Neurobiological correlates of problem gambling in a quasi-realistic blackjack scenario as revealed by fMRI

In the present study we obtained functional magnetic resonance imaging (fMRI) data in occasional gamblers (OG) and problem gamblers (PG) during a quasi-realistic blackjack game. We focused on neuronal correlates of risk assessment and reward processing. Participants had to decide whether to draw or not to draw a card in a high-risk or low-risk blackjack situation. We assumed PG would show differences in prefrontal and ventral striatal brain regions in comparison to OG during risk assessment and due to the winning or losing of money. Although both groups did not differ in behavioral data, blood oxygen level dependent (BOLD) signals in PG and OG significantly differed in thalamic, inferior frontal, and superior temporal regions. Whereas PG demonstrated a consistent signal increase during high-risk situations and a decrease in low-risk situations, OG presented the opposite pattern. During reward processing as derived from contrasting winning vs. losing situations, both PG and OG groups showed an enhancement of ventral striatal and posterior cingulate activity. Furthermore, PG demonstrated a distinct fronto-parietal activation pattern which has been discussed to reflect a cue-induced addiction memory network which was triggered by gambling-related cues.