Abstract
Background: Pathological gambling affects 1-3% of the adult population, and has high comorbidity. Although mood stabilizers and serotonin reuptake inhibitors have shown some efficacy in the treatment of this condition, there is little known about how these pharmacological interventions work. Methods: Twenty-one patients with pathological gambling, who met lifetime comorbid bipolar spectrum diagnoses, received baseline PET scans. Sixteen of these patients were entered into a randomized double-blind placebo-controlled parallel group design trial of lithium, and received follow-up PET scans at 10 weeks. A comparison group of 32 age- and sex-matched controls was also available. Anatomical MRIs were obtained as a structural template. Results: In patients with pathological gambling, relative glucose metabolic rates (rGMR) in the orbitofrontal cortex and medial frontal cortex were significantly increased at baseline compared to normal controls. Lithium increased rGMR further in the orbitofrontal cortex, heightening normal/patient differences, but it also increased the rGMR of the posterior cingulate and the dorsolateral frontal cortex normalizing the metabolic rate in these regions. Conclusion: Cortical areas implicated in impulse control disorders show increased rGMR in pathological gambling at baseline. Lithium treatment, while alleviating the symptoms, further increases rGMR in these areas.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 37-47 |
| Number of pages | 11 |
| Journal | Neuropsychobiology |
| Volume | 58 |
| Issue number | 1 |
| DOIs | |
| State | Published - Oct 2008 |
| Externally published | Yes |
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Keywords
- Cingulate gyrus
- Lithium
- Orbital frontal cortex
- Pathological gambling
- Relative glucose metabolic rate
ASJC Scopus subject areas
- Psychiatry and Mental health
- Neuropsychology and Physiological Psychology
- Biological Psychiatry
Cite this
FDG-PET study in pathological gamblers : 1. Lithium increases orbitofrontal, dorsolateral and cingulate metabolism. / Hollander, Eric; Buchsbaum, Monte S.; Haznedar, M. Mehmet; Berenguer, Jessica; Berlin, Heather A.; Chaplin, William; Goodman, Chelain R.; LiCalzi, Elizabeth M.; Newmark, Randall; Pallanti, Stefano.
In: Neuropsychobiology, Vol. 58, No. 1, 10.2008, p. 37-47.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - FDG-PET study in pathological gamblers
T2 - 1. Lithium increases orbitofrontal, dorsolateral and cingulate metabolism
AU - Hollander, Eric
AU - Buchsbaum, Monte S.
AU - Haznedar, M. Mehmet
AU - Berenguer, Jessica
AU - Berlin, Heather A.
AU - Chaplin, William
AU - Goodman, Chelain R.
AU - LiCalzi, Elizabeth M.
AU - Newmark, Randall
AU - Pallanti, Stefano
PY - 2008/10
Y1 - 2008/10
N2 - Background: Pathological gambling affects 1-3% of the adult population, and has high comorbidity. Although mood stabilizers and serotonin reuptake inhibitors have shown some efficacy in the treatment of this condition, there is little known about how these pharmacological interventions work. Methods: Twenty-one patients with pathological gambling, who met lifetime comorbid bipolar spectrum diagnoses, received baseline PET scans. Sixteen of these patients were entered into a randomized double-blind placebo-controlled parallel group design trial of lithium, and received follow-up PET scans at 10 weeks. A comparison group of 32 age- and sex-matched controls was also available. Anatomical MRIs were obtained as a structural template. Results: In patients with pathological gambling, relative glucose metabolic rates (rGMR) in the orbitofrontal cortex and medial frontal cortex were significantly increased at baseline compared to normal controls. Lithium increased rGMR further in the orbitofrontal cortex, heightening normal/patient differences, but it also increased the rGMR of the posterior cingulate and the dorsolateral frontal cortex normalizing the metabolic rate in these regions. Conclusion: Cortical areas implicated in impulse control disorders show increased rGMR in pathological gambling at baseline. Lithium treatment, while alleviating the symptoms, further increases rGMR in these areas.
AB - Background: Pathological gambling affects 1-3% of the adult population, and has high comorbidity. Although mood stabilizers and serotonin reuptake inhibitors have shown some efficacy in the treatment of this condition, there is little known about how these pharmacological interventions work. Methods: Twenty-one patients with pathological gambling, who met lifetime comorbid bipolar spectrum diagnoses, received baseline PET scans. Sixteen of these patients were entered into a randomized double-blind placebo-controlled parallel group design trial of lithium, and received follow-up PET scans at 10 weeks. A comparison group of 32 age- and sex-matched controls was also available. Anatomical MRIs were obtained as a structural template. Results: In patients with pathological gambling, relative glucose metabolic rates (rGMR) in the orbitofrontal cortex and medial frontal cortex were significantly increased at baseline compared to normal controls. Lithium increased rGMR further in the orbitofrontal cortex, heightening normal/patient differences, but it also increased the rGMR of the posterior cingulate and the dorsolateral frontal cortex normalizing the metabolic rate in these regions. Conclusion: Cortical areas implicated in impulse control disorders show increased rGMR in pathological gambling at baseline. Lithium treatment, while alleviating the symptoms, further increases rGMR in these areas.
KW - Cingulate gyrus
KW - Lithium
KW - Orbital frontal cortex
KW - Pathological gambling
KW - Relative glucose metabolic rate
UR - http://www.scopus.com/inward/record.url?scp=51049102164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=51049102164&partnerID=8YFLogxK
U2 - 10.1159/000154478
DO - 10.1159/000154478
M3 - Article
C2 - 18781089
AN - SCOPUS:51049102164
VL - 58
SP - 37
EP - 47
JO - Neuropsychobiology
JF - Neuropsychobiology
SN - 0302-282X
IS - 1
ER -