A Preliminary Study of the Neural Correlates of the Intensities of Self-Reported Gambling Urges and Emotions in Men with Pathological Gambling

Although self-reported gambling urge intensities have clinical utility in the treatment of pathological gambling (PG), prior
studies have not investigated their neural correlates. Functional magnetic resonance imaging (fMRI) was conducted while 10
men with PG and 11 control comparison (CON) men viewed videotaped scenarios of gambling, happy or sad content. Participants
rated the intensity of their emotions and motivations and reported the qualities of their responses. Relative to the CON group,
the PG group reported similar responses to sad and happy scenarios, but stronger emotional responses and gambling urges when
viewing the gambling scenarios. Correlations between self-reported responses and brain activations were typically strongest
during the period of reported onset of emotional/motivational response and more robust in PG than in CON subjects for all
conditions. During this epoch, corresponding with conscious awareness of an emotional/motivational response, subjective ratings
of gambling urges in the PG group were negatively correlated with medial prefrontal cortex activation and positively correlated
with middle temporal gyrus and temporal pole activations. Sadness ratings in the PG group correlated positively with activation
of the medial orbitofrontal cortex, middle temporal gyrus, and retrosplenial cortex, while self-reported happiness during
the happy videos demonstrated largely inverse correlations with activations in the temporal poles. Brain areas identified
in the PG subjects have been implicated in explicit, self-referential processing and episodic memory. The findings demonstrate
different patterns of correlations between subjective measures of emotions and motivations in PG and CON subjects when viewing
material of corresponding content, suggesting in PG alterations in the neural correlates underlying experiential aspects of
affective processing.