Associations Among the Opioid Receptor Gene (OPRM1) A118G Polymorphism, Psychiatric Symptoms, and Quantitative EEG in Korean Males with Gambling Disorder: A Pilot Study

Background and aims: A single nucleotide polymorphism of A118G (SNP; rs1799971) in the opioid receptor μ-1 (OPRM1) gene is a missense variant that influences the affinity of μ-opioid receptors. This study aimed to investigate the associations among the A118G polymorphism in the OPRM1 gene, psychiatric symptoms, and quantitative electroencephalography (qEEG) findings in patients with gambling disorder. Methods: Fifty-five male patients with gambling disorder aged between 18 and 65 years old participated in the study. The A118G polymorphism was genotyped into the AA, GA, and GG groups by the polymerase chain reaction/restriction fragment length polymorphism method. Resting-state qEEG was recorded with the eyes closed, and the absolute power of the delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–30 Hz) frequency bands was analyzed. Psychiatric symptoms, including depression, anxiety, impulsivity and severity of gambling, were assessed by a self-rating scale. Results: There were no significant differences in psychiatric symptoms among the three genotype groups (AA, GA, and GG). However, the frequency band power of qEEG showed significant differences among the three genotype groups. The absolute power of the beta and theta bands in the frontal lobe was higher in G allele carriers. Discussion and conclusion: Based on the findings of this study, the polymorphism in the OPRM1 gene might affect the neurophysiological process in patients with gambling disorder

Serum BDNF levels in patients with gambling disorder are associated with the severity of gambling disorder and Iowa Gambling Task indices

Background and aims Gambling disorder (GD) shares many similarities with substance use disorders (SUDs) in clinical, neurobiological, and neurocognitive features, including decision-making. We evaluated the relationships among, GD, decision-making, and brain-derived neurotrophic factor (BDNF), as measured by serum BDNF levels. Methods Twenty-one male patients with GD and 21 healthy sex- and age-matched control subjects were evaluated for associations between serum BDNF levels and the Problem Gambling Severity Index (PGSI), as well as between serum BDNF levels and Iowa Gambling Task (IGT) indices. Results The mean serum BDNF levels were significantly increased in patients with GD compared to healthy controls. A significant correlation between serum BDNF levels and PGSI scores was found when controlling for age, depression, and duration of GD. A significant negative correlation was obtained between serum BDNF levels and IGT improvement scores. Discussion These findings support the hypothesis that serum BDNF levels constitute a dual biomarker for the neuroendocrine changes and the severity of GD in patients. Serum BDNF level may serve as an indicator of poor decision-making performance and learning processes in GD and help to identify the common physiological underpinnings between GD and SUDs

Resting-state EEG activity related to impulsivity in gambling disorder

Background and aims Impulsivity is a core feature of gambling disorder (GD) and is related to the treatment response. Thus, it is of interest to determine objective neurobiological markers associated with impulsivity in GD. We explored resting-state electroencephalographic (EEG) activity in patients with GD according to the degree of impulsivity. Methods In total, 109 GD subjects were divided into three groups according to Barratt impulsiveness scale-11 (BIS-11) scores: high (HI; 25th percentile of BIS-11 scores, n = 29), middle (MI; 26th–74th percentile, n = 57), and low-impulsivity (LI) groups (75th percentile, n = 23). We used generalized estimating equations to analyze differences in EEG absolute power considering group (HI, MI, and LI), brain region (frontal, central, and posterior), and hemisphere (left, midline, and right) for each frequency band (delta, theta, alpha, beta, and gamma). Results The results indicated that GD patients in the HI group showed decreased theta absolute power, and decreased alpha and beta absolute power in the left, right, particularly midline frontocentral regions. Discussion and conclusions This study is a novel attempt to reveal impulsive features in GD by neurophysiological methods. The results suggest different EEG patterns among GD patients according to the degree of impulsivity, raising the possibility of neurophysiological objective features in GD and helping clinicians in treating GD patients with impulsive features

