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Sharma R, Weinstein AM. Recent treatment and novel imaging studies evaluating treatment of internet gaming disorder: a narrative review. Front Psychiatry 2024; 15:1408560. [PMID: 38938461 PMCID: PMC11210348 DOI: 10.3389/fpsyt.2024.1408560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/03/2024] [Indexed: 06/29/2024] Open
Abstract
Internet Gaming Disorder (IGD) is an emerging public health concern; effective treatments are still under development. This mini-review focuses on summarizing the main scientific evidence from psychological, pharmacological, brain imaging, and emerging treatment approaches for IGD. We searched PubMed and Scopus databases using keywords related to IGD and treatment. Cognitive behavioral therapy (CBT) is the most extensively researched psychological treatment for IGD, supported by several randomized controlled trials (RCTs). Other promising approaches include mindfulness, relapse prevention, abstinence protocols, and family therapy. Pharmacological treatments like bupropion and escitalopram have shown benefits, especially when IGD is comorbid with conditions like major depressive disorder. However, the quality of evidence is moderate for psychological interventions but low to moderate for pharmacological approaches. Emerging treatments such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and electro-acupuncture have demonstrated efficacy in reducing IGD symptoms and modulating brain activity. Brain imaging techniques like functional magnetic resonance imaging (fMRI) have provided insights into the neural mechanisms underlying IGD and treatment effects, although these studies lack randomized controlled designs. While multimodal approaches show promise, larger, well-designed RCTs are needed to establish effective IGD treatments.
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Affiliation(s)
- Rishi Sharma
- Department of Psychology, Ariel University, Ariel, Israel
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Penzkofer M, Daub J, Becker S, Flor H. Reduced reactivity to fear conditioning and pain tests in persons involved in violent video gaming is influenced by adverse childhood experiences. Psychophysiology 2024; 61:e14542. [PMID: 38462579 DOI: 10.1111/psyp.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/07/2024] [Accepted: 02/02/2024] [Indexed: 03/12/2024]
Abstract
Video gaming, including violent video gaming, has become very common and lockdown measures of the COVID-19 pandemic even increased the prevalence rates. In this study, we examined if violent video gaming is associated with more adverse childhood experiences (ACE) and if it impairs pain processing and fear conditioning. We tested three groups of participants (violent video gamers, nonviolent video gamers, and non-gamers) and examined fear conditioning as well as pain perception during functional magnetic resonance imaging (fMRI). Violent video gamers displayed significantly higher pain thresholds as well as pain tolerance for electric stimulation, pressure pain stimulation, and cold pressor pain measurements than nonviolent video gamers and non-gamers. This relationship was moderated by adverse childhood experiences, especially physical neglect. Brain images acquired during the fear conditioning fMRI task showed that violent video gamers display significantly less differential brain activation to stimuli signaling pain versus no pain in the anterior cingulate cortex, the juxtapositional lobule cortex, and the paracingulate gyrus compared to non-gamers. There was also a significant negative correlation between adverse childhood experiences and activation in the precuneus and the intracalcarine cortex for signals of pain versus safety. The results of this study imply that violent video gaming is related to reduced processing of pain and signals of pain in a fear learning task, dependent of adverse childhood experiences. These mechanisms need to be examined in more detail and these data could be helpful in preventing the onset and adverse consequences of violent video gaming.
