Abstract
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.
Keywords
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Article info
Publication history
Accepted:
June 21,
2001
Received in revised form:
April 5,
2001
Received in revised form:
June 15,
2001
Received:
January 9,
2001
Identification
Copyright
© 2002 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
