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Right on Cue? Striatal Reactivity in Problem Gamblers

  • Ruth J. van Holst
    Correspondence
    Corresponding author
    Affiliations
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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  • Dick J. Veltman
    Affiliations
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands

    Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
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  • Wim van den Brink
    Affiliations
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
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  • Anna E. Goudriaan
    Affiliations
    Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands

    Arkin, Mental Health Care, Amsterdam, The Netherlands
    Search for articles by this author
      The commentary by Leyton and Vezina (
      • Leyton M.
      • Vezina B.
      On cue: striatal ups and downs in addictions.
      ) addresses how to interpret the seemingly contradictory findings of two published papers in Biological Psychiatry on reward processing in problem gambling (PrG) (
      • Balodis I.M.
      • Kober H.
      • Worhunsky P.D.
      • Stevens M.C.
      • Pearlson G.D.
      • Potenza M.N.
      Diminished frontostriatal activity during processing of monetary rewards and losses in pathological gambling.
      ,
      • van Holst R.J.
      • Veltman D.J.
      • Büchel C.
      • van den Brink W.
      • Goudriaan A.E.
      Distorted expectancy coding in problem gambling: is the addictive in the anticipation?.
      ). Leyton and Vezina propose that these contrasting findings could be explained by differences in specific cues used. They argue that problem gamblers show enhanced striatal activation when confronted with disorder-specific cues and attenuated responses to disorder-irrelevant appetitive stimuli. We agree with Leyton and Vezina that disorder-relevant stimuli likely modulate appetitive brain responses and may contribute to the differences between the results of van Holst et al. (
      • van Holst R.J.
      • Veltman D.J.
      • Büchel C.
      • van den Brink W.
      • Goudriaan A.E.
      Distorted expectancy coding in problem gambling: is the addictive in the anticipation?.
      ) and Balodis et al. (
      • Balodis I.M.
      • Kober H.
      • Worhunsky P.D.
      • Stevens M.C.
      • Pearlson G.D.
      • Potenza M.N.
      Diminished frontostriatal activity during processing of monetary rewards and losses in pathological gambling.
      ). However, the neuroimaging literature in PrG suggests that other factors must be considered as well.
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      Linked Article

      • On Cue: Striatal Ups and Downs in Addictions
        Biological PsychiatryVol. 72Issue 10
        • Preview
          Two recent papers report that problem gamblers exhibit altered striatal responses to cues that predict monetary reward, as compared with healthy controls. Significantly, however, in one study the activation was increased (1), whereas in the other it was decreased (2). We propose that this discrepancy could result from the fact that different types of cues were used. In the study by van Holst et al. (1), the cues were images of familiar playing cards. In comparison, Balodis et al. (2) used cues that consisted of text.
        • Full-Text
        • PDF
      • Attending to Striatal Ups and Downs in Addictions
        Biological PsychiatryVol. 72Issue 10
        • Preview
          Altered striatal responses during monetary reward anticipation have recently been reported in pathological gambling (PG). Whereas van Holst et al. (1) reported an increased response, Balodis et al. (2) found a diminished response. Leyton and Vezina proposed that these divergent results may relate to cue specificity; in addicted populations addiction-related cues increase striatal activity, whereas in the absence of such cues, diminished striatal activity is observed. The authors suggested that the playing cards presented by van Holst et al.
        • Full-Text
        • PDF