Gambling disorder in financial markets: Clinical and treatment-related features

Background and Aims To date, few studies have examined the clinical manifestation of disordered gamblers in financial markets. This study examined the differences in the clinical and treatment-related features of gambling disorder between financial markets and horse races. Methods Subjects who met the DSM-IV criteria for pathological gambling (PG) and who sought treatment were assessed by retrospective chart review. One hundred forty-four subjects were included in this sample, which consisted of the following groups: financial markets (n = 45; 28.6%) and horse races (n = 99; 71.4%). Results Multiple similar manifestations were found between the groups, including severity of PG, age of PG onset, amounts of gambling debts, drinking days per week, depressive mood, duration of seeking treatment after the onset of PG, and treatment follow-up duration. However, disordered gamblers who invested in the financial market were significantly more likely to be educated (p = 0.003), live with their spouses (p = 0.007), have full-time jobs (p = 0.006), and they were more likely to participate in the first type of gambling than the horse races group (p Discussion and Conclusions These findings suggest that disordered gamblers in financial markets show different socio-demographic, clinical and treatment-related features compared with the horse race gamblers, despite a similar severity of gambling disorder. Understanding these differential manifestations may provide insight into prevention and treatment development for specific types of gambling

EEG correlates associated with the severity of gambling disorder and serum BDNF levels in patients with gambling disorder

Background and aims This study aimed to evaluate the association between the severity of pathological gambling, serum brain-derived neurotrophic factor (BDNF) level, and the characteristics of quantitative electroencephalography (EEG) in patients with gambling disorder. Methods A total of 55 male patients aged 18–65 with gambling disorder participated. The severity of pathological gambling was assessed with the nine-item Problem Gambling Severity Index from the Canadian Problem Gambling Index (CPGI-PGSI). The Beck Depression Inventory and Lubben Social Network Scale were also assessed. Serum BDNF levels were assessed from blood samples. The resting-state EEG was recorded while the eyes were closed, and the absolute power of five frequency bands was analyzed: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), and gamma (30–50 Hz). Results Serum BDNF level was positively correlated with theta power in the right parietal region (P4, r = .403, p = .011), beta power in the right parietal region (P4, r = .456, p = .010), and beta power in the right temporal region (T8, r = .421, p = .008). Gambling severity (CPGI-PGSI) was positively correlated with absolute beta power in the left frontal region (F7, r = .284, p = .043) and central region [(C3, r = .292, p = .038), (C4, r = .304, p = .030)]. Conclusions These findings support the hypothesis that right-dominant lateralized correlations between BDNF and beta and theta power reflect right-dominant brain activation in addiction. The positive correlations between beta power and the severity of gambling disorder may be associated with hyperexcitability and increased cravings. These findings contribute to a better understanding of brain-based electrophysiological changes and BDNF levels in patients with pathological gambling

Similarities and differences among Internet gaming disorder, gambling disorder and alcohol use disorder: A focus on impulsivity and compulsivity

Background and aims: The aim of the present study was to test the impulsivities and compulsivities of behavioral addictions, including Internet gaming disorder (IGD) and gambling disorder (GD), by directly comparing them with alcohol use disorder (AUD) and a healthy control (HC) group. Methods: We enrolled male patients who were diagnosed with IGD, GD or AUD, with 15 patients per group, as well as 15 HCs. Trait impulsivity was measured using the Barratt Impulsiveness Scale version 11 (BIS-11). The stop-signal test (SST) from the Cambridge Neuro-psychological Test Automated Battery (CANTAB) was used to assess the patients’ abilities to inhibit prepotent responses. Compulsivity was measured using the intra–extra dimensional set shift (IED) test from the CANTAB. The Trail Making Test (TMT) was also used in this study. Results: The IGD and AUD groups scored significantly higher on the BIS-11 as a whole than did the HC group (p = 0.001 and p = 0.001, respectively). The IGD and AUD groups also scored significantly higher on the BIS-11 as a whole than did the GD group (p = 0.006 and p = 0.001, respectively). In addition, the GD group made significantly more errors (p = 0.017 and p = 0.022, respectively) and more individuals failed to achieve criterion on the IED test compared with the IGD and HC groups (p = 0.018 and p = 0.017, respectively). Discussion: These findings may aid in the understanding of not only the differences in categorical aspects between individuals with IGD and GD but also in impulsivity–compulsivity dimensional domains. Conclusion: Additional studies are needed to elucidate the neurocognitive characteristics of behavioral addictive disorders in terms of impulsivity and compulsivity

