Frontal lobe dysfunction in pathological gambling patients
Frontal lobe dysfunction in pathological gambling patients
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DOI：
10.1016/s0006-3223(01)01227-6
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发表时间：
2002-02-15
影响因子：
10.6
通讯作者：
Bellodi, L
中科院分区：
文献类型：
--
作者：
Cavedini, P;Riboldi, G;Bellodi, L
背景资料：关于病理性赌博（PG）诊断的有效性以及这种疾病的病因和不同治疗策略的有效性的数据有限;然而，PG患者和腹内侧前额叶皮层损伤患者在决策行为上的相似性表明，这些区域可能在这种疾病的病理生理学中有意义，如强迫症，其中决策障碍与对5-羟色胺再摄取抑制剂治疗的反应显著相关。然而，一些研究表明，在功能性神经影像学研究中显示腹内侧前额叶皮质异常的药物成瘾患者的决策功能也受损。方法：我们使用模拟现实生活决策的赌博任务，评估了20名PG患者和40名健康对照（HC）受试者的腹内侧前额叶皮层介导的决策功能，测试的能力，以平衡即时奖励对长期的负面consequence.Results：显着差异，发现在赌博任务的表现HC科目和PG患者，谁表现出特定的决策配置文件在整个序列的游戏。这种差异似乎并不取决于PG组的基本认知功能缺陷。结论：这些数据似乎表明PG和其他疾病之间存在联系（即，强迫症和药物成瘾），所有这些都具有评估未来后果的能力减弱，这至少可以部分地由眶额皮质的异常功能来解释。(C)2002生物精神病学学会。
Background: Limited data are available about the validity of the diagnosis of pathological gambling (PG) and about the etiology and the efficacy of different treatment strategies of this disorder; however, similarities in decision-making behavior between PG patients and patients with ventromedial prefrontal cortex lesions suggest a possible implication of these areas in the pathophysiology of this disorder, as in obsessive-compulsive disorder, in which the decision-making impairment is significantly associated with response to serotonin reuptake inhibitor treatment. Nevertheless, several studies have shown that decision-making functioning is also impaired in drug-addicted patients who have shown abnormalities in ventromedial prefrontal cortex during functional neuroimaging studies.Methods: We assessed the decision-making function mediated by, the ventromedial prefrontal cortex in 20 PG patients and 40 healthy control (HC) subjects using the Gambling Task, which simulates real-life decision-making, testing the ability to balance immediate rewards against long-term negative consequence.Results: Significant differences were found in Gambling Task performance between HC subjects and PG patients, who showed a specific decision-making profile across the sequence of the game. The dissimilarity does not appear to depend on the basic cognitive function deficit of the PG group.Conclusions: These data seem to suggest the existence of a link between PG and other disorders (i.e., obsessive-compulsive disorder and drug addiction) all having diminished ability to evaluate future consequences, which may be explained at least in part by an abnormal functioning of the orbitofrontal cortex. (C) 2002 Society of Biological Psychiatry.