Altered functional connectivity in default mode network in Internet gaming disorder: Influence of childhood ADHD

The role of the cerebellum in internet gaming disorder-A systematic review

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.

Online Behavioral Addictions Among Adolescents Before and After the COVID-19 Pandemic

Background The COVID-19 pandemic changed people's lives and created a "new normal." It threatened individuals' mental health owing to reduced physical activity and social interaction, excessive indoor time, financial hardship, and insecurity. Moreover, the risk of online behavioral addiction increased in the general population, particularly among adolescents. The present study examined the differences between the pre-and post-pandemic periods regarding online behavioral addictions in adolescents. Methods The pre-pandemic data were obtained from 175 adolescents (August 2019 to February 2020) (T1). An online survey was sent to these participants to obtain the post-pandemic data (March to September 2022) (T2). Seventy participants completed the online survey (response rate: 40%). The participants completed the Smartphone Addiction Scale (SAS), the Internet Gaming Disorder Scale 9-Short Form (IGDS9-SF), and the Social Media Disorder Scale-Short Form (SMDS-SF) both before and after the pandemic. Results  Before the pandemic, females had significantly higher SMDS-SF scores compared to males (p = 0.005). On the other hand, males had higher IGDS9-SF scores than females before the pandemic (p<.001). Individuals with attention deficit hyperactivity disorder (ADHD) had higher IGDS9-SF scores before the pandemic than those with depressive disorders or other diagnoses (p = 0.004). However, the primary diagnosis was not related to pre-pandemic SAS and SMDS-SF scores. Lastly, there was no significant difference in IGDS9-SF (p = 0.151), SMDS-SF (p = 0.200), or SAS scores (p = 0.413) between pre-pandemic and post-pandemic scores. Conclusion Although the current study did not support this view, in emotionally challenging times, people may spend more time on online activities, which can lead to behavioral addiction. It is important for parents to monitor their children's online activities and provide guidance. More research is needed to compare online behavioral addictions before and after the pandemic.

Gaming disorder: A summary of its characteristics and aetiology

The emergence, development, and maintenance of gaming disorder (GD) is the result of an interplay between gaming-related factors, individual factors, and environmental factors. None of these alone are sufficient to cause a disordered state, but it is the interactive co-occurrence of all these factors, which in some cases leads to GD. The goal of the present paper is to discuss in detail these three factors based on relevant and recent findings of the literature. Among gaming-related factors, we discuss online vs. offline videogames, the role of game genres, structural characteristics, game design elements, as well as some important monetization techniques. Among individual factors demographic risk factors, personality traits, motivational factors, comorbid psychopathology, genetic predisposition, and neurobiological processes are considered. Finally, among environmental factors we discuss family factors, early life experiences, the role of peers and school-related factors, as well as the broader context of culture including the popularity of esports.

Dynamic functional connectivity changes of resting-state brain network in attention-deficit/hyperactivity disorder

Patients with attention-deficit/hyperactivity disorder (ADHD) have shown abnormal functional connectivity and network disruptions at the whole-brain static level. However, the changes in brain networks in ADHD patients from dynamic functional connectivity (DFC) perspective have not been fully understood. Accordingly, we executed DFC analysis on resting-state fMRI data of 25 ADHD patients and 27 typically developing (TD) children. A sliding window and Pearson correlation were used to construct the dynamic brain network of all subjects. The k-means+ + clustering method was used to recognize three recurring DFC states, and finally, the mean dwell time, the fraction of time spent for each state, and graph theory metrics were quantified for further analysis. Our results showed that ADHD patients had abnormally increased mean dwell time and the fraction of time spent in state 2, which reached a significant level (p < 0.05). In addition, a weak correlation between the default mode network was associated in three states, and the positive correlations between visual network and attention network were smaller than TD in three states. Finally, the integration of each network node of ADHD in state 2 is more potent than that of TD, and the degree of node segregation is smaller than that of TD. These findings provide new evidence for the DFC study of ADHD; dynamic changes may better explain the developmental delay of ADHD and have particular significance for studying neurological mechanisms and adjuvant therapy of ADHD.

Methadone maintenance treatment alters couplings of default mode and salience networks in individuals with heroin use disorder: A longitudinal self-controlled resting-state fMRI study

Background

Methadone maintenance treatment (MMT) is a common treatment for heroin use disorder (HUD). Although individuals with HUD have been reported to show impaired coupling among the salience network (SN), executive control network (ECN), and default mode network (DMN), the effects of MMT on the coupling among three large-scale networks in individuals with HUD remains unclear.

Methods

Thirty-seven individuals with HUD undergoing MMT and 57 healthy controls were recruited. The longitudinal one-year follow-up study aimed to evaluate the effects of methadone on anxiety, depression, withdrawal symptoms and craving and number of relapse, and brain function (SN, DMN and bilateral ECN) in relation to heroin dependence. The changes in psychological characteristics and the coupling among large-scale networks after 1 year of MMT were analyzed. The associations between the changes in coupling among large-scale networks and psychological characteristics and the methadone dose were also examined.

Results

After 1 year of MMT, individuals with HUD showed a reduction in the withdrawal symptom score. The number of relapses was negatively correlated with the methadone dose over 1 year. The functional connectivity between the medial prefrontal cortex (mPFC) and the left middle temporal gyrus (MTG; both key nodes of the DMN) was increased, and the connectivities between the mPFC and the anterior insular and middle frontal gyrus (key nodes of the SN) were also increased. The mPFC-left MTG connectivity was negatively correlated with the withdrawal symptom score.

Conclusion

Long-term MMT enhanced the connectivity within the DMN which might be related to reduced withdrawal symptoms, and that between the DMN and SN which might be related to increase in salience values of heroin cues in individuals with HUD. Long-term MMT may be a double-edged sword in treatment for HUD.

The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses

BACKGROUND

As a spreading addictive behaviour in recent years, internet gaming disorder (IGD) has been studied a lot and the overall research results indicate that IGD has a high prevalence among adolescents and young adults (AYAs). To update the status quo of prevalence, it is necessary to conduct comprehