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Stanković M, Bjekić J, Filipović SR. Effects of Transcranial Electrical Stimulation on Gambling and Gaming: A Systematic Review of Studies on Healthy Controls, Participants with Gambling/Gaming Disorder, and Substance Use Disorder. J Clin Med 2023; 12:jcm12103407. [PMID: 37240512 DOI: 10.3390/jcm12103407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023] Open
Abstract
Gambling disorder (GD) and internet gaming disorder (IGD) are formally recognized behavioral addictions with a rapidly growing prevalence and limited treatment options. Recently, transcranial electrical stimulation (tES) techniques have emerged as potentially promising interventions for improving treatment outcomes by ameliorating cognitive functions implicated in addictive behaviors. To systematize the current state of evidence and better understand whether and how tES can influence gambling and gaming-related cognitive processes, we conducted a PRISMA-guided systematic review of the literature, focusing on tES effects on gaming and gambling in a diverse range of population samples, including healthy participants, participants with GD and IGD, as well as participants with substance abuse addictions. Following the literature search in three bibliographic databases (PubMed, Web of Science, and Scopus), 40 publications were included in this review, with 26 conducted on healthy participants, 6 focusing on GD and IGD patients, and 8 including participants with other addictions. Most of the studies targeted the dorsolateral prefrontal cortex, using transcranial direct current stimulation (tDCS), and assessed the effects on cognition, using gaming and gambling computerized cognitive tasks measuring risk taking and decision making, e.g., balloon analogue risk task, Iowa gambling task, Cambridge gambling task, etc. The results indicated that tES could change gambling and gaming task performances and positively influence GD and IGD symptoms, with 70% of studies showing neuromodulatory effects. However, the results varied considerably depending on the stimulation parameters, sample characteristics, as well as outcome measures used. We discuss the sources of this variability and provide further directions for the use of tES in the context of GD and IGD treatment.
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Affiliation(s)
- Marija Stanković
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
| | - Jovana Bjekić
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
| | - Saša R Filipović
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
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Lin HM, Chang YT, Chen MH, Liu ST, Chen BS, Li L, Lee CY, Sue YR, Sung TM, Sun CK, Yeh PY. Structural and Functional Neural Correlates in Individuals with Excessive Smartphone Use: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16277. [PMID: 36498362 PMCID: PMC9739413 DOI: 10.3390/ijerph192316277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Background: Despite known association of internet addiction with a reduced brain volume and abnormal connectivity, the impact of excessive smartphone use remains unclear. Methods: PubMed, Embase, ClinicalTrial.gov, and Web of Science databases were systematically searched from inception to July 2022 using appropriate keywords for observational studies comparing differences in brain volumes and activations between excessive smartphone users and individuals with regular use by magnetic resonance imaging. Results: Of the 11 eligible studies retrieved from 6993 articles initially screened, seven and six evaluated brain volumes and activations, respectively. The former enrolled 421 participants (165 excessive smartphone users vs. 256 controls), while the latter recruited 276 subjects with 139 excessive smartphone users. The results demonstrated a smaller brain volume in excessive smartphone users compared to the controls (g = −0.55, p < 0.001), especially in subcortical regions (p < 0.001). Besides, the impact was more pronounced in adolescents than in adults (p < 0.001). Regression analysis revealed a significant positive association between impulsivity and volume reduction. Regarding altered activations, the convergences of foci in the declive of the posterior lobe of cerebellum, the lingual gyrus, and the middle frontal gyrus were noted. Conclusions: Our findings demonstrated a potential association of excessive smartphone use with a reduced brain volume and altered activations.
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Affiliation(s)
- Hsiu-Man Lin
- Division of Child and Adolescent Psychiatry & Division of Developmental and Behavioral Pediatrics, China Medical University Children’s Hospital, Taichung 404327, Taiwan
| | - Yu-Tzu Chang
- School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung 406040, Taiwan
- Division of Pediatric Neurology, China Medical University Children’s Hospital, Taichung 404327, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
- College of Medicine, Chang Gung University, Kaohsiung 83300, Taiwan
| | - Shu-Tsen Liu
- Division of Child and Adolescent Psychiatry & Division of Developmental and Behavioral Pediatrics, China Medical University Children’s Hospital, Taichung 404327, Taiwan
| | - Bo-Shen Chen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Lin Li
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Chiao-Yu Lee
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Yu-Ru Sue
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Tsai-Mei Sung
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824005, Taiwan
- School of Medicine for International Students, I-Shou University, Kaohsiung 82445, Taiwan
| | - Pin-Yang Yeh
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Clinical Psychology Center, Asia University Hospital, Taichung 41354, Taiwan
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Peng W, Hao Q, Gao H, Wang Y, Wang J, Tu Y, Yu S, Li H, Zhu T. Functional Neural Alterations in Pathological Internet Use: A Meta-Analysis of Neuroimaging Studies. Front Neurol 2022; 13:841514. [PMID: 35518207 PMCID: PMC9062178 DOI: 10.3389/fneur.2022.841514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/28/2022] [Indexed: 11/24/2022] Open
Abstract
Previous resting-state functional MRI (fMRI) studies found spontaneous neural activity in the brains of Pathological Internet Use (PIU) subjects. However, the findings were inconsistent in studies using different neuroimaging analyses. This meta-analytic study aimed to identify a common pattern of altered brain activity from different studies. Resting-state fMRI studies, based on whole-brain analysis methods published before July 1, 2021, were searched in multiple databases (PubMed, EMBASE, MEDLINE, and Web of Science). A voxel-based signed differential mapping (SDM) method was used to clarify brain regions, which showed anomalous activity in PIU subjects compared with healthy controls (HCs). Ten eligible publications consisting of 306 PIU subjects and 314 HCs were included in the SDM meta-analysis. Compared with HCs, subjects with PIU showed increased spontaneous neural functional activity in the left temporal pole of the superior temporal cortex, left amygdala, bilateral median cingulate cortex, and right insula. Meanwhile, a decreased spontaneous neural activity was identified in the left dorsolateral superior frontal gyrus and right middle frontal gyrus in the subjects with PIU. These abnormal brain regions are associated with cognitive executive control and emotional regulation. The consistent changes under different functional brain imaging indicators found in our study may provide important targets for the future diagnosis and intervention of PIU. Systematic Review Registration:www.crd.york.ac.uk/PROSPERO, identifier: CRD42021258119.
