Response Perseveration and Ventral Prefrontal Sensitivity to Reward and Punishment in Male Problem Gamblers and Smokers
Response Perseveration and Ventral Prefrontal Sensitivity to Reward and Punishment in Male Problem Gamblers and Smokers
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DOI：
10.1038/npp.2008.175
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发表时间：
2009-03-01
影响因子：
7.6
通讯作者：
van den Brink, Wim
中科院分区：
文献类型：
--
作者：
de Ruiter, Michiel B.;Veltman, Dick J.;van den Brink, Wim
病理性赌博(PG)与适应不良的持久性行为有关，但其潜在机制和神经回路尚不完全清楚。在这里，对PG的假设进行了检验，即PG的特征是反应持久化，以及前额纹状体腹侧回路中奖惩敏感性的异常。执行功能被评估以验证这些影响是否独立于额纹状体背侧环路。一组吸烟者也被包括在内，以检查PG的损害是否概括为物质使用障碍。反应持久度和奖惩敏感度是用概率反转学习任务来测量的，在该任务中，受试者可能赢钱也可能输钱。行政职能是通过一项规划任务--伦敦塔--来衡量的。研究人员收集了19名问题赌徒、19名吸烟者和19名健康对照的绩效和功能磁共振数据。问题赌徒表现出严重的反应持续性，与右腹外侧前额叶皮质对金钱收益和损失的反应减少有关。结果并不完全适用于吸烟者。问题赌徒和吸烟者的计划执行和背侧额纹状体环路的相关激活都是完整的。PG与反应、持久力和奖惩敏感度降低有关，这表现为当金钱获得和损失时，前额叶腹外侧皮层的活动减退。此外，完整的计划能力和正常的背侧额纹状体反应表明，这种缺陷不是由于执行功能受损造成的。反应持之以恒和前额叶腹侧对金钱损失的低反应可能是化学和非化学成瘾中出现的不适应行为的标志。
Pathological gambling ( PG) is associated with maladaptive perseverative behavior, but the underlying mechanism and neural circuitry is not completely clear. Here, the hypothesis was tested that PG is characterized by response perseveration and abnormalities in reward and/or punishment sensitivity in the ventral frontostriatal circuit. Executive functioning was assessed to verify if these effects are independent of the dorsal frontostriatal circuit. A group of smokers was also included to examine whether impairments in PG generalize to substance use disorders. Response perseveration and reward/punishment sensitivity were measured with a probabilistic reversal-learning task, in which subjects could win and lose money. Executive functioning was measured with a planning task, the Tower of London. Performance and fMRI data were acquired in 19 problem gamblers, 19 smokers, and 19 healthy controls. Problem gamblers showed severe response perseveration, associated with reduced activation of right ventrolateral prefrontal cortex in response to both monetary gain and loss. Results did not fully generalize to smokers. Planning performance and related activation of the dorsal frontostriatal circuit were intact in both problem gamblers and smokers. PG is related to response perseveration and diminished reward and punishment sensitivity as indicated by hypoactivation of the ventrolateral prefrontal cortex when money is gained and lost. Moreover, intact planning abilities and normal dorsal frontostriatal responsiveness indicate that this deficit is not due to impaired executive functioning. Response perseveration and ventral prefrontal hyporesponsiveness to monetary loss may be markers for maladaptive behavior seen in chemical and nonchemical addictions.