Testing the Interplay of Gambling, Emotion and Reward
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- Striatal BOLD response to reward outcomes and amygdala BOLD response to emotional stimuli
研究概览
简要总结
Background The nature and direction of dysfunctional reward processing in gambling disorder remains unclear. We aim to test a novel neurobiological model of gambling addiction, that takes into account inter-individual differences, as well as the multifactorial nature of gaming addiction.
Objectives
Primary objective:
This project will test the hypothesis that there are two opposite brain phenotypes that characterize two distinct subpopulations of gamblers, so-called impulsive vs. emotional, respectively.
Secondary objective:
This project will also seek to determine whether the brain phenotypes proposed above are capable of predicting gambling behavior outside the laboratory.
Study design The primary objective will be tested using a reward task and a facial emotion recognition task performed by participants in an fMRI scanner.
The secondary objective will be tested by combining fMRI measures with behavioral measures from everyday life collected via Ecological Momentary Assessment (EMA).
Study population This study will focus on individuals with gambling problems, as well healthy subjects with no gambling problems and no psychiatric comorbidities.
Outcomes/Endpoints
Primary endpoint:
We will compare striatum and amygdala reactivity between the three groups of impulsive gamblers, emotional gamblers and healthy subjects.
Secondary endpoint:
We will assess the correlation between emotional states and gambling behavior in everyday life, based on striatum and amygdala reactivity, using multiple linear regression models.
详细描述
Background Gambling addiction has often been conceptualized as the result of reward processing dysfunction in the brain, particularly in the striatum, a key structure of the reward system. Although a number of studies have provided support for this hypothesis, neuroimaging studies have produced inconsistent results, suggesting either hypo- or hyper-reactivity to rewards in gambling addiction. These inconsistencies have been the subject of intense debate, but remain unexplained to this day, hampering our understanding of the disease and the development of effective therapeutic strategies. The aim of this project is to test a new neurobiological model of gambling addiction that has the potential to reconcile these inconsistencies. A particular feature of this model is that it takes into account inter-individual differences, as well as the multifactorial nature of gaming addiction.
Objectives
Primary objective:
This project will test the hypothesis that there are two opposite brain phenotypes in gambling addiction: striatal hyper-reactivity to reward combined with amygdala hypo-reactivity to emotional stimuli, and striatal hypo-reactivity to reward combined with amygdala hyper-reactivity to emotional stimuli. The investigators further hypothesize that these two brain phenotypes characterize two distinct subpopulations of gamblers, so-called impulsive vs. emotional, respectively.
Secondary objective:
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •For all participants (gamblers and healthy subjects)
- •Aged between 18 and 65
- •Fluent French, read and spoken
- •Male and Female
- •Informed consent to take part in the research
- •For gamblers :
- •Number of DSM-5 critera for gambling disorder ≥3
- •Score ≥ 5 on the Problem Gambling Severity Index questionnaire (PGSI)
- •Have a smartphone
- •For healthy subjects :
- •no DSM-5 criteria for gambling addiction
- •Score ≤ 2 on the Problem Gambling Severity Index questionnaire (PGSI)
排除标准
- •For all participants (gamblers and healthy subjects):
- •Contra-indication to MRI
- •Protected Adults
- •Breast feeding or pregnant women
- •Neurological disorder or severe chronic illness (diabetes, heart disease, kidney disease, lung disease or liver disease, inflammatory disease....)
- •Pharmacological treatment with psychotropic action (>1 time / week)
- •Regular drug use (> 1 time/ week for at least 3 months in the last 6 months)
- •Positive urine drug test on the day of the MRI sessions
- •For gamblers:
- •Psychiatric treatment > 1 month (pharmacological or CBT)
- •Other DSM-5 diagnosis : schizophrenia, bipolar disorder, ADHD, autism, current PTSD, eating disorders, current major depressive episode, anxiety disorder, substance use disorder except nicotine, obsessive compulsive disorder.
- •For healthy subjects :
- •Any DSM-5 diagnosis except nicotine addiction
结局指标
主要结局
Striatal BOLD response to reward outcomes and amygdala BOLD response to emotional stimuli
时间窗: 4 weeks
Striatal BOLD response: average BOLD signal as measured with fMRI in the striatum in response to monetary reward outcomes in a gambling task. amygdala BOLD response: average BOLD signal as measured with fMRI in the amygdala in response to emotional faces in a facial emotion recognition task.
次要结局
- Correlation between emotional states and gambling behavior in everyday life(4 weeks)