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Affiliation(s)
- Wei Peng
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qinghong Hao
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Heng Gao
- Medical Quality Control Department, Chengdu Seventh People's Hospital, Chengdu, China
| | - Yang Wang
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, China
| | - Jun Wang
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Tu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Siyi Yu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hui Li
- School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Tianmin Zhu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Quaglieri A, Mari E, Boccia M, Piccardi L, Guariglia C, Giannini AM. Brain Network Underlying Executive Functions in Gambling and Alcohol Use Disorders: An Activation Likelihood Estimation Meta-Analysis of fMRI Studies. Brain Sci 2020; 10:E353. [PMID: 32517334 PMCID: PMC7348890 DOI: 10.3390/brainsci10060353] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neuroimaging and neuropsychological studies have suggested that common features characterize both Gambling Disorder (GD) and Alcohol Use Disorder (AUD), but these conditions have rarely been compared. METHODS We provide evidence for the similarities and differences between GD and AUD in neural correlates of executive functions by performing an activation likelihood estimation meta-analysis of 34 functional magnetic resonance imaging studies involving executive function processes in individuals diagnosed with GD and AUD and healthy controls (HC). RESULTS GD showed greater bilateral clusters of activation compared with HC, mainly located in the head and body of the caudate, right middle frontal gyrus, right putamen, and hypothalamus. Differently, AUD showed enhanced activation compared with HC in the right lentiform nucleus, right middle frontal gyrus, and the precuneus; it also showed clusters of deactivation in the bilateral middle frontal gyrus, left middle cingulate cortex, and inferior portion of the left putamen. CONCLUSIONS Going beyond the limitations of a single study approach, these findings provide evidence, for the first time, that both disorders are associated with specific neural alterations in the neural network for executive functions.
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Affiliation(s)
- Alessandro Quaglieri
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
| | - Emanuela Mari
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
| | - Maddalena Boccia
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Laura Piccardi
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Anna Maria Giannini
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy; (E.M.); (M.B.); (L.P.); (C.G.); (A.M.G.)
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Ruiz de Lara CM, Perales JC. Psychobiology of gambling-related cognitions in gambling disorder. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Altered brain functional networks in Internet gaming disorder: independent component and graph theoretical analysis under a probability discounting task. CNS Spectr 2019; 24:544-556. [PMID: 30968814 DOI: 10.1017/s1092852918001505] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Internet gaming disorder (IGD) is becoming a matter of concern around the world. However, the neural mechanism underlying IGD remains unclear. The purpose of this paper is to explore the differences between the neuronal network of IGD participants and that of recreational Internet game users (RGU). METHODS Imaging and behavioral data were collected from 18 IGD participants and 20 RGU under a probability discounting task. The independent component analysis (ICA) and graph theoretical analysis (GTA) were used to analyze the data. RESULTS Behavioral results showed the IGD participants, compared to RGU, prefer risky options to the fixed ones and spent less time in making risky decisions. In imaging results, the ICA analysis revealed that the IGD participants showed stronger functional connectivity (FC) in reward circuits and executive control network, as well as lower FC in anterior salience network (ASN) than RGU; for the GTA results, the IGD participants showed impaired FC in reward circuits and ASN when compared with RGU. CONCLUSIONS These results suggest that IGD participants were more sensitive to rewards, and they were more impulsive in decision-making as they could not control their impulsivity effectively. This might explain why IGD participants cannot stop their gaming behaviors even when facing severe negative consequences.
