병적도박의 신경생물학

Neurobiology of Pathological Gambling

As gambling becomes available to more and more individuals in this country, the problems of compulsive or pathological gambling are being also increased. Despite relatively high prevalence rates and significant morbidity and mortality associated with pathological gambling (PG), our understanding of the neurobiological basis of PG lags considerably than most of other psychiatric illness for comparable magnitude. Although studies of the neurobiological studies of PG are just beginning, a number of interesting observations have been made and are reviewed in this article. Studies have shown that a number of different neurotransmitters are affected in pathological gamblers and the genetic factors play a role in this regard. Similarities in decision-making behavior between PG patients and patients with ventromedial prefrontal cortex lesions suggest a possible implication of these areas in the pathophysiology of this disorder, as in obsessive-compulsive disorder, in which the decision-making impairment is significantly associated with response to serotonin reuptake inhibitor treatment. Nevertheless, several studies have shown that decision-making function is also impaired in drug addicted patients. These findings both challenge current conceptualization of addictions and provide a substantial basis of knowledge on which to design investigations into the understanding and treatment of PG. An improved understanding of the neurobiology of PG would facilitate targeted investigations into more effective treatments.