Gray Matter Volume Differences in Impulse Control and Addictive Disorders-An Evidence From a Sample of Heterosexual Males

Backgrounds: The classification of addictions and impulse control disorders is changing as reflected in the 11th version of International Classification of Disorders (WHO, 2018). However, studies focusing on direct comparison of structural brain differences in behavioral and substance addictions are limited. Aim: Here, we contrast gray matter volumes (GMVs) across groups of individuals with compulsive sexual behavior disorder (CSBD), gambling disorder (GD), and alcohol use disorder (AUD) with those with none of these disorders (healthy controls participants; HCs). Methods: Voxel-based morphometry was used to study brain structure, and severities of addiction symptoms were assessed with questionnaires. To identify brain regions related to severities of addictions, correlations between questionnaire scores and GMVs were computed. Main Outcome: We collected magnetic resonance imaging (GMVs) data from 26 patients with CSBD, 26 patients with GD, 21 patients with AUD, and 25 HC participants (all heterosexual males; age: 24-60; mean = 34.5, standard deviation = 6.48). Results: Affected individuals (CSBD, GD, AUD) compared with HC participants showed smaller GMVs in the left frontal pole, specifically in the orbitofrontal cortex. The most pronounced differences were observed in the GD and AUD groups, and the least in the CSBD group. In addition, a negative correlation was found between GMVs and disorder severity in the CSBD group. Higher severity of CSBD symptoms was correlated with decreased GMVs in the right anterior cingulate gyrus. Clinical Implications: Our findings suggest similarities between CSBD and addictions. Strenghs and Limitiations: This study is the first showing smaller GMVs in 3 clinical groups of CSBD, GD, and AUD. But the study was limited only to heterosexual men. Longitudinal studies should examine the extent to which ventral prefrontal decrements in volume may represent preexisting vulnerability factors or whether they may develop with disorder progression. Conclusions: Our research extends prior findings in substance use disorders of lower GMVs in prefrontal cortical volumes among 3 clinical groups of patients with specific impulse control (CSBD) and behavioral (GD) and substance (AUD) addictive disorders. The negative correlation between CSBD symptoms and GMV of right anterior cingulate gyrus suggests a link with clinical symptomatology. Copyright (C) 2020, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.