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Zheng H, Hu Y, Wang Z, Wang M, Du X, Dong G. Meta-analyses of the functional neural alterations in subjects with Internet gaming disorder: Similarities and differences across different paradigms. Prog Neuropsychopharmacol Biol Psychiatry 2019; 94:109656. [PMID: 31145927 DOI: 10.1016/j.pnpbp.2019.109656] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/18/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
Abstract
Internet gaming disorder (IGD) has become a global public health concern due to its increasing prevalence and potential negative consequences. Researchers have sought to identify which brain regions are associated with this disorder. However, inconsistent results have been reported among studies due to the heterogeneity of paradigms and subjects. The present research aimed to combine the results of individual studies to provide a more coherent and powerful explanation. By selecting 40 studies utilizing a qualified whole-brain analysis, we performed a comprehensive series of meta-analyses that employed seed-based d mapping. We divided the existing experimental paradigms into 3 categories: game-related cue-reactivity, executive control, and risk-reward-related decision-making tasks. We divided all studies into three subgroups according to their paradigms. In cue-reactivity tasks, patients with IGD exhibited significant hyperactivation in the bilateral precuneus and bilateral cingulate and significant hypoactivation in the insula, but there were no differences in the striatum. In executive control tasks, patients with IGD displayed significant hyperactivation in the right superior temporal gyrus, bilateral precuneus, bilateral cingulate, and insula and hypoactivation in the left inferior frontal gyrus. In risky decision-making paradigms, IGD patients exhibited significant hyperactivation in the left striatum, right inferior frontal gyrus, and insula and hypoactivation in the left superior frontal gyrus, left inferior frontal gyrus, and right precentral gyrus. Our study aimed to discover the similarities among all studies and to explore the uniqueness of the different paradigms. This study further confirmed the critical role of reward circuitry and executive control circuitry in IGD but not under all conditions.
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Affiliation(s)
- Hui Zheng
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, Zhejiang Province 311121, PR China; Shanghai Key Laboratory of Psychotic disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, PR China
| | - Yanbo Hu
- Department of Psychology, London Metropolitan University, London N7 8DB, UK
| | - Ziliang Wang
- School of Psychology, Beijing Normal University, Beijing 10010, PR China
| | - Min Wang
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, Zhejiang Province 311121, PR China
| | - Xiaoxia Du
- Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, PR China
| | - Guangheng Dong
- Center for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, Zhejiang Province 311121, PR China; Zhejiang Key Laboratory for Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, PR China.
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Resting-state fMRI in Parkinson's disease patients with cognitive impairment: A meta-analysis. Parkinsonism Relat Disord 2019; 62:16-27. [DOI: 10.1016/j.parkreldis.2018.12.016] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 10/29/2018] [Accepted: 12/15/2018] [Indexed: 12/14/2022]
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Spagnolo PA, Gómez Pérez LJ, Terraneo A, Gallimberti L, Bonci A. Neural correlates of cue‐ and stress‐induced craving in gambling disorders: implications for transcranial magnetic stimulation interventions. Eur J Neurosci 2019; 50:2370-2383. [DOI: 10.1111/ejn.14313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 09/28/2018] [Accepted: 11/26/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Primavera A. Spagnolo
- Human Motor Control Section National Institute on Neurological Disorders and Stroke National Institutes of Health 10 Center Drive Room I3471:10CRC Bethesda MD 20892‐9412 USA
| | - Luis J. Gómez Pérez
- Novella Fronda Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine Padua Italy
| | - Alberto Terraneo
- Novella Fronda Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine Padua Italy
| | - Luigi Gallimberti
- Novella Fronda Foundation for Studies and Applied Clinical Research in the Field of Addiction Medicine Padua Italy
| | - Antonello Bonci
- Intramural Research Program National Institute on Drug Abuse US National Institutes of Health Baltimore MD USA
- Solomon H. Snyder Department of Neuroscience Johns Hopkins University School of Medicine Baltimore MD USA
- Department of Psychiatry Johns Hopkins University School of Medicine Baltimore MD USA
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Um M, Whitt ZT, Revilla R, Hunton T, Cyders MA. Shared Neural Correlates Underlying Addictive Disorders and Negative Urgency. Brain Sci 2019; 9:E36. [PMID: 30744033 PMCID: PMC6406305 DOI: 10.3390/brainsci9020036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/06/2019] [Indexed: 12/15/2022] Open
Abstract
Negative urgency is a personality trait reflecting the tendency to act rashly in response to extreme negative emotions and is considered a transdiagnostic endophenotype for problematic levels of addictive behaviors. Recent research has begun to identify the neural correlates of negative urgency, many of which appear to overlap with neural circuitry underlying addictive disorders associated with negative urgency. The goal of this qualitative review is to summarize the extant literature concerning the neural correlates of negative urgency, to compare these correlates with those implicated with addictive disorders, and to propose new ways to begin to leverage such findings in treatment and intervention approaches. We also address current limitations in the field and make recommendations for areas for future growth in this research domain. Patterns of structure and function in the ventral striatum, frontal regions, such as the prefrontal cortex (PFC) and orbitofrontal cortex (OFC), and amygdala are common across addictive disorders and are related to both real-world risky behaviors and self-report measures of negative urgency. We propose that the time has come to move past considering this trait and these disorders as completely separate entities, and instead for the field to consider how general patterns of convergence across these disorders can lead to a more transdiagnostic approach to treatment and intervention. We suggest future work utilize these convergent patterns in the development of animal models of negative urgency, in the identification and testing of prime pharmacological and physiological interventions, and as objective biomarkers to be used when testing behavioral, pharmacological, and physiological intervention effectiveness. Little empirical work has been done to date in these areas and advances in these nascent fields would advance understanding and applications of the neuroscience of negative urgency.