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Affiliation(s)
- Maximilian Penzkofer
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Julia Daub
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Susanne Becker
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Clinical Psychology, Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Integrative Spinal Research, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Botelho ADO, Bernardo Ribeiro F, Soares Machado J, Souza DCBD. Functional connectivity alterations in individuals with gaming disorder assessed by functional magnetic resonance imaging: a systematic review. J Addict Dis 2024:1-8. [PMID: 38468374 DOI: 10.1080/10550887.2024.2322861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Neuroimaging has continually advanced, playing a crucial role in the accurate diagnosis of various brain pathologies and disorders. This integrative review aimed to identify the main changes in brain connections found in fMRI scans of individuals with Internet Gaming Disorder (IGD). The data collection method involved searching for the terms "Magnetic Resonance Imaging", "Psychological Dependence" and "Internet Addiction Disorder" in the PubMed and Embase databases. Studies published between 2020 and January 2023 were included and manually analyzed through the virtual environment created in the "Rayyan" software, compiling a total of 18 scientific studies. The main findings reveal changes such as significant increases or decreases in functional connectivity in certain regions of the brain. Some potential negative impacts on the uncontrolled use of technologies among the young population were evaluated, such as the loss of inhibitory control in decision-making, transforming leisure into dependence, and although the IGD understands the associated risks and harms, it faces difficulties in resisting the desire to stop playing. This situation emphasizes the need for more long-term studies that can be comparative between different age groups. Conclusion, the brain regions with the most significant changes in functional connectivity in individuals with IGD symptoms are the prefrontal cortex, fronto-parietal regions, frontal gyrus, insula lobe, cingulate cortex and striatum. The lack of comprehensive knowledge about the effects of video game addiction across different age groups is a significant concern. Therefore, it is essential to carry out research that evaluates the impact of these technologies on different stages of human development.
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Danielsen PA, Mentzoni RA, Låg T. Treatment effects of therapeutic interventions for gaming disorder: A systematic review and meta-analysis. Addict Behav 2024; 149:107887. [PMID: 37826910 DOI: 10.1016/j.addbeh.2023.107887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023]
Abstract
The prevalence of gaming disorder is assumed to be between 2%-5%. The treatment effect of different therapeutic interventions of gaming disorder has not been studied extensively. This systematic review and meta-analysis sought to identify all intervention studies on gaming disorder with a control group, determine the effect of the interventions, and examine moderators. Studies applying a therapeutic intervention and using an appropriate comparison group were identified by searching electronic databases, previous reviews, and reference lists. Data on type of treatment, name of outcome measurement, symptom level and other study characteristics were extracted and analyzed using meta-analysis and meta-regression. A total of 38 studies and 76 effect sizes, originating from 9524 participants were included. RoB2 and ROBINS-I risk of bias tools were used to assess within-study risk of bias. Correlational hierarchical models with robust variance estimation were fitted to effect size data and yielded a moderate summary estimate. Egger's sandwich test, funnel plot inspections, and other tests were conducted to assess risk of bias between studies. Results indicate that there may be an overall effect of therapeutic interventions for gaming disorder, but confidence in these findings is compromised by small-study effects, possible publication bias, a limited study pool, and a lack of standardization. The field needs more higher quality studies before the evidence-base can support reliable meta-analytic estimates.
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Affiliation(s)
- Paul A Danielsen
- Department of Psychology, UiT the Arctic University of Norway, Norway.
| | - Rune A Mentzoni
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Norway
| | - Torstein Låg
- University Library, UiT the Arctic University of Norway, Norway
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Mestre-Bach G, Potenza MN. Neural mechanisms linked to treatment outcomes and recovery in substance-related and addictive disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:75-91. [PMID: 37594217 PMCID: PMC10444012 DOI: 10.1080/19585969.2023.2242359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/19/2023]
Abstract
The present review focuses on potential neural mechanisms underlying recovery from psychiatric conditions characterised by impaired impulse control, specifically substance use disorders, gambling disorder, and internet gaming disorder. Existing treatments (both pharmacological and psychological) for these addictions may impact brain processes, and these have been evaluated in neuroimaging studies. Medication challenge and short-term intervention administration will be considered with respect to treatment utility. Main models of addiction (e.g., dual process, reward deficiency syndrome) will be considered in the context of extant data. Additionally, advanced analytic approaches (e.g., machine-learning approaches) will be considered with respect to guiding treatment development efforts. Thus, this narrative review aims to provide directions for treatment development for addictive disorders.
