With the number of people seeking treatment for gambling, consideration of individual vulnerabilities is extremely important. Gambling behaviour and its causes are described in many ways and all of them implicate different elements; individual, familial, social, economic, cultural and governmental.

Do we then have to consider which factors predispose or influence the development of a gambling problem? We are aware that many illnesses have co-morbid components of psychological dysfunction. For instance organic conditions such as lupus also have depression as a silent partner in the disease.

Parkinson’s disease is as yet an unquantifiable disease with little known about its antecedents, globally slowing its progression or effective treatment.

Some of the latest research by Braak, H., Rub, U., Gai, W.P., and Del Tredici, K. (2003) using autopsy analysis suggests that the earliest changes in Parkinson’s disease are found in the olfactory tubercle and cortex. Many different drugs are used to manage rather than "cure" the illness.

Amongst these drugs are dopamine agonists which have been implicated in the development of gambling behavior in sufferers of Parkinson’s disease.

Molina, J.A., Sainz-Artiga, M.J., Fraile, A., Jimenez-Jimenez, F.J.,Villanueva, C.,Orti-Pareja, M., and Bermejo, F. (2000) describe 12 patients presenting with both Parkinson ’s disease and problem gambling. Of the 12 patients 10 began gambling after the onset of the Parkinson ’s disease and subsequent treatment with levodopa. These authors suggest that the gambling could "represent a behavioural manifestation of pharmacologic treatment".

By contrast, Kurlan, R. (2004) reported on six patients with repetitive behaviours which included gambling. They discussed these behaviours occurring exclusively during motor on periods and often during the night. They believed the onset of these behaviours was not related to antiparkinsonian medication as changes to mediations did not improve the behaviours. They hypothesis that these repetitive behaviours are part of the underlying illness rather than caused by the medication.

Although some researchers have suggested a connection between obsessive compulsive symptoms and gambling the connection to Parkinson’s disease has only recently been considered. Maia, A.F., Pinto, A.S., Barbosa, E.R., Menezes, P.R., and Miguel, E.C. (2003)

when examining 100 patients with Parkinson’s disease with 100 individually matched controls found no higher incidence of Obsessive Compulsive Disorder, Obsessive Compulsive symptoms or related disorders. What they did discover was that "some Obsessive Compulsive symptoms had left side motor symptom predominance" in patient’s with Parkinson ’s disease, particularly for "symmetry and ordering/arranging" symptoms. These findings then suggest that the right hemisphere is likely to be involved in the functional expressions of some Obsessive Compulsive symptoms.

With these findings, we could perhaps then suggest the possibility that changes to the brain functioning of patients with Parkinson’s disease could offer us information about the neurological pathways to the development of gambling. Considered, more broadly the role of gambling as more a symptomatic expression of neurological changes.

Then in context with our original question perhaps these neurological changes predispose the individual to developing gambling problems.