Anticipation helps pathological gamblers hold out for larger-but-later rewards

Pathological gambling is a behavioral addiction associated with preference for a smaller but more immediate reward over a larger reward in the future. In the brain, the nucleus accumbens (NAcc) and ventromedial prefrontal cortex (vmPFC) are thought to encode how these rewards are valued.

Antonius Wiehler and colleagues presented 24 male pathological gamblers and 24 healthy men with a choice between an immediate monetary reward or a larger-but-delayed reward, while also reminding them of a future personal event such as an upcoming vacation. The researchers found that thinking about this future event might shift reward preference and its associated representation in the brain in the pathological gamblers. Brain activity while thinking about the future event was similar in both the pathological gamblers and healthy men. A correlation between decision-making and activity in the hippocampus was found only in healthy men, suggesting a possible role for this region in regulating impulsive behavior. These findings suggest interventions that enhance the value of future rewards may be effective in reducing impulsive decision-making in pathological gamblers.