FDG-PET study in pathological gamblers. 1. Lithium increases orbitofrontal, dorsolateral and cingulate metabolism

Area of Science:

• Neuroscience
• Psychiatry
• Addiction Research

Background:

• Pathological gambling affects 1-3% of adults and often co-occurs with other conditions.
• Pharmacological treatments like mood stabilizers and SSRIs show some efficacy, but their mechanisms remain unclear.

Purpose of the Study:

• To investigate brain glucose metabolism in pathological gambling using Positron Emission Tomography (PET).
• To examine the effects of lithium treatment on brain metabolism in pathological gamblers.

Main Methods:

• PET scans were performed on 21 pathological gamblers (with comorbid bipolar spectrum diagnoses) and 32 controls.
• 16 gamblers received lithium treatment for 10 weeks in a double-blind, placebo-controlled trial, with follow-up PET scans.

Main Results:

• Pathological gamblers showed increased relative glucose metabolic rates (rGMR) in the orbitofrontal and medial frontal cortex compared to controls.
• Lithium treatment further increased rGMR in the orbitofrontal cortex but normalized metabolic rates in the posterior cingulate and dorsolateral frontal cortex.

Conclusions:

• Increased rGMR in cortical areas associated with impulse control is characteristic of pathological gambling.
• Lithium treatment impacts brain metabolism in pathological gambling, potentially by modulating these specific cortical regions.