Abstract
Gambling disorder is a serious psychiatric condition characterized by decision-making and reward processing impairments that are associated with dysfunctional brain activity in the orbitofrontal cortex (OFC). However, it remains unclear whether OFC functional abnormalities in gambling disorder are accompanied by structural abnormalities. We addressed this question by examining the organization of sulci and gyri in the OFC. This organization is in place very early and stable across life, such that OFC sulcogyral patterns (classified into Types I, II, and III) can be regarded as potential pre-morbid markers of pathological conditions. We gathered structural brain data from nine existing studies, reaching a total of 165 individuals with gambling disorder and 159 healthy controls. Our results, supported by both frequentist and Bayesian statistics, show that the distribution of OFC sulcogyral patterns is skewed in individuals with gambling disorder, with an increased prevalence of Type II pattern compared with healthy controls. Examination of gambling severity did not reveal any significant relationship between OFC sulcogyral patterns and disease severity. Altogether, our results provide evidence for a skewed distribution of OFC sulcogyral patterns in gambling disorder and suggest that pattern Type II might represent a pre-morbid structural brain marker of the disease. It will be important to investigate more closely the functional implications of these structural abnormalities in future work.
Highlights
Gambling disorder, from here onwards referred to as pathological gambling[1], is a behavioral addiction with severe consequences, including bankruptcy, relationship problems, and suicide[1]
We aimed to examine the distribution of orbitofrontal cortex (OFC) sulcogyral patterns among pathological gamblers (PGs), as well as their relationship with gambling severity, under the premise that the well-described functional impairments reported in the OFC might reflect pre-morbid structural markers
In line with the results from Nakamura et al.[31], we did not find evidence supporting a relationship between the OFC sulcogyral patterns present in left and right hemispheres, as revealed by likelihood ratio (LR) tests in multinomial logistic regressions (HCs: LRχ2 = 3.32, p = 0.51; PGs: LRχ2 = 8.81, p = 0.08; detailed distributions of OFC sulcogyral patterns as a function of left–right combination are reported in Supplementary Table 4)
Summary
From here onwards referred to as pathological gambling[1], is a behavioral addiction with severe consequences, including bankruptcy, relationship problems, and suicide[1]. Consistent with the idea that psychiatric disorders have a biological basis in the brain[2], functional neuroimaging studies have revealed a core network of dysfunctional brain regions in individuals suffering from pathological gambling[3]. While a few studies have reported decreased OFC gray matter volume[13,14,15] and decreased cortical thickness[16] in pathological gamblers (PGs) compared with healthy controls (HCs), other studies have failed to report significant group differences[17,18,19,20]. These inconsistencies might reflect the influence of factors
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