Bulletin de l'Academie nationale de medecine · 2014
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Аннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
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Sescousse Guillaume
Аннотация
Although most people consider gambling as a recreational activity, some individuals lose control and enter into a spiral of compulsive gambling with dramatic consequences. The many similarities with substance addiction have led psychiatrists to redefine pathological gambling as a behavioural addiction. A number of neurobiological hypotheses originating from this framework have been tested in the past ten years, in particular using neuroimaging. Similarly to substance addiction, a number of observations indicate a central role for dopamine in pathological gambling. However the underlying mechanism seems to be different and is still poorly understood. Neuropsychological studies have shown decision-making deficits in pathological gamblers, accompanied by a lack of inhibition and cognitive flexibility. This disruption of so-called "executive functions" is typical of frontal lobe dysfunction. Finally, functional MRI studies have revealed abnormal reactivity within the brain regions of the " reward system ", including the striatum and ventro-medial prefrontal cortex. These regions are over-activated by gambling cues, and under-activated by monetary gains. However, the scarcity and heterogeneity of brain imaging studies currently hinders the development of a coherent neurobiological model of pathological gambling. Further replications and diversification of approaches will be needed in the coming years in order to produce such a model that will have the ability to inform prevention and treatment strategies.