (PGs; n = 26) and healthy controls (HCs; n = 26). Cognitive flexibility performance was measured behaviorally by accuracy and reaction time on the switch task, while brain activity was measured in terms of blood oxygen level-dependent responses. We also used diffusion tensor imaging on a subset of data (PGs = 21; HCs = 21) in combination with tract-based spatial statistics and probabilistic fiber tracking to assess white matter integrity between the basal ganglia and the dorsolateral prefrontal cortex. Although there were no significant group differences in either task performance, related neural activity or tract-based spatial statistics, PGs did show decreased white matter integrity between the left basal ganglia and prefrontal cortex. Our results complement and expand similar findings from a previous study in alcohol-dependent patients. Although we found no association between white matter integrity and task performance here, decreased white matter connections may contribute to a diminished ability to recruit prefrontal networks needed for regulating behavior in PG. Hence, our findings could resonate an underlying risk factor for PG, and we speculate that these findings may extend to addiction in general.
Department of Psychiatry, Academic Medical Center, Amsterdam Brain and Cognition Center, University of Amsterdam, The Netherlands.
Tim
T
van Timmeren
Department of Psychiatry, Academic Medical Center, Amsterdam Brain and Cognition Center, University of Amsterdam, The Netherlands.|Institute for Criminal Law and Criminology, Leiden University, The Netherlands.
Jochem M
JM
Jansen
Department of Radiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Matthan W A
MWA
Caan
Department of Psychiatry, Academic Medical Center, Amsterdam Brain and Cognition Center, University of Amsterdam, The Netherlands.|Arkin Institute of Mental Health, The Netherlands.
Anna E
AE
Goudriaan
Department of Psychiatry, Academic Medical Center, Amsterdam Brain and Cognition Center, University of Amsterdam, The Netherlands.|Donders Institute for Cognition, Brain and Behaviour, Radboud University, The Netherlands.|Department of Neurology, Radboud University Medical Center, The Netherlands.
Ruth J
RJ
van Holst
D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000473:pathology*; D016739:Behavior, Addictive / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods; D005715:Gambling / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
Addiction; DTI; behavioral addiction; compulsivity; corticostriatal; disordered gambling; fMRI