Decreased cognitive control over the urge to participate in gambling activities is a core feature of Gambling Disorder (GD).
Cognitive control can be differentiated into several cognitive sub-processes pivotal in GD clinical phenomenology, such as response inhibition, conflict monitoring, decision-making, and cognitive flexibility. This presentation aims to systematically describe fMRI studies, elaborating on the neural mechanisms underlying diminished cognitive control in GD. The impaired activity in prefrontal cortex may account for decreased cognitive control in GD, contributing to the progressive loss of control over gambling urges. Among prefrontal regions, orbital and ventromedial areas seem to be a possible nexus for sensory integration, value-based decision-making and emotional processing, thus contributing to both motivational and affective aspects of cognitive control. Finally, the possible therapeutic approaches aimed at the restoration of cognitive control in GD will be discussed, and pharmacological and brain stimulation treatments will be addressed.