Submission Type

Presentation

Submission Title

Exploring Testosterone as emerging Modulator of Risky choices and Impulsivity in Problem Gambling

Session Title

Session 2-2-A: Behavior and Detection

Location

Caesars Palace, Las Vegas, Nevada

Start Date

29-5-2019 11:00 AM

End Date

29-5-2019 12:25 PM

Disciplines

Behavior and Behavior Mechanisms | Medicine and Health Sciences | Mental Disorders | Neurosciences

Abstract

Growing evidence supports the mediating role of testosterone in risk taking decision making. Community studies show endogenous testosterone level is linked to high economic risk of stock trading and the Iowa-Gambling-Task performance scores. High testosterone levels in healthy male subjects are linked to increased risk taking under conditions of unknown probabilities. Impulsivity and faculty decision making underlie problem gambling(PG). We hypothesize that opiate substitution treatments in opiate use disorders(OUD) exert differential effects in suppressing testosterone and concurrently modify gambling and substance use craving. In our study, we recruited male OUD subjects maintained on :1)methadone, (MET),the prototypal mu-opiate receptor agonist(n=33);2)buprenorphine (BUP),mixed-mu-opiate agonist/kappa-antagonist,(n=31) attending the community-based OUD rehabilitation program. We compared plasma levels of free and total testosterone, prolactin, FSH and LH between BUP and MET groups and determined the prevalence of DSM V criteria :Gambling Disorder(GD):[SOGS(South Oaks Gambling Screen) >5]and craving measures of gambling, substance abuse craving and psychopathology. We found male subjects, MET suppressed free testosterone to a greater extent than BUP:[12.26 nmol/l vs 16.32 nmol/l). BUP group approached normal testosterone level. Gambling urge, smoking urge and alcohol urge are highly inter-related ( p < 0.05). Gambling urge correlated significantly (P < 0.05) with SCL-90(Symptom-Check-list) score of obsessive-compulsiveness in mixed male/female PG cohort (n=50). The findings of our study implicate that testosterone dysregulation underlies the link of OUD and GD , and explain the efficacy of naltrexone, opiate receptor antagonist, in blocking gambling craving through resetting opiate-testosterone signaling modulating behavioral and cognitive impulsivity ,decision- making and reward-punishment sensitivity in GD.

Keywords

Problem Gambling, testosterone, opiates, impulsivity, methadone, buprenorphine

Author Bio

The study if accepted will be presented by Ms. Autumn Carriere

Autumn Carriere graduated Bachelor of Arts: Honors-Kinesiology ,Western University ON. She designed a protocol to examine testosterone influence on the modulatory effects of neuromuscular system on aiming movements in a risky upper limb task and collaborated in testosterone study in gambling disorder. She is currently enrolled in B.Sc. program in nursing and has intense aspirations for medical career. She hopes to translate kinesiology in patient care by implementing exercise programs for disease prevention and rehabilitation.

Simon Chiu graduated with MD , M.Sc. (Kinesiology) ,PhD (neurosciences), Professor emeritus Western Univeristy ON and has become board certified in psychiatry with subspecialty certification in addiction psychiatry and geriatric psychiatry. He has worked as a clinician-investigator in USA and Canada conducting clinical and drug trials in cognition and neuro-psychiatric disorders and translational studies in neurodegenerative disorders, especially on psychiatric comorbidity of addiction disorders. He has mentored research and clinical trainees in biomedical sciences.

Investigators who participated in the study and in preparation of the abstract

Autumn Carriere B.A. (Honors: Kinesology), currently B.Sc.Nursing program, Nipissing University North Bay, ON, Canada

Simon S Chiu MD PhD FRCP, Department of Psychiatry,University of Western Ontario London ON; London Health Sciences Centre, London ON. Canada N6C 0A7

Zack Cernvosky PhD (Cert. Psychol) , Department of psychiatry, University of Western Ontario London ON Canada

Gupreeet Sidhu MD MRC(Psy), FRCP, Medical Director, Oxford Recovery clinic London ON Canada

Andrew Sadek MD, Research trainee, University of Western Ontario London ON. Canada.

Funding Sources

The study was funded partly from Lawson Health Research Institute, London ON Canada :seed grant on Gambling Disorder, and from the clnical practice of Dr Simon CHIU

Competing Interests

None of the investigators/co-investigators/collaborators receive any competing funding from pharmaceutical companies deemed as potential conflicts of interest.

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May 29th, 11:00 AM May 29th, 12:25 PM

Exploring Testosterone as emerging Modulator of Risky choices and Impulsivity in Problem Gambling

Caesars Palace, Las Vegas, Nevada

Growing evidence supports the mediating role of testosterone in risk taking decision making. Community studies show endogenous testosterone level is linked to high economic risk of stock trading and the Iowa-Gambling-Task performance scores. High testosterone levels in healthy male subjects are linked to increased risk taking under conditions of unknown probabilities. Impulsivity and faculty decision making underlie problem gambling(PG). We hypothesize that opiate substitution treatments in opiate use disorders(OUD) exert differential effects in suppressing testosterone and concurrently modify gambling and substance use craving. In our study, we recruited male OUD subjects maintained on :1)methadone, (MET),the prototypal mu-opiate receptor agonist(n=33);2)buprenorphine (BUP),mixed-mu-opiate agonist/kappa-antagonist,(n=31) attending the community-based OUD rehabilitation program. We compared plasma levels of free and total testosterone, prolactin, FSH and LH between BUP and MET groups and determined the prevalence of DSM V criteria :Gambling Disorder(GD):[SOGS(South Oaks Gambling Screen) >5]and craving measures of gambling, substance abuse craving and psychopathology. We found male subjects, MET suppressed free testosterone to a greater extent than BUP:[12.26 nmol/l vs 16.32 nmol/l). BUP group approached normal testosterone level. Gambling urge, smoking urge and alcohol urge are highly inter-related ( p < 0.05). Gambling urge correlated significantly (P < 0.05) with SCL-90(Symptom-Check-list) score of obsessive-compulsiveness in mixed male/female PG cohort (n=50). The findings of our study implicate that testosterone dysregulation underlies the link of OUD and GD , and explain the efficacy of naltrexone, opiate receptor antagonist, in blocking gambling craving through resetting opiate-testosterone signaling modulating behavioral and cognitive impulsivity ,decision- making and reward-punishment sensitivity in GD.