Comparison of risk and protective factors associated with smartphone addiction and Internet addiction

Background and Aims Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction. Methods College students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young’s Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State–Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor–Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses. Results The risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor was courage. Discussion These differences may result from unique features of smartphones, such as high availability and primary use as a tool for interpersonal relationships. Conclusions Our findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction

Changes of Functional MRI Findings in a Patient Whose Pathological Gambling Improved with Fluvoxamine

Legalized gambling is a growing industry, and is probably a factor in the presently increasing prevalence of pathological gambling. We present a case of a 36-year-old pathological gambler who was treated with fluvoxamine, a selective serotonin reuptake inhibitor, and who was assessed by functional MRI before and after drug administration. During activation periods, the pathological gambler was shown cards as stimuli, and fMRI results in several brain regions showed differential effects before and after medication and a maintenance period. This case demonstrates that the treatment response to fluvoxamine in a pathological gambler was observed not only by subjective self-report, but also by objective fMRI results. Therefore, fMRI may be a useful tool in the diagnosis and prediction of treatment response in patients afflicted with pathological gambling

Shared psychological characteristics that are linked to aggression between patients with Internet addiction and those with alcohol dependence

Background : Internet addiction (IA) is considered as one of behavioral addictions. Although common neurobiological mechanisms have been suggested to underlie behavioral addiction and substance dependence, few studies have directly compared IA with substance dependence, such as alcohol dependence (AD). Methods : We compared patients with IA, AD, and healthy controls (HC) in terms of the Five Factor Model of personality and with regard to impulsiveness, anger expression, and mood to explore psychological factors that are linked to aggression. All patients were treatment-seeking and had moderate-to-severe symptoms. Results : The IA and AD groups showed a lower level of agreeableness and higher levels of neuroticism, impulsivity, and anger expression compared with the HC group, which are characteristics related to aggression. The addiction groups showed lower levels of extraversion, openness to experience, and conscientiousness and were more depressive and anxious than the HCs, and the severity of IA and AD symptoms was positively correlated with these types of psychopathology. Conclusions : IA and AD are similar in terms of personality, temperament, and emotion, and they share common characteristics that may lead to aggression. Our findings suggest that strategies to reduce aggression in patients with IA are necessary and that IA and AD are closely related and should be dealt with as having a close nosological relationship.This work was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health and Welfare, Republic of Korea (HI12C-0113-020013).Peer Reviewe

Airway obstruction by extrinsic tracheal compression during spinal surgery under prone position -A case report-

Tracheal compression by vascular anomalies in adults is uncommon and most related reports are of children. A 79-year-old woman without any respiratory history underwent a lumbar spine surgery under general anesthesia. She suddenly developed airway obstruction after a position change from supine to prone. A fiberoptic bronchoscopy showed the obstruction of endotracheal tube. The obstruction was relieved after we changed the depth of endotracheal tube and supported the patient's neck with a cotton roll. The surgery ended without any other event and the patient recovered safely. A computed tomography revealed the rightward tracheal deviation and tortuous innominate artery contact with trachea. The patient didn't manifest any respiratory related symptoms during postoperative period, and she was discharged without any treatment