Previous imaging studies suggested that impairments of prefrontal-striatal and limbic circuits are correlated to excessive gambling. However, the neural underpinnings of gambling disorder (GD) continue to be the topic of debate. The present study aimed to identify structural changes in GD and differentiate the specific brain activity patterns associated with decision-making and reward-processing. We performed a systematic review complemented by Activation likelihood estimation (ALE) meta-analyses on morphometric and functional studies on neural correlates of GD. The ALE meta-analysis on structural studies revealed that patients with GD showed significant cortical grey-matter thinning in the right ventrolateral and ventromedial prefrontal cortex compared to healthy subjects. The ALE meta-analyses on functional studies revealed that patients with GD showed a significant hyperactivation in the medial prefrontal cortex and in the right ventral striatum during decision-making and gain processing compared to healthy subjects. These findings suggest that GD is related to an alteration of brain mechanisms underlying top-down control and appraisal of gambling-related stimuli and provided indications to develop new interventions in clinical practice.

先前的影像学研究表明前额纹状体和边缘回路的损害与过度赌博有关。但是，赌博疾病（GD）的神经基础仍然是争论的话题。本研究旨在确定GD的结构变化，并区分与决策和奖励处理相关的特定大脑活动模式。我们对GD神经相关的形态和功能研究进行了激活可能性估计（ALE）荟萃分析，并进行了系统的综述。ALE对结构研究的荟萃分析显示，与健康受试者相比，GD患者的右腹外侧和腹膜前额叶皮层显示出明显的皮质灰质变薄。对功能研究的ALE荟萃分析显示，与健康受试者相比，GD患者在决策和获得过程中，内侧前额叶皮层和右腹侧纹状体显示出明显的过度激活。这些发现表明，GD与自上而下控制和评估与赌博有关的刺激相关的脑机制的改变有关，并为临床实践中开发新的干预措施提供了指示。