Gambling And The Brain

Interesting article, and one I can relate to:

Researchers are learning that the heads — or to be more accurate, the brains — of pathological gamblers are biologically different from those of most of the estimated 73 million Americans who are able to play bingo, pull the arm of a slot machine or flip some aces and then simply stop.

... About 1.6% of Americans have a full-blown gambling addiction and an additional 2% have a serious problem with gambling, says Jon Grant, assistant professor of psychiatry at Brown Medical School and author of "Stop Me Because I Can't Stop Myself," (McGraw Hill, 2003). By these estimates, nearly 4% of the population experiences a mild to severe gambling problem — and as the number of gamblers goes up, so does the number of those with a gambling problem.

... Now, with the aid of neuroimaging techniques and a greater understanding of neurotransmitters, researchers are discovering that the brain's hard-wired reward system and frontal lobes have certain unique characteristics in these gamblers. Even some of their personalities and genes may be different from those without gambling problems.

"We are finding that pathological gambling is very definitely a brain disease," says Timothy Fong, a psychiatrist and codirector of the UCLA Gambling Studies Program. "The central question is: Were pathological gamblers born that way or are the changes in their brains the results of excessive gambling? We are far from answering that question in a meaningful way."

... The brain can become addicted to behaviors as well as substances, Grant says. "It can be addicted to anything that we find rewarding," he says. "If we find it too rewarding, we will want to do it again and again. Even when they lose all their money and credit cards, they describe intense cravings much like people do for drugs."

The explanation for why gambling is the drug of choice for one person, and for another it's heroin is still unknown. But the key to most addictions can be found in the brain's reward system, particularly a region called the ventral striatum. Neuroimaging studies of compulsive gamblers point to a different functioning in this neural system.

... When the area is working normally, it responds appropriately to pleasure stimuli — such as winning money or getting a gift — filling us with a sense of happiness or satisfaction. When it is not working properly, as in cocaine addicts, this area seems almost indifferent. What would make a normal person react does nothing for people addicted to substances or behaviors. Even more stimuli, such as drugs, alcohol or gambling, are needed to feel the pleasure from a particular activity.

"You experience something very nice that gives you pleasure," says UCLA's Fong. "But then other parts of the brain seem to shut down and you need to have the reward so much that it takes over the rest of the brain."

... Research presented at the American Academy of Neurology meeting in April found that executive function, the brain circuitry that underlies inhibition and self-control, was deeply impaired in pathological gamblers. These impairments made the gamblers unable to truly comprehend the trade-off between short-term reward and long-term negative consequences.

This loss of self-control in turn affects other important brain functions needed to step on the brakes when emotions spin out of control. Those who suffer from attention-deficit disorder experience difficulty with executive function, and researchers have found, not coincidentally, that a high percentage of pathological gamblers also have ADD.

Many studies suggest that compulsive gamblers may have reduced frontal lobe activity, which may in turn be triggered by decreased activity in the basal ganglia, a deeper part of the forebrain that generates two important neurotransmitters called dopamine and norepinephrine.

The feel-good neurotransmitter dopamine, in particular, has intrigued those studying compulsive gamblers. Several studies have looked at a dopamine receptor gene and have found real differences in the structure of that gene between gamblers and non-gamblers.

That genetic predisposition has direct consequences on brain chemistry. The dopamine receptor sites in the midbrain that are driven by anticipation, but uncertain of the rewards, are especially sensitive. They require more and more dopamine to create the rush of happiness and satisfaction. When gambling is the trigger for the dopamine rush, a vicious cycle is created.

... "This research makes us more sensitive to the idea that there are deficits in certain brain areas of gamblers," says Leann Dodd, a psychiatrist at the Mayo Clinic and lead researcher in the study. "It adds to the evidence that gamblers might have a decreased capacity to get stimulation from their pleasure system and they need extra stimulus to get there."

... In a paper last month in the Archives of General Psychiatry, researchers looked at the personality and temperament of 939 men and women, all born in 1972 or 1973, to see if they could discern some personality traits that compulsive gamblers all shared. They also wanted to find out if these traits related to those in substance abusers.

All the participants were given a personality test when they were 18, and then at 21 they were screened to see if problem behaviors such as compulsive gambling, drug and alcohol abuse or nicotine dependence, had emerged. The researchers found that the problem gamblers shared many personality traits with others with addictive disorders: risk taking and impulsivity.