Episodic Tags Enhance Striatal Valuation Signals during Temporal Discounting in pathological Gamblers.

Similar to many addiction disorders, pathological gambling is associated with an increased preference for immediate rewards (steep temporal discounting). In healthy participants, episodic future thinking has been shown to reduce impulsivity during intertemporal choice. Here, we examine for the first time a modulation of temporal discounting via episodic future thinking in a group of pathological gamblers. We investigated a sample of 24 pathological gamblers and 24 matched healthy controls with functional magnetic resonance imaging (fMRI). Participants made intertemporal choices in two experimental conditions. In the control condition, delayed monetary rewards were offered with the respective amount and delay. In the episodic condition, rewards were additionally associated with participant-specific personal future events. We replicated previous findings of increased temporal discounting in pathological gambling. On a trend level, episodic future thinking attenuated discounting across all participants. We found that pathological gamblers could successfully recruit a prospection related network during decision-making in the presence of episodic information. The episodic condition modulated the functional connection between ventromedial prefrontal cortex (vmPFC) and ventral striatum, a mechanism that might support the increase in striatal value coding observed in the episodic condition in gamblers. However, in controls, but not in gamblers, valuation signal changes in the hippocampus were associated with less impulsive behavior. We provide first evidence that by episodic cues during intertemporal decision-making striatal valuation signals can be enhanced in pathological gamblers. Further research is needed to explore interventions that reliably reduce impulsive choice behavior in pathological gambling.