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Affiliation(s)
- Miji Um
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Zachary T Whitt
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Rebecca Revilla
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Taylor Hunton
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
| | - Melissa A Cyders
- Department of Psychology, Indiana University⁻Purdue University Indianapolis, Indianapolis, IN, 46202, USA.
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Quintero Garzola GC. Review: brain neurobiology of gambling disorder based on rodent models. Neuropsychiatr Dis Treat 2019; 15:1751-1770. [PMID: 31308669 PMCID: PMC6612953 DOI: 10.2147/ndt.s192746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/16/2019] [Indexed: 11/23/2022] Open
Abstract
Different literature reviews of gambling disorder (GD) neurobiology have been focused on human studies, others have focused on rodents, and others combined human and rodent studies. The main question of this review was: which are the main neurotransmitters systems and brain structures relevant for GD based on recent rodent studies? This work aims to review the experimental findings regarding the rodent´s neurobiology of GD. A search in the Pub Med database was set (October 2012-October 2017) and 162 references were obtained. After screening, 121 references were excluded, and only 41 references remained from the initial output. More, other 25 references were added to complement (introduction section, neuroanatomical descriptions) the principal part of the work. At the end, a total of 66 references remained for the review. The main conclusions are: 1) according to studies that used noninvasive methods for drug administration, some of the neurotransmitters and receptors involved in behaviors related to GD are: muscarinic, N-methyl-D-aspartate (NMDA), cannabinoid receptor 1 (CB1), cannabinoid receptor 2 (CB2), dopamine 2 receptor (D2), dopamine 3 receptor (D3), and dopamine 4 receptor (D4); 2) moreover, there are other neurotransmitters and receptors involved in GD based on studies that use invasive methods of drug administration (eg, brain microinjection); example of these are: serotonin 1A receptor (5-HT1A), noradrenaline receptors, gamma-aminobutyric acid receptor A (GABAA), and gamma-aminobutyric acid receptor B (GABAB); 3) different brain structures are relevant to behaviors linked to GD, like: amygdala (including basolateral amygdala (BLA)), anterior cingulate cortex (ACC), hippocampus, infralimbic area, insular cortex (anterior and rostral agranular), nucleus accumbens (NAc), olfactory tubercle (island of Calleja), orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), prefrontal cortex (PFC) - subcortical network, striatum (ventral) and the subthalamic nucleus (STN); and 4) the search for GD treatments should consider this diversity of receptor/neurotransmitter systems and brain areas.
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Victorri-Vigneau C, Spiers A, Caillet P, Bruneau M, Ignace-Consortium, Challet-Bouju G, Grall-Bronnec M. Opioid Antagonists for Pharmacological Treatment of Gambling Disorder: Are they Relevant? Curr Neuropharmacol 2018; 16:1418-1432. [PMID: 28721822 PMCID: PMC6295935 DOI: 10.2174/1570159x15666170718144058] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/05/2017] [Accepted: 07/12/2017] [Indexed: 12/21/2022] Open
Abstract
Background: To date, no drugs have been approved for gambling disorder. Numerous publications have described the value of opioid antagonists. Indeed, the mesocorticolimbic dopaminergic pathway has been suggested as the underlying cause of reward-seeking behaviour, and it is modulated by the opioid system. Objective: This study aims to evaluate the relevance of opioid antagonists for treating GD. Method: A systematic literature review was conducted. A search of the PubMed electronic database, PsycINFO and the Cochrane Systematic Review Database without any limits was performed. Results: There is little information concerning the effects of opioid antagonists on GD. The total search with “nalmefene and gambling” without any limits revealed only 11 articles. The search with “naltrexone and gambling” without any limits gener-ated 47 articles. Nevertheless, the best available data support the use of opioid antagonists, particularly in individuals with a history of alcohol use disorder or strong gambling urges. Conclusion: Future trials are still needed. Indeed, opioid antagonists effectiveness has been investigated in only a limited number of patients, clinical trials do not reflect the heterogeneity of GD and there is little knowledge of the predictive factors of response to treatments. Moreover, differential affinity to nalmefene for kappa receptors may be associated with a particular effect in a yet to be defined addiction phenotype. Head to head comparisons between naltrexone and nalmefene would be helpful in combining other medication or psychotherapy. The identification of subgroups of patients that are more likely to benefit from opioid antagonists should be a goal
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Affiliation(s)
- Caroline Victorri-Vigneau
- Pharmacology Department, Nantes University Hospital, Nantes, France.,INSERM UMR1246 SPHERE Methods in Patients-centered outcomes and Health Research, University of Nantes and Tours, Nantes, France
| | - Andrew Spiers
- Pharmacology Department, Nantes University Hospital, Nantes, France
| | - Pascal Caillet
- Pharmacology Department, Nantes University Hospital, Nantes, France
| | - Mélanie Bruneau
- Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Ignace-Consortium
- Service de Pharmacologie Clinique, Institut de Biologie, 9 quai moncousu, 44093 Nantes cedex, France
| | - Gaëlle Challet-Bouju
- INSERM UMR1246 SPHERE Methods in Patients-centered outcomes and Health Research, University of Nantes and Tours, Nantes, France.,Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Marie Grall-Bronnec
- INSERM UMR1246 SPHERE Methods in Patients-centered outcomes and Health Research, University of Nantes and Tours, Nantes, France.,Addictology and Psychiatry Department, Nantes University Hospital, Nantes, France
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Chen X, Chen Z, Dong Z, Liu M, Yu S. Morphometric changes over the whole brain in caffeine-containing combination-analgesic-overuse headache. Mol Pain 2018; 14:1744806918778641. [PMID: 29877133 PMCID: PMC5992799 DOI: 10.1177/1744806918778641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective To investigate brain morphometric changes in medication-overuse headache with excessive intake of caffeine-containing combination analgesics. Materials and methods We recruited 32 medication-overuse headache patients overusing caffeine-containing combination analgesics and 26 normal controls with matched sex and age. Magnetic resonance T1-weighted images were processed by automatic volume algorithm of brain regions over the whole brain according to the neuromorphometrics template. We explored the volume differences between groups and correlation with clinical variables. Results Medication-overuse headache patients demonstrated decreased volume in cerebellum, optic chiasm, and increased volume in right lateral orbital gyrus, left calcarine, bilateral middle occipital gyrus, right superior parietal lobe, and right temporal transverse gyrus compared with normal controls. The increased volume was primarily contributed by patients of lower headache frequency (10–20 days/month) and with no psychological comorbidities. In regression analyses, the volume of bilateral middle occipital gyrus had negative association with migraine duration, and the volume of right lateral orbital gyrus and right superior parietal lobe was negatively correlated with number of medications per month. Conclusions Volume changes of brain regions involved in affective and cognitive processing, visual and auditory perception, and pain sensory/discrimination suggested a particular role of those regions in the pathogenesis of medication-overuse headache overusing caffeine-containing combination analgesics. Morphometric changes in multiple visual processing areas and volume gain in lower headache frequency and less anxiety and depression may be specific features related to overusing caffeine-containing combination analgesics.
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Affiliation(s)
- Xiaoyan Chen
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhiye Chen
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China.,2 Department of Radiology, Chinese PLA General Hospital, Beijing, China.,3 Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Hainan, China
| | - Zhao Dong
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Mengqi Liu
- 2 Department of Radiology, Chinese PLA General Hospital, Beijing, China.,3 Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Hainan, China
| | - Shengyuan Yu
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
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Starcke K, Antons S, Trotzke P, Brand M. Cue-reactivity in behavioral addictions: A meta-analysis and methodological considerations. J Behav Addict 2018; 7:227-238. [PMID: 29788752 PMCID: PMC6174580 DOI: 10.1556/2006.7.2018.39] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and aims Recent research has applied cue-reactivity paradigms to behavioral addictions. The aim of the current meta-analysis is to systematically analyze the effects of learning-based cue-reactivity in behavioral addictions. Methods The current meta-analysis includes 18 studies (29 data sets, 510 participants) that have used a cue-reactivity paradigm in persons with gambling (eight studies), gaming (nine studies), or buying (one study) disorders. We compared subjective, peripheral physiological, electroencephal, and neural responses toward addiction-relevant cues in patients versus control participants and toward addiction-relevant cues versus control cues in patients. Results Persons with behavioral addictions showed higher cue-reactivity toward addiction-relevant cues compared with control participants: subjective cue-reactivity (d = 0.84, p = .01) and peripheral physiological and electroencephal measures of cue-reactivity (d = 0.61, p < .01). Increased neural activation was found in the caudate nucleus, inferior frontal gyrus, median cingulate cortex, subgenual cingulate, and precentral gyrus. Persons with gambling, gaming, or buying disorders also showed higher cue-reactivity toward addiction-relevant cues compared with control cues: subjective cue-reactivity (d = 0.39, p = .11) and peripheral physiological and electroencephal measures of cue-reactivity (d = 0.47, p = .05). Increased neural activation was found in the caudate nucleus, inferior frontal gyrus, angular gyrus, inferior network, and precuneus. Discussion and conclusions Cue-reactivity not only exists in substance-use disorders but also in gambling, gaming, and buying disorders. Future research should differentiate between cue-reactivity in addictive behaviors and cue-reactivity in functional excessive behaviors such as passions, hobbies, or professions.
