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. 2014 Sep 9:5:1013.
doi: 10.3389/fpsyg.2014.01013. eCollection 2014.

Insular activation during reward anticipation reflects duration of illness in abstinent pathological gamblers

Kosuke Tsurumi  1 , Ryosaku Kawada  1 , Naoto Yokoyama  1 , Genichi Sugihara  1 , Nobukatsu Sawamoto  2 , Toshihiko Aso  3 , Hidenao Fukuyama  3 , Toshiya Murai  1 , Hidehiko Takahashi  1
Affiliations

Insular activation during reward anticipation reflects duration of illness in abstinent pathological gamblers

Kosuke Tsurumi et al. Front Psychol. .

Abstract

Pathological gambling (PG) is a chronic mental disorder characterized by a difficulty restraining gambling behavior despite negative consequences. Although brain abnormalities in patients with substance use disorders are caused by repetitive drug use and recover partly with drug abstinence, the relationship between brain activity and duration of illness or abstinence of gambling behavior in PG patients remains unclear. Here, using functional magnetic resonance imaging, we compared the brain activity of 23 PG patients recruited from a treatment facility with 27 demographically-matched healthy control subjects during reward anticipation, and examined the correlations between brain activity and duration of illness or abstinence in PG patients. During reward anticipation, PG patients showed decreased activity compared to healthy controls in a broad range of the reward system regions, including the insula cortex. In PG patients, activation in the left insula showed a significant negative correlation with illness duration. Our findings suggest that insular activation during reward anticipation may serve as a marker of progression of pathological gambling.

Keywords: addiction; fMRI; insula; neuroimaging; pathological gambling; reward.

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Figures

Figure 1
Figure 1
Activation patterns of each subject group during reward anticipation. The activation patterns of PG and HC groups during reward anticipation are shown in the left and right panels, respectively (p < 0.001, uncorrected). PG patients showed reduced activation compared to HC subjects. Abbreviations: PG, pathological gambling; HC, healthy control.
Figure 2
Figure 2
Differences in activation during reward anticipation in the insula between groups. Pathological gambling patients showed blunted activation compared to healthy controls (masked by insular region of interest; p < 0.05, small volume corrected).
Figure 3
Figure 3
Scatter plots and regression slopes of activation in left insula and duration of illness (A) or abstinence (B) in pathological gambling patients.
See this image and copyright information in PMC

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