Pathological gambling (PG) is classified as an “Impulse Control Disorder” in DSM-IV. However, researches on the brain’s re-ward process have revealed many commonalities between PG and substance-use disorders. Recent studies of Parkinson’s dis-ease (PD) have shed light on the mechanism underlying pathological gambling. PD is a progressive neurodegenerative disease primarily characterized by motor symptoms. However, another feature of PD which is receiving increasing attention is the phenomenon of impulse control disorders, such as pathological gambling. Gambling severity in PD was associated with a dysfunction of the brain network implicated in decision making, risk processing, and response inhibition. Continued gambling to re-cover previous losses (“loss-chasing”) is central to PG. Some people seem to have an internal governor that shuts off their de-sire to gamble, especially when they’re losing. Prospect theory proposes the hypothesis that people have a tendency to be risk-tolerant over losses while being generally risk averse over gains. Loss-chasing was associated with increased activity in cortical areas linked to incentive-motivation and an expectation of re-ward. By contrast, quitting was associated with decreased ac-tivity in these areas but increased activity in areas associated with anxiety and conflict monitoring. Serotonin and dopamine are considered to play complementary roles in the tendency to keep gambling in order to recover losses. This article reviews the neurochemial and neuroimaging research on PG.
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