Elsevier

Biological Psychiatry

Volume 83, Issue 12, 15 June 2018, Pages 1036-1043
Biological Psychiatry

Archival Report
Increased Striatal Dopamine Synthesis Capacity in Gambling Addiction

https://doi.org/10.1016/j.biopsych.2017.06.010Get rights and content

Abstract

Background

The hypothesis that dopamine plays an important role in the pathophysiology of pathological gambling is pervasive. However, there is little to no direct evidence for a categorical difference between pathological gamblers and healthy control subjects in terms of dopamine transmission in a drug-free state. Here we provide evidence for this hypothesis by comparing dopamine synthesis capacity in the dorsal and ventral parts of the striatum in 13 pathological gamblers and 15 healthy control subjects.

Methods

This was achieved using [18F]fluoro-levo-dihydroxyphenylalanine dynamic positron emission tomography scans and striatal regions of interest that were hand-drawn based on visual inspection of individual structural magnetic resonance imaging scans.

Results

Our results show that dopamine synthesis capacity was increased in pathological gamblers compared with healthy control subjects. Dopamine synthesis was 16% higher in the caudate body, 17% higher in the dorsal putamen, and 17% higher in the ventral striatum in pathological gamblers compared with control subjects. Moreover, dopamine synthesis capacity in the dorsal putamen and caudate head was positively correlated with gambling distortions in pathological gamblers.

Conclusions

Taken together, these results provide empirical evidence for increased striatal dopamine synthesis in pathological gambling.

Section snippets

Subjects

In total, 15 PGs and 15 HCs were recruited. All HCs and 13 PGs had also participated in a previous pharmaco-functional magnetic resonance imaging (fMRI) study 41, 46. The other 2 PGs were newly recruited. PGs were recruited through advertisement and addiction treatment centers, and they reported not to be medicated or in treatment for their gambling at the time of the PET study. HCs were recruited through advertisement.

All subjects who had participated in the pharmaco-fMRI study underwent a

Subject Characteristics and Traits

Subject characteristics are summarized in Table 1. The two groups were matched for age, body mass index, net income, and verbal IQ [based on the Dutch version of the National Adult Reading Test (54)]. Measures acquired on the PET testing day indicated that PGs were significantly more impulsive, had higher SOGS scores during the past year and past 3 months, and had more gambling distortions than HCs.

PET Measures

Mean Ki was significantly different between ROIs (F3,78 = 122.95, p < .001, Cohen’s d = 4.34) and

Discussion

Our study establishes for the first time a key link between pathological gambling and increased striatal dopamine synthesis capacity. This observation is in line with previous findings showing that dopamine release is increased in the dorsal striatum of PGs following amphetamine administration (40) and is positively correlated with subjective excitement 36, 39 and gambling severity (36) in the ventral striatum in the context of gambling. Our results also agree with reports of greater

Acknowledgments and Disclosures

RJvH was supported by a Rubicon grant from the Netherlands Research Organization (Grant No. 446.11.025). GS was supported by a Veni grant from the Netherlands Research Organization (Grant No. 016.155.218). RC was supported by a Vici grant from the Netherlands Research Organization (Grant No. 2015/24762/MaGW) and a James McDonnell scholar award.

WJJ serves as a consultant to Genentech, Novartis, and Bioclinica. All other authors report no biomedical financial interests or potential conflicts of

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    RJvH and GS contributed equally to this work.

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