Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:78

Review

Moccia, Lorenzo¹  Pettorruso, Mauro¹  De Crescenzo, Franco¹  De Risio, Luisa¹  di Nuzzo, Luigi^1,2  Martinotti, Giovanni³  Bifone, Angelo⁴  Janiri, Luigi¹  Di Nicola, Marco¹ 

[1] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli, Inst Psychiat & Psychol, Largo Francesco Vito 1, I-00168 Rome, Italy

[2] Univ Rome Sapienza, Dept Physiol & Pharmacol V Erspamer, Largo Francesco Vito 1, I-00168 Rome, Italy

[3] Univ G dAnnunzio, Inst Psychiat, Dept Neurosci & Imaging, Via Vestini 31, I-66100 Pescara, Italy

[4] Ist Italiano Tecnol, Ctr Neurosci & Cognit Syst, Corso Bettini 31, I-38068 Rovereto, Italy

关键词: Pathological gambling;    Prefrontal cortex;    Response inhibition;    Value-based decision-making;    Impulsivity;    Cognitive flexibility;    Delay discounting;    Iowa Gambling Task;    Reversal learning;    Conflict monitoring;    Orbitofrontal cortex;    Affective processing;    Transcranial magnetic stimulation;   

DOI  :  10.1016/j.neubiorev.2017.04.025

来源: Elsevier

【 摘 要 】

Decreased cognitive control over the urge to be involved in gambling activities is a core feature of Gambling Disorder (GD). Cognitive control can be differentiated into several cognitive sub-processes pivotal in GD clinical phenomenology, such as response inhibition, conflict monitoring, decision-making, and cognitive flexibility. This article aims to systematically review fMRI studies, which investigated the neural mechanisms underlying diminished cognitive control in GD. We conducted a comprehensive literature search and collected neuropsychological and neuroimaging data investigating cognitive control in GD. We included a total of 14 studies comprising 499 individuals. Our results indicate that impaired activity in prefrontal cortex may account for decreased cognitive control in GD, contributing to the progressive loss of control over gambling urges. Among prefrontal regions, orbital and ventromedial areas seem to be a possible nexus for sensory integration, value-based decision-making and emotional processing, thus contributing to both motivational and affective aspects of cognitive control. Finally, we discussed possible therapeutic approaches aimed at the restoration of cognitive control in GD, including pharmacological and brain stimulation treatments.

【 授权许可】

Free