Brain Network Underlying Executive Functions in Gambling and Alcohol Use Disorders: An Activation Likelihood Estimation Meta-Analysis of fMRI Studies.

Alessandro Quaglieri,Maddalena Boccia,Cecilia Guariglia,Emanuela Mari,Anna Maria Giannini,Laura Piccardi

doi:10.3390/brainsci10060353

Abstract

Background: Neuroimaging and neuropsychological studies have suggested that common features characterize both Gambling Disorder (GD) and Alcohol Use Disorder (AUD), but these conditions have rarely been compared. Methods: We provide evidence for the similarities and differences between GD and AUD in neural correlates of executive functions by performing an activation likelihood estimation meta-analysis of 34 functional magnetic resonance imaging studies involving executive function processes in individuals diagnosed with GD and AUD and healthy controls (HC). Results: GD showed greater bilateral clusters of activation compared with HC, mainly located in the head and body of the caudate, right middle frontal gyrus, right putamen, and hypothalamus. Differently, AUD showed enhanced activation compared with HC in the right lentiform nucleus, right middle frontal gyrus, and the precuneus; it also showed clusters of deactivation in the bilateral middle frontal gyrus, left middle cingulate cortex, and inferior portion of the left putamen. Conclusions: Going beyond the limitations of a single study approach, these findings provide evidence, for the first time, that both disorders are associated with specific neural alterations in the neural network for executive functions.

Highlights

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [1] and its revised edition (DSM-IV-TR) [2], pathological gambling (PG) was defined as an impulse control disorder and characterized by “persistent, recurrent and maladaptive behavior that compromises personal, family or work activities” [2]
We found clusters of activation in the right middle frontal gyrus (MFG) and in the right putamen
We found clusters of activation in the right middle frontal gyrus (MFG), and in the left posterior cingulate cortex (PCC) extending to the precuneus

Summary

Introduction

In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [1] and its revised edition (DSM-IV-TR) [2], pathological gambling (PG) was defined as an impulse control disorder (not otherwise specified) and characterized by “persistent, recurrent and maladaptive behavior that compromises personal, family or work activities” [2]. Gambling Disorder (GD) is currently included within the spectrum of dependencies and disorders related to substance use (substance-related and addictive disorders). It is described as a chronic and relapsing disorder that affects an individual’s health and sociality, mainly due to addictive behavior (i.e., individuals aim to continue playing despite losing money), loss of control (i.e., despite willingness to stop, they cannot avoid playing again), withdrawal syndrome (i.e., physical and psychological feelings of discomfort when gambling is stopped), and craving (i.e., the compulsive desire to play again). Neuroimaging and neuropsychological studies have suggested that common features characterize both Gambling Disorder (GD) and Alcohol Use Disorder (AUD), but these conditions have rarely been compared. Conclusions: Going beyond the limitations of a single study approach, these findings provide evidence, for the first time, that both disorders are associated with specific neural alterations in the neural network for executive functions.

Methods

Results

Discussion

Conclusion