Martin Zack1, Sang Soo Cho2, Jennifer Parlee3, Mark Jacobs2, Crystal Li2, Isabelle Boileau2, Antonio Strafella2. 1. Neuroscience Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada. Electronic address: martin.zack@camh.ca. 2. Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada. 3. Neuroscience Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
Abstract
BACKGROUND: Repeated transcranial magnetic stimulation (rTMS) can reduce cravings and improve cognitive function in substance dependent individuals. Whether these benefits extend to individuals with pathological gambling (PG) is unclear. High-frequency rTMS of the medial prefrontal cortex (PFC) and continuous theta burst stimulation (cTBS) of the right dorsolateral PFC can reduce impulsive choice in healthy volunteers. OBJECTIVE: This study aimed to assess the effects of these two protocols on gambling reinforcement and related responses in otherwise healthy men with PG. METHODS: Participants (n = 9) underwent active or sham treatments at weekly intervals in a repeated-measures, Latin square design. Subjective and physiological responses were assessed before and after a 15-min slot machine game on each session. Delay discounting and Stroop tasks measured post-game impulsive choice and attentional control. RESULTS: Multivariate analysis of covariance, controlling for winnings on the slot machine under each treatment, found that rTMS reduced the post-game increase in Desire to Gamble; cTBS reduced amphetamine-like effects, and decreased diastolic blood pressure. Treatment had no significant univariate effects on bet size or speed of play in the game; however, a multivariate effect for the two indices suggested that treatment decreased behavioral activation. Neither treatment reduced impulsive choice, while both treatments increased Stroop interference. CONCLUSIONS: rTMS and cTBS can reduce gambling reinforcement in non-comorbid men with PG. Separate processes appear to mediate gambling reinforcement and betting behavior as against delay discounting and Stroop interference. Interventions that modify risky as opposed to temporal aspects of decision making may better predict therapeutic response in PG.
BACKGROUND: Repeated transcranial magnetic stimulation (rTMS) can reduce cravings and improve cognitive function in substance dependent individuals. Whether these benefits extend to individuals with pathological gambling (PG) is unclear. High-frequency rTMS of the medial prefrontal cortex (PFC) and continuous theta burst stimulation (cTBS) of the right dorsolateral PFC can reduce impulsive choice in healthy volunteers. OBJECTIVE: This study aimed to assess the effects of these two protocols on gambling reinforcement and related responses in otherwise healthy men with PG. METHODS:Participants (n = 9) underwent active or sham treatments at weekly intervals in a repeated-measures, Latin square design. Subjective and physiological responses were assessed before and after a 15-min slot machine game on each session. Delay discounting and Stroop tasks measured post-game impulsive choice and attentional control. RESULTS: Multivariate analysis of covariance, controlling for winnings on the slot machine under each treatment, found that rTMS reduced the post-game increase in Desire to Gamble; cTBS reduced amphetamine-like effects, and decreased diastolic blood pressure. Treatment had no significant univariate effects on bet size or speed of play in the game; however, a multivariate effect for the two indices suggested that treatment decreased behavioral activation. Neither treatment reduced impulsive choice, while both treatments increased Stroop interference. CONCLUSIONS: rTMS and cTBS can reduce gambling reinforcement in non-comorbid men with PG. Separate processes appear to mediate gambling reinforcement and betting behavior as against delay discounting and Stroop interference. Interventions that modify risky as opposed to temporal aspects of decision making may better predict therapeutic response in PG.
Authors: Hamed Ekhtiari; Hosna Tavakoli; Giovanni Addolorato; Chris Baeken; Antonello Bonci; Salvatore Campanella; Luis Castelo-Branco; Gaëlle Challet-Bouju; Vincent P Clark; Eric Claus; Pinhas N Dannon; Alessandra Del Felice; Tess den Uyl; Marco Diana; Massimo di Giannantonio; John R Fedota; Paul Fitzgerald; Luigi Gallimberti; Marie Grall-Bronnec; Sarah C Herremans; Martin J Herrmann; Asif Jamil; Eman Khedr; Christos Kouimtsidis; Karolina Kozak; Evgeny Krupitsky; Claus Lamm; William V Lechner; Graziella Madeo; Nastaran Malmir; Giovanni Martinotti; William M McDonald; Chiara Montemitro; Ester M Nakamura-Palacios; Mohammad Nasehi; Xavier Noël; Masoud Nosratabadi; Martin Paulus; Mauro Pettorruso; Basant Pradhan; Samir K Praharaj; Haley Rafferty; Gregory Sahlem; Betty Jo Salmeron; Anne Sauvaget; Renée S Schluter; Carmen Sergiou; Alireza Shahbabaie; Christine Sheffer; Primavera A Spagnolo; Vaughn R Steele; Ti-Fei Yuan; Josanne D M van Dongen; Vincent Van Waes; Ganesan Venkatasubramanian; Antonio Verdejo-García; Ilse Verveer; Justine W Welsh; Michael J Wesley; Katie Witkiewitz; Fatemeh Yavari; Mohammad-Reza Zarrindast; Laurie Zawertailo; Xiaochu Zhang; Yoon-Hee Cha; Tony P George; Flavio Frohlich; Anna E Goudriaan; Shirley Fecteau; Stacey B Daughters; Elliot A Stein; Felipe Fregni; Michael A Nitsche; Abraham Zangen; Marom Bikson; Colleen A Hanlon Journal: Neurosci Biobehav Rev Date: 2019-07-02 Impact factor: 8.989
Authors: Karolina Kozak; Aliya M Lucatch; Darby J E Lowe; Iris M Balodis; James MacKillop; Tony P George Journal: Ann N Y Acad Sci Date: 2018-10-05 Impact factor: 5.691
Authors: Anne Sauvaget; Samuel Bulteau; Alice Guilleux; Juliette Leboucher; Anne Pichot; Pierre Valrivière; Jean-Marie Vanelle; Véronique Sébille-Rivain; Marie Grall-Bronnec Journal: J Behav Addict Date: 2018-02-21 Impact factor: 6.756