PT  - JOURNAL ARTICLE
AU  - Alexander Genauck
AU  - Milan Andrejevic
AU  - Katharina Brehm
AU  - Caroline Matthis
AU  - Andreas Heinz
AU  - André Weinreich
AU  - Norbert Kathmann
AU  - Nina Romanczuk-Seiferth
TI  - Cue-induced effects on decision-making distinguish subjects with gambling disorder from healthy controls
AID  - 10.1101/564781
DP  - 2019 Jan 01
TA  - bioRxiv
PG  - 564781
4099  - http://biorxiv.org/content/early/2019/03/01/564781.short
4100  - http://biorxiv.org/content/early/2019/03/01/564781.full
AB  - While an increased impact of cues on decision-making has been associated with substance dependence, it is yet unclear whether this is also a phenotype of non-substance related addictive disorders, such as gambling disorder. To better understand the basic mechanisms of impaired decision-making in addiction, we investigated whether cue-induced changes in decision-making could distinguish gambling disorder (GD) from healthy control (HC) subjects. We expected that cue-induced changes in gamble acceptance and specifically in loss aversion would distinguish GD from HC subjects.30 GD subjects and 30 matched HC subjects completed a mixed gambles task where gambling and other emotional cues were shown in the background. We used machine learning and classification to carve out the importance of cue-dependency of decision-making and of loss aversion for distinguishing GD from HC subjects.Cross-validated classification yielded an area under the receiver operating curve (AUC-ROC) of 68.9% (p=0.002). Applying the classifier to an independent sample yielded an AUC-ROC of 65.0% (p=0.047). As expected, the classifier used cue-induced changes in gamble acceptance to distinguish GD from HC. Especially increased gambling during the presentation of gambling cues was characteristic of GD subjects. However, unexpectedly, cue-induced changes in loss aversion were irrelevant for distinguishing GD from HC subjects. To our knowledge, this is the first study to investigate the classificatory power of addiction-relevant behavioral task parameters when distinguishing GD from HC subjects. The results indicate that cue-induced changes in decision-making are a characteristic feature of addictive disorders, independent of a substance of abuse.