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Affiliation(s)
- Katrin Starcke
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Stephanie Antons
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Patrick Trotzke
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Matthias Brand
- Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany,Corresponding author: Matthias Brand; Department of General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, Duisburg 47057, Germany; Phone: +49 203 3792541; Fax: +49 203 3791846; E-mail:
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15
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Dong G, Li H, Wang Y, Potenza MN. Individual differences in self-reported reward-approach tendencies relate to resting-state and reward-task-based fMRI measures. Int J Psychophysiol 2018; 128:31-39. [DOI: 10.1016/j.ijpsycho.2018.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 01/27/2018] [Accepted: 03/20/2018] [Indexed: 11/27/2022]
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16
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Personality biomarkers of pathological gambling: A machine learning study. J Neurosci Methods 2018; 294:7-14. [DOI: 10.1016/j.jneumeth.2017.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/02/2017] [Accepted: 10/24/2017] [Indexed: 02/02/2023]
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17
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Yakovenko I, Hodgins DC. A scoping review of co-morbidity in individuals with disordered gambling. INTERNATIONAL GAMBLING STUDIES 2017. [DOI: 10.1080/14459795.2017.1364400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Igor Yakovenko
- School of Public Health, University of Alberta, Edmonton, Canada
| | - David C. Hodgins
- School of Public Health, University of Alberta, Edmonton, Canada
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Boffo M, Willemen R, Pronk T, Wiers RW, Dom G. Effectiveness of two web-based cognitive bias modification interventions targeting approach and attentional bias in gambling problems: study protocol for a pilot randomised controlled trial. Trials 2017; 18:452. [PMID: 28974265 PMCID: PMC5627491 DOI: 10.1186/s13063-017-2190-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 09/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Disordered gamblers have phenotypical and pathological similarities to those with substance use disorders (SUD), including exaggerated automatic cognitive processing of motivationally salient gambling cues in the environment (i.e., attentional and approach bias). Cognitive bias modification (CBM) is a family of computerised interventions that have proved effective in successfully re-training these automatic cognitive biases in SUD. CBM interventions can, in principle, be administered online, thus showing potential of being a low-cost, low-threshold addition to conventional treatments. This paper presents the design of a pilot randomised controlled trial exploring the effectiveness of two web-based CBM interventions targeting attentional and approach bias towards gambling cues in a sample of Dutch and Belgian problematic and pathological gamblers. METHODS/DESIGN Participants (N = 182) are community-recruited adults experiencing gambling problems, who have gambled at least twice in the past 6 months and are motivated to change their gambling behaviour. After a baseline assessment session, participants are randomly assigned to one of four experimental conditions (attentional or approach bias training, or the placebo version of the two trainings) and complete six sessions of training. At baseline and before each training session, participants receive automated personalised feedback on their gambling motives and reasons to quit or reduce gambling. The post-intervention, 1-month, and 3-month follow-up assessments will examine changes in gambling behaviour, with frequency and expenditure as primary outcomes, and depressive symptoms and gambling-related attentional and approach biases as secondary outcomes. Secondary analyses will explore possible moderators (interference control capacity and trait impulsivity) and mediators (change in cognitive bias) of training effects on the primary outcomes. DISCUSSION This study is the first to explore the effectiveness of an online CBM intervention for gambling problems. The results of this study can be extremely valuable for developing e-health interventions for gambling problems and further understanding the role of motivational implicit cognitive processes underlying problematic gambling behaviour. TRIAL REGISTRATION Netherlands Trial Register, NTR5096 . Registered on 11 March 2015.
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Affiliation(s)
- Marilisa Boffo
- Addiction Development and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands. .,Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Wilrijk, Belgium. .,Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
| | - Ronny Willemen
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Wilrijk, Belgium.,Centre for Alcohol and other Substance Problems (CAD Limburg), Hasselt, Belgium
| | - Thomas Pronk
- Addiction Development and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Wilrijk, Belgium
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Trotzke P, Brand M, Starcke K. Cue-Reactivity, Craving, and Decision Making in Buying Disorder: a Review of the Current Knowledge and Future Directions. CURRENT ADDICTION REPORTS 2017. [DOI: 10.1007/s40429-017-0155-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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20
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Fauth-Bühler M, Mann K, Potenza MN. Pathological gambling: a review of the neurobiological evidence relevant for its classification as an addictive disorder. Addict Biol 2017; 22:885-897. [PMID: 26935000 DOI: 10.1111/adb.12378] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/09/2015] [Accepted: 01/26/2016] [Indexed: 01/13/2023]
Abstract
In light of the upcoming eleventh edition of the International Classification of Diseases (ICD-11), the question arises as to the most appropriate classification of 'Pathological Gambling' ('PG'). Some academic opinion favors leaving PG in the 'Impulse Control Disorder' ('ICD') category, as in ICD-10, whereas others argue that new data especially from the neurobiological area favor allocating it to the category of 'Substance-related and Addictive Disorders' ('SADs'), following the decision in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders. The current review examines important findings in relation to PG, with the aim of enabling a well-informed decision to be made with respect to the classification of PG as a SAD or ICD in ICD-11. Particular attention is given to cognitive deficits and underlying neurobiological mechanisms that play a role in SADs and ICDs. These processes are impulsivity, compulsivity, reward/punishment processing and decision-making. In summary, the strongest arguments for subsuming PG under a larger SAD category relate to the existence of similar diagnostic characteristics; the high co-morbidity rates between the disorders; their common core features including reward-related aspects (positive reinforcement: behaviors are pleasurable at the beginning which is not the case for ICDs); the findings that the same brain structures are involved in PG and SADs, including the ventral striatum. Research on compulsivity suggests a relationship with PG and SAD, particularly in later stages of the disorders. Although research is limited for ICDs, current data do not support continuing to classify PG as an ICD.