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Affiliation(s)
- Gemma Mestre-Bach
- Centro de Investigación, Transferencia e Innovación (CITEI), Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
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Mundorf A, Siebert A, Desmond JE, Peterburs J. The role of the cerebellum in internet gaming disorder-A systematic review. Addict Biol 2023; 28:e13331. [PMID: 37753565 PMCID: PMC10662475 DOI: 10.1111/adb.13331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/30/2023] [Accepted: 08/15/2023] [Indexed: 09/28/2023]
Abstract
Recent studies increasingly highlight involvement of the cerebellum in drug craving and addiction. However, its exact role, that is, whether the cerebellum is a critical component of a brain network underlying addictive behaviour, or whether it rather is a facilitator or mediator, is still unclear. Findings concerning the newly recognized internet gaming disorder (IGD) suggest that changes in cerebellar connectivity and functioning are associated with behavioural/non-substance addiction. Here, we systematically review the literature on IGD and cerebellar involvement following the PRISMA guidelines. A total of 13 neuroimaging studies met the inclusion criteria. Studies utilized a broad range of diagnostic instruments and resulting cut-off criteria, rendering it difficult to compare findings. Results on altered cerebro-cerebellar connectivity in patients with IGD are mixed; most studies report altered or increased functional connectivity. Moreover, decreased cerebellar grey matter volume is reported. Studies have further indicated that differential activation patterns in the cerebellum may enable discrimination between healthy subjects and subjects with IGD, even allowing for prediction of treatment outcomes. Given the strong connectivity between the cerebellum and cerebral regions, the cerebellum may act as an intermediary between regions involved in craving and addiction and consequently affect symptoms of IGD. Results suggest differential involvement of the cerebellar lobes, emphasizing a need for high-resolution parcellation of the cerebellum in future studies. However, the studies included in the present review have small sample sizes and include mostly male participants. Thus, results may have limited generalizability yet highlight a crucial role of the cerebellum in IGD that needs further investigation.
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Affiliation(s)
- Annakarina Mundorf
- Institute for Systems Medicine & Department of Human Medicine, MSH Medical School Hamburg, Germany
| | - Annabelle Siebert
- Institute for Systems Medicine & Department of Human Medicine, MSH Medical School Hamburg, Germany
| | - John E. Desmond
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jutta Peterburs
- Institute for Systems Medicine & Department of Human Medicine, MSH Medical School Hamburg, Germany
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Mestre-Bach G, Potenza MN. Neuroimaging correlates of internet gaming disorder: Can we achieve the promise of translating understandings of brain functioning into clinical advances? CANADIAN JOURNAL OF ADDICTION 2023; 14:7-17. [PMID: 38371925 PMCID: PMC10871672 DOI: 10.1097/cxa.0000000000000178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Objectives Here we aimed to consider the neural factors associated with internet gaming disorder (IGD), as well as the associations between these factors and existing treatments for the disorder. Methods A narrative review was conducted. Results Pharmacological as well as psychological treatments for IGD may be associated with specific changes in multiple brain areas and circuits. In particular, fronto-striatal and subcortical regions and pathways appear relevant to IGD and its treatment. Conclusions Neuroimaging holds promise for identifying specific mechanisms underlying IGD interventions. However, to date, firm conclusions are difficult to draw and more research examining neural mechanisms of empirically supported treatments for IGD is needed.
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Affiliation(s)
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA
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Diers M, Müller SM, Mallon L, Schmid AM, Thomas TA, Klein L, Krikova K, Stark R, Wegmann E, Steins-Loeber S, Brand M, Antons S. Cue-reactivity to distal cues in individuals at risk for gaming disorder. Compr Psychiatry 2023; 125:152399. [PMID: 37437451 DOI: 10.1016/j.comppsych.2023.152399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used. METHODS We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective. FINDINGS We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups. INTERPRETATION The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.
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Affiliation(s)
- Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany.
