Problem gambling associated with brain impairments

Pathological gamblers exhibit complex impairments in decision-making and executive function processes associated with the prefrontal cortex of the brain, according to research that will be presented at the American Academy of Neurology 57th Annual Meeting in Miami Beach, Fla., April 9 – 16, 2005.

Researchers learned that decision-making functions and inhibitory control in chronic pathological gamblers appear to be altered and may influence the trade-off between short-term reward and the long-term negative consequences of gambling on employment, social relationships, and family life. Better understanding of these processes could lead to the development of more effective strategies for treating pathological gamblers.

The study, led by Dr. Maria Roca, investigated the decision-making processes and executive functions in pathological gamblers. "Executive functions encompass a variety of processes and are defined as the ability to abstract, plan, organize, shift set, and adapt current and past knowledge to future behavior," said co-author Facundo Manes, MD, of the Raul Carrea Institute for Neurological Research (FLENI) in Buenos Aires, Argentina. "Decision-making involves assessment of possible reward and punishment outcomes from the various response options, and the selection of the option that one thinks will be best."

Dr. Roca's study examined 11 pathological gamblers and 10 control subjects, using decision-making tasks, inhibitory control and attention tasks, and other measures. In the decision-making tasks, the gamblers made more "disadvantageous" choices. In the inhibitory control and attention tasks, the gamblers made more errors.

"We think that the results of our study are important for two reasons," said Manes. "First, our findings add more evidence to the possible role of the prefrontal cortex in the pathophysiology of this neuropsychiatric disorder. Second, the characterization of executive deficits involved in chronic pathological gambling has clear implications for rational pharmacological and rehabilitative treatment strategies."

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