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Affiliation(s)
- Mira Fauth-Bühler
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Marc N. Potenza
- Departments of Psychiatry, Neurobiology and Child Study Center and CASAColumbia; Yale University School of Medicine; New Haven CT USA
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Wang Y, Wu L, Zhou H, Lin X, Zhang Y, Du X, Dong G. Impaired executive control and reward circuit in Internet gaming addicts under a delay discounting task: independent component analysis. Eur Arch Psychiatry Clin Neurosci 2017; 267:245-255. [PMID: 27506757 DOI: 10.1007/s00406-016-0721-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/01/2016] [Indexed: 12/28/2022]
Abstract
This study utilized independent component analysis to explore the abnormal functional connectivity (FC) in male participants with Internet gaming disorder (IGD). Functional magnetic resonance imaging and behavioral data were collected from 21 healthy controls (HC) and 18 IGD patients when they were performing a delay discounting task. Behavioral results revealed that the IGD patients showed higher delay discounting rates than HC. Two networks were found to be associated with IGD: (1) the executive control network containing the anterior cingulate cortex and the medial and superior frontal gyrus, and (2) the basal ganglia network containing the lentiform nucleus. Comparing to HC, IGD exhibited stronger FC when selecting small and now options. In addition, the delay discounting rates were positively correlated with the modulation of the two networks and the reaction time. The results suggested that the IGD patients have enhanced sensitivity to reward and decreased ability to control their impulsivity effectively, which leads to myopic decision making.
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Affiliation(s)
- Yifan Wang
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Lingdan Wu
- Department of Psychology, University of Konstanz, Constance, Germany
| | - Hongli Zhou
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Xiao Lin
- Peking-Tsinghua Center for Life Science, Peking University, Beijing, People's Republic of China
| | - Yifen Zhang
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China
| | - Xiaoxia Du
- Department of Physics, Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, People's Republic of China
| | - Guangheng Dong
- Department of Psychology, Zhejiang Normal University, 688 Yingbin Road, Jinhua, 321004, Zhejiang Province, People's Republic of China.
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Fauth-Bühler M, Mann K. Neurobiological correlates of internet gaming disorder: Similarities to pathological gambling. Addict Behav 2017; 64:349-356. [PMID: 26621112 DOI: 10.1016/j.addbeh.2015.11.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/15/2015] [Accepted: 11/18/2015] [Indexed: 01/12/2023]
Abstract
The number of massively multiplayer online games (MMOs) is on the rise worldwide along with the fascination that they inspire. Problems occur when the use of MMOs becomes excessive at the expense of other life domains. Although not yet formally included as disorder in common diagnostic systems, internet gaming disorder (IGD) is considered a "condition for further study" in section III of the DSM-5. The current review aims to provide an overview of cognitive and neurobiological data currently available on IGD, with a particular focus on impulsivity, compulsivity, and sensitivity to reward and punishment. Additionally, we also compare these findings on IGD with data from studies on pathological gambling (PG)-so far the only condition officially classified as a behavioral addiction in the DSM-5. Multiple similarities have been observed in the neurobiology of IGD and PG, as measured by alterations in brain function and behavior. Both patients with IGD and those with PG exhibited decreased loss sensitivity; enhanced reactivity to gaming and gambling cues, respectively; enhanced impulsive choice behavior; aberrant reward-based learning; and no changes in cognitive flexibility. In conclusion, the evidence base on the neurobiology of gaming and gambling disorders is beginning to illuminate the similarities between the two. However, as only a few studies have addressed the neurobiological basis of IGD, and some of these studies suffer from significant limitations, more research is required before IGD's inclusion as a second behavioral addiction in the next versions of the ICD and DSM can be justified.
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Affiliation(s)
- M Fauth-Bühler
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
| | - K Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
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23
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Lai TH, Chou KH, Fuh JL, Lee PL, Kung YC, Lin CP, Wang SJ. Gray matter changes related to medication overuse in patients with chronic migraine. Cephalalgia 2016; 36:1324-1333. [DOI: 10.1177/0333102416630593] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 12/23/2015] [Accepted: 01/10/2016] [Indexed: 01/03/2023]
Abstract
Objective The objective of this article is to investigate the neurological substrates associated with medication overuse (MO) in patients with chronic migraine (CM). Methods We recruited age- and sex-matched CM patients with MO (CMwMO), CM patients without MO (CMwoMO), and healthy controls (HCs). Magnetic resonance T1-weighted images were processed by voxel-based morphometry, and the findings were correlated with clinical variables and treatment responses. Results A total of 66 patients with CM (half with MO) and 33 HCs completed the study. Patients with CMwMO compared to the patients with CMwoMO showed gray matter volume (GMV) decrease in the orbitofrontal cortex and left middle occipital gyrus as well as GMV increase in the left temporal pole/parahippocampus. The GMV changes explained 31.1% variance of the analgesics use frequency. The patients who responded to treatment had greater GMV in the orbitofrontal cortex ( p = 0.028). Patients with CM (with and without MO), compared with HCs, had decreased GMV at multiple brain areas including the frontal, temporal and occipital lobes, precuneus and cerebellum. Conclusions Our study showed GMV changes in CMwMO patients compared to the CMwoMO patients. These three cerebral regions accounted for significant variance in analgesics use frequency. Moreover, the GMV of the orbitofrontal cortex was predictive of the response to MO treatments.