| | - Silke M Müller
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Lukas Mallon
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Anna M Schmid
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
| | - Tobias A Thomas
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Lena Klein
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Kseniya Krikova
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Clinical Psychology and Psychotherapy, University Siegen, Siegen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, Giessen, Germany; Bender Institute for Neuroimaging, Justus Liebig University, Giessen, Germany; Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Germany
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Stephanie Antons
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
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Mestre-Bach G, Potenza MN. Potential Biological Markers and Treatment Implications for Binge Eating Disorder and Behavioral Addictions. Nutrients 2023; 15:827. [PMID: 36839185 PMCID: PMC9962023 DOI: 10.3390/nu15040827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 02/08/2023] Open
Abstract
The reward system is highly relevant to behavioral addictions such as gambling disorder (GD), internet gaming disorder (IGD), and food addiction/binge eating disorder (FA/BED). Among other brain regions, the ventral striatum (VS) has been implicated in reward processing. The main objective of the present state-of-the-art review was to explore in depth the specific role of the VS in GD, IGD and FA/BED, understanding it as a possible biomarker of these conditions. Studies analyzing brain changes following interventions for these disorders, and especially those that had explored possible treatment-related changes in VS, are discussed. More evidence is needed on how existing treatments (both pharmacological and psychobehavioral) for behavioral addictions affect the activation of the VS and related circuitry.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 Logroño, Spain
| | - Marc N. Potenza
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, School of Medicine, Yale University, New Haven, CT 06510, USA
- Department of Neuroscience, School of Medicine, Yale University, New Haven, CT 06510, USA
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Wang ZL, Potenza MN, Song KR, Dong GH, Fang XY, Zhang JT. Subgroups of internet gaming disorder based on addiction-related resting-state functional connectivity. Addiction 2023; 118:327-339. [PMID: 36089824 DOI: 10.1111/add.16047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/31/2022] [Indexed: 01/05/2023]
Abstract
AIMS To identify subgroups of people with internet gaming disorder (IGD) based on addiction-related resting-state functional connectivity and how these subgroups show different clinical correlates and responses to treatment. DESIGN Secondary analysis of two functional magnetic resonance imaging (fMRI) data sets. SETTING Zhejiang province and Beijing, China. PARTICIPANTS One hundred and sixty-nine IGD and 147 control subjects. MEASUREMENTS k-Means algorithmic and support-vector machine-learning approaches were used to identify subgroups of IGD subjects. These groups were examined with respect to assessments of craving, behavioral activation and inhibition, emotional regulation, cue-reactivity and guessing-related measures. FINDINGS Two groups of subjects with IGD were identified and defined by distinct patterns of connectivity in brain networks previously implicated in addictions: subgroup 1 ('craving-related subgroup') and subgroup 2 ('mixed psychological subgroup'). Clustering IGD on this basis enabled the development of diagnostic classifiers with high sensitivity and specificity for IGD subgroups in 10-fold validation (n = 218) and out-of-sample replication (n = 98) data sets. Subgroup 1 is characterized by high craving scores, cue-reactivity during fMRI and responsiveness to a craving behavioral intervention therapy. Subgroup 2 is characterized by high craving, behavioral inhibition and activations scores, non-adaptive emotion-regulation strategies and guessing-task fMRI measures. Subgroups 1 and 2 showed largely opposite functional-connectivity patterns in overlapping networks. CONCLUSIONS There appear to be two subgroups of people with internet gaming disorder, each associated with differing patterns of brain functional connectivity and distinct clinical symptom profiles and gender compositions.
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Affiliation(s)
- Zi-Liang Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Department of Neuroscience and Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Kun-Ru Song
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, Zhejiang Province, China
| | - Xiao-Yi Fang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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Dong H, Zheng H, Wang M, Ye S, Dong GH. The unbalanced behavioral activation and inhibition system sensitivity in internet gaming disorder: Evidence from resting-state Granger causal connectivity analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110582. [PMID: 35661790 DOI: 10.1016/j.pnpbp.2022.110582] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/05/2022] [Accepted: 05/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Patients with behavioral or substance addiction show an unbalanced behavioral activation system (BAS) and behavioral inhibition system (BIS) sensitivity. However, the relationship between internet gaming disorder (IGD) and BAS/BIS is obscure and the neurobiological mechanism underlying this relationship remains unclear. METHODS We recruited 154 IGDs and 229 recreational game users (RGUs) in the current study. First, we explored the relationship between BAS/BIS and IGD. Second, subjects were subdivided into subgroups by BAS/BIS sensitivity. Third, whole-brain Granger causal connectivity (GCC) of striatum and amygdala subdivisions was estimated for the subgroup. Fourth, mediation analysis was performed to explore the role of connectivity in the relationship between IGD and BAS/BIS sensitivity. RESULTS We found the IGD group scored higher than the RGU on BIS and BASf (fun-seeking) sensitivity. Then, we identified 4 (2*2) subgroups: low/high risk of IGD with low/high BAS/BIS sensitivity groups. Two-way ANCOVA main results of interaction effects showed that in the high BAS/BIS group, the RGU exhibited increased strength in the GCC from the left putamen to the right cuneus, and the IGD exhibited decreased strength in the GCC from the right medial frontal gyrus to the caudate, from the left superior frontal gyrus to the centromedial amygdala, and from the right superior parietal lobule to the left laterobasal amygdala. Moreover, the GCC from the centromedial amygdala to the middle frontal gyrus mediated the directional relationship between BIS and IAT (Young's internet addiction test) scores. CONCLUSIONS The IGD individuals exhibited higher BIS and BAS-fun seeking sensitivity. Moreover, IGD with unbalanced BAS/BIS sensitivity exhibited alternative connectivity patterns involving amygdala and striatum subdivisions. These findings suggest a neurobiological mechanism for an alternation between IGD and RGU with different BAS/BIS sensitivity.
