For some time, scientists have been aware of a link between alcohol use disorders and problem gambling. Problem gambling is more common among people who abuse alcohol than those without alcohol use disorders (AUDs).
New research findings may explain why: researchers from Imperial College London have discovered that gambling addiction activates the same brain pathways as drug and alcohol cravings. Targeting those pathways might lead to new treatments for addictive gambling.
The findings, published in the journal Translational Psychiatry, provide new understanding of the biology of gambling addiction, about which little has been known. The study results also indicate that connections between the areas of the brain that provide impulse control may be weaker in those who are addicted to gambling, according to Dr. Henrietta Bowden-Jones, co-author from the Department of Medicine at Imperial, and director of the National Problem Gambling Clinic, at Central and North West London NHS Foundation Trust.
“We know the condition may have a genetic component — and that the children of gambling addicts are at higher risk of gambling addiction themselves — but we still don’t know the exact parts of the brain involved. This research identifies key brain areas, and opens avenues for targeted treatments that prevent cravings and relapse.”
The researchers discovered that, when addictive gamblers experience cravings, two brain areas, called the insula and nucleus accumbens, show high levels of activity. Previous research has linked activity in these areas, which regulate decision-making, reward and impulse control, to the cravings experienced by alcoholics and drug addicts.
Activity in these areas, which are found deep in the center of the brain and involved in decision-making, reward and impulse control, has been previously linked to drug and alcohol cravings. The addiction can be treated with talk therapy, such as cognitive behavioral therapy, or medications that block cravings.
The research, which was conducted between Imperial and the National Problem Gambling Clinic, studied 19 patients with gambling addiction, and 19 healthy volunteers.
The most commonly reported gambling activities among the patients were electronic roulette and sports gambling.
The scientists used a magnetic resonance imaging scanner to monitor patients’ brain activity as they viewed photos of gambling scenes, such as a roulette wheel or an off-track betting shop. Participants were asked to rate their level of craving when they saw the images.
The team, which included scientists from the University of British Columbia and the University of Cambridge, determined which brain areas were activated when the volunteers experienced cravings. The scans indicated that, in problem gamblers, the insula and nucleus accumbens were highly active when they were shown an image associated with gambling, and experienced a craving.
The scientists also discovered that weaker connections between the nucleus accumbens and the frontal lobe were associated with greater craving.
The frontal lobe, which controls decision-making, may help keep the insula in-check by controlling impulses, said Anne Lingford-Hughes, co-author from the Department of Medicine at Imperial.
“Weak connections between these regions have also been identified in drug addiction. The frontal lobe can help control impulsivity, therefore a weak link may contribute to people being unable to stop gambling, and ignoring the negative consequences of their actions. The connections may also be affected by mood — and be further weakened by stress, which may be why gambling addicts relapse during difficult periods in their life.”
Monitoring activity and connections in the insula and nucleus accumbens in gambling addicts may not only help assess the effectiveness of a treatment, but may also be useful in preventing relapse.
The next step for the researchers is comparing which treatments may reduce activity in those areas, in order to reduce gamblers’ cravings. They also want to compare the brain activity of problem gamblers with those who gamble but do not have a problem, to identify what causes the addiction.
Another recent study, by Japanese researchers, has also linked reduced frontal lobe activity to compulsive gambling. The team conducted game-based experiments on 21 adult men receiving gambling addiction therapy, and 29 adult men without addiction.
They were asked to choose either a gambling game of a high risk for a high return or a game of a low risk for a low return at 20 stages. The results showed 43.2 percent of the addicts picked high-risk, high-return games, compared with 32.5 percent of non-addicts. MRI scans found reduced frontal lobe activity among the addicts who took unnecessary risks.
“Although a main cause of gambling addiction has been believed to be personality favoring excessive risks, a brain disorder is also a cause and new therapy is needed,” the scientists said.