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Problem Gamblers Show Brain Impairment

Frontal lobe dysfunction mirrors that of substance abusers, study finds

WEDNESDAY, April 13, 2005 (HealthDay News) -- America's estimated 7 million problem gamblers may have more in common with alcoholics or drug addicts than they think.

A new study of Argentine gamblers finds that functional changes in their brains' inhibitory and decision-making centers resemble those seen in hard-core substance abusers.

"Given that the neurobiology of what happens when somebody is gambling is much the same as what happens when they are taking cocaine, for example, we can certainly predict that you might see some of these same kind of changes," said gambling addiction expert Linda Chamberlain, psychologist and coordinator of the Center for Addiction and Substance Abuse at the University of South Florida, Tampa. She was not involved in the study.

The findings, to be presented April 13 at the American Academy of Neurology annual meeting, in Miami Beach, Fla., could someday lead to treatments to help spot and curb problem gambling, the researchers said.

According to lead researcher Dr. Facundo F. Manes, a professor of neurophysiology and neuroscience at Raul Carrea Institute for Neurological Research, in Buenos Aires, pathological gambling differs from ordinary gambling in that it is a "persistent and maladaptive" behavior that has "disruptive consequences on familiar, occupational and social functions."

"It's when people start to prioritize gambling over other activities," Chamberlain added. Even as problems linked to gambling emerge, "they just keep going -- that's one of the hallmarks of addiction," she said.

Indeed, Chamberlain said she and other experts in the field are coming to the consensus that gambling addiction shares certain "commonalities" with substance-linked addictions.

"There's been research before on the brain's frontal lobe activity with relapse in recovering alcoholics," she said, "so it makes sense to me to look for it to be a factor in pathological gambling, as well."

The Argentine study -- involving 11 unmedicated problem gamblers recruited at Buenos Aires casinos and racetracks -- took a close look at these neurological factors.

Manes' team had the gamblers take a series of standard psychological tests aimed at assessing their "executive functions" -- higher-level activities such as decision making, impulse control, and working memory, all centered in the brain's frontal lobe. They then compared those test results to those of 10 non-gamblers.

The result: "The disadvantageous decision-making and impairment in inhibitory control that the pathological gamblers exhibited in this study was similar to that of individuals with prefrontal lesions and individuals with drug addiction," Manes said. These findings support the notion that gambling addiction "shares characteristics with substance abuse and impulse control disorders," he said.

Manes said these cognitive deficits may help explain why problem gamblers continue to head to casinos and racetracks, even though their habit poses a grave threat to their family, finances and career. But he also believes his team's work "has clear implications" for the future development of therapies that might help curb problem gambling.

Chamberlain said she's not surprised by the findings, given what is known about addiction in general.

"One expert, Howard Shaffer, of Harvard Medical School, said it best: 'It's not about the brain being addicted to a substance, it's about the brain being addicted to its own chemistry,'" she explained.

"So, it's not alcohol that causes these changes in the brain -- it just sets that brain chemistry in motion. And that's the same thing that gambling does."

Manes stressed that it remains unclear whether these brain impairments were somehow caused by problem gambling, or whether they made individuals more vulnerable to gambling addiction in the first place.

"Our study reveals only an association, not cause-and-effect," Manes said.

More study might help answer that question, but according to Chamberlain, U.S. public funding for research and treatment into gambling addiction remains pitifully low.

"Despite the fact that we spend hundreds of billions of dollars every year in this country on gambling, there's no money dedicated on a national basis for treatment," she said. In fact, she estimates that U.S. inpatient services devoted to problem gambling total just 200 beds -- a drop in the bucket, given the estimated 7 million Americans suffering from the condition, she said.

"With gambling, we are where we were at 25 years ago with treating alcohol and drug addicts," Chamberlain said. With the paucity of trained professionals available to help problem gamblers, "most likely what you'll find is somebody who might do individual or group counseling, or refer you to Gamblers Anonymous," she said.

And the problem is likely to get worse.

"The real dilemma, for those of us working in this field, is that the generation coming up may be developing an addiction to gambling at a much higher rate," Chamberlain said. "There's now online gambling and video gambling, and all of this generation that's now in their 20s grew up playing GameBoys and other video games. And that's exactly what's popular now in casino-style gambling."

More information

For help in the diagnosis and treatment of gambling addiction, visit Gamblers Anonymous.

SOURCES: Linda Chamberlain, Psy.D., psychologist and coordinator, Center for Addiction and Substance Abuse, University of South Florida, Tampa; Facundo F. Manes, M.D., professor, neurophysiology and cognitive neurosciences, and chief, Cognitive Neurology, Neuropsychology & Neuropsychiatry Section, Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina; April 13, 2005, presentation, American Academy of Neurology annual meeting, Miami Beach, Fla.
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