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Affiliation(s)
- Haohao Dong
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Wang
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Shuer Ye
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China
| | - Guang-Heng Dong
- Center for Cognition and Brain Disorders, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China; Institute of Psychological Science, Hangzhou Normal University, Hangzhou, Zhejiang Province, PR China.
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Yen JY, Chou WP, Liao HY, Ko CH. Comparing the Approaches and Validity of ICD-11 Criteria for Gaming Disorder and DSM-5 Criteria for Internet Gaming Disorder. CURRENT ADDICTION REPORTS 2022. [DOI: 10.1007/s40429-022-00459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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13
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Cheng S, Zhang X, Zheng H, Jiang N, Zhou J, Li X, Fang Y, Huang X, Liang J, Yin T, Liang F, Zeng F, Li Z. Efficacy prediction of acupuncture treatment for migraine without aura based on multimodal MRI: A study protocol. Front Neurol 2022; 13:953921. [PMID: 36299271 PMCID: PMC9589438 DOI: 10.3389/fneur.2022.953921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/14/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction Acupuncture is an effective and safe therapy for patients with migraine without aura (MwoA), but only 41–59% of patients show improvement with this treatment. Screening positive responders to acupuncture treatment for MwoA can ensure that healthcare resources can be appropriately targeted to specific patients who would most benefit. The objective of this study is to determine whether the structure and functional activity in certain brain regions can predict analgesia response in patients with MwoA who receive acupuncture treatment. Methods and analysis A total of 72 patients with MwoA and 72 healthy controls (HCs) will be enrolled in this study. Resting-state structural and functional magnetic resonance imaging (MRI) data will be collected from each participant at baseline. Patients with MwoA will undergo 12 sessions of acupuncture treatment for 8 weeks, twice per week in the first 4 weeks and once per week for the last 4 weeks. The follow-up will be 12 weeks. The number of days with migraine, frequency of migraine attacks, and average visual analog scale scores will be recorded in detail at weeks 0, 4, 8, 12, and 16 and at the end of follow-up (week 20). The positive response rate will be calculated as the proportion of patients with ≥50% reduction in the number of migraine days during follow-up compared with baseline. Machine learning methods will be applied to classify patients with MwoA and HCs and predict patients with response or non-response to acupuncture treatment based on multimodal MRI parameters, such as gray matter volume, regional homogeneity, amplitude of low-frequency fluctuation, fractional anisotropy, and mean diffusivity. Discussion This study aims to establish brain structural and functional characteristics that can identify patients with MwoA who will derive analgesia benefits from acupuncture treatment. Trial registration number http://www.chictr.org.cn/showproj.aspx?proj=65443, identifier: ChiCTR2100042915.
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Affiliation(s)
- Shirui Cheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyue Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huabin Zheng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Nannan Jiang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jun Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinling Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Fang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaopeng Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingtao Liang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Yin
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Fang Zeng
| | - Zhengjie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture and Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Zhengjie Li
| |
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