Decision-making impairments in patients with pathological gambling

Brand, Matthias; Kalbe, Elke; Labudda, Kirsten; Fujiwara, Esther; Kessler, Josef; Markowitsch, Hans J.

doi:10.1016/j.psychres.2004.10.003

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Volume 133, Issue 1 , Pages 91-99, 30 January 2005

Decision-making impairments in patients with pathological gambling

Matthias Brand
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany
- Corresponding author. Tel.: +49 521 1064488; fax: +49 521 1066049.
Elke Kalbe
- Max-Planck-Institute for Neurological Research, Gleuelerstr. 50, 50931 Cologne, Germany
Kirsten Labudda
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany
Esther Fujiwara
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany
Josef Kessler
- Max-Planck-Institute for Neurological Research, Gleuelerstr. 50, 50931 Cologne, Germany
Hans J. Markowitsch
- Department of Physiological Psychology, University of Bielefeld, P.O. Box 100131, 33501 Bielefeld, Germany

Received 9 December 2003; received in revised form 13 September 2004; accepted 15 October 2004.

Abstract

Pathological gambling (PG) is most likely associated with functional brain changes as well as neuropsychological and personality alterations. Recent research with the Iowa Gambling Task suggests decision-making impairments in PG. These deficits are usually attributed to disturbances in feedback processing and associated functional alterations of the orbitofrontal cortex. However, previous studies with other clinical populations found relations between executive (dorsolateral prefrontal) functions and decision-making using a task with explicit rules for gains and losses, the Game of Dice Task. In the present study, we assessed 25 male PG patients and 25 male healthy controls with the Game of Dice Task. PG patients showed pronounced deficits in the Game of Dice Task, and the frequency of risky decisions was correlated with executive functions and feedback processing. Therefore, risky decisions of PG patients might be influenced by both dorsolateral prefrontal and orbitofrontal cortex dysfunctions.

Keywords: Risk-taking behavior, Executive functions, Dorsolateral prefrontal cortex, Orbitofrontal cortex, Gambling task