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Affiliation(s)
- Tzu-Hsien Lai
- Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taiwan
- Institute of Neuroscience, National Yang-Ming University, Taiwan
- Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan
- Section of Neurology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taiwan
| | - Kung-Hsien Chou
- Brain Research Center, National Yang-Ming University, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan
- Department of Neurology, Neurological Institute, Taipei-Veterans General Hospital, Taiwan
| | - Pei-Lin Lee
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Yi-Chia Kung
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang-Ming University, Taiwan
- Brain Research Center, National Yang-Ming University, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan
- Brain Research Center, National Yang-Ming University, Taiwan
- Department of Neurology, Neurological Institute, Taipei-Veterans General Hospital, Taiwan
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24
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Chamberlain SR, Lochner C, Stein DJ, Goudriaan AE, van Holst RJ, Zohar J, Grant JE. Behavioural addiction-A rising tide? Eur Neuropsychopharmacol 2016; 26:841-55. [PMID: 26585600 DOI: 10.1016/j.euroneuro.2015.08.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/17/2015] [Accepted: 08/15/2015] [Indexed: 01/21/2023]
Abstract
The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust (CPFT), UK.
| | - Christine Lochner
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Dan J Stein
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Anna E Goudriaan
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, The Netherlands and Arkin Mental Health, Amsterdam, The Netherlands
| | - Ruth Janke van Holst
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, The Netherlands and Arkin Mental Health, Amsterdam, The Netherlands
| | - Joseph Zohar
- Division of Psychiatry, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
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Piquet-Pessôa M, Fontenelle LF. Opioid antagonists in broadly defined behavioral addictions: a narrative review. Expert Opin Pharmacother 2016; 17:835-44. [PMID: 26798982 DOI: 10.1517/14656566.2016.1145660] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Naltrexone (NTX), a mu-opioid receptor antagonist, has been approved for the treatment of alcoholism and opioid dependence. More recently, however, NTX and a related drug, nalmefene (NMF), have also shown positive results for the treatment of gambling disorders. AREAS COVERED In this study, we reviewed the trials testing the effect of opioid antagonists (OA) in gambling disorders and in other broadly defined behavioral addictions, including selected DSM-5 disruptive, impulse-control, and conduct disorders, obsessive-compulsive and related disorders, eating disorders, and other conditions not currently recognized by official classification schemes. We found six randomized controlled trials (RCTs) of OA in gambling disorder, two RCTs of OA in trichotillomania (hair pulling disorder), two RCTs of OA in binge eating disorder, and one RCT of OA for kleptomania. We also reviewed case reports on hypersexual disorder, compulsive buying and skin picking disorders. EXPERT OPINION The reviewed data supported the use of OA, namely NTX and NMF, in gambling disorder (both) and kleptomania (NTX). We did not find enough evidence to support the use of NTX or NMF in trichotillomania (hair pulling disorder), excoriation (skin-picking) disorder, compulsive buying disorder, hypersexual disorder, or binge eating disorder.
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Affiliation(s)
- Marcelo Piquet-Pessôa
- a Obsessive, Compulsive, and Anxiety Spectrum Disorders Research Program, Institute of Psychiatry , Federal University of Rio de Janeiro (UFRJ) , Rio de Janeiro , Brasil
| | - Leonardo F Fontenelle
- a Obsessive, Compulsive, and Anxiety Spectrum Disorders Research Program, Institute of Psychiatry , Federal University of Rio de Janeiro (UFRJ) , Rio de Janeiro , Brasil.,b D'Or Institute for Research and Education (IDOR) , Rio de Janeiro , Brasil.,c Monash Institute of Cognitive and Clinical Neurosciences (MICCN), School of Psychological Sciences & Monash Biomedical Imaging (MBI) Facility , Monash University , Victoria , Australia
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27
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Banz BC, Yip SW, Yau YHC, Potenza MN. Behavioral addictions in addiction medicine: from mechanisms to practical considerations. PROGRESS IN BRAIN RESEARCH 2015; 223:311-28. [PMID: 26806783 DOI: 10.1016/bs.pbr.2015.08.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Recent progress has been made in our understanding of nonsubstance or "behavioral" addictions, although these conditions and their most appropriate classification remain debated and the knowledge basis for understanding the pathophysiology of and treatments for these conditions includes important gaps. Recent developments include the classification of gambling disorder as a "Substance-Related and Addictive Disorder" in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and proposed diagnostic criteria for Internet Gaming Disorder in Section 3 of DSM-5. This chapter reviews current neuroscientific understandings of behavioral addictions and the potential of neurobiological data to assist in the development of improved policy, prevention, and treatment efforts.
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Affiliation(s)
- Barbara C Banz
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yvonne H C Yau
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Montreal Neurological Institute, 3801 Rue University, Montréal, QC, Canada
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neurobiology, Child Study Center, and CASA Columbia, Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, Yale University School of Medicine, New Haven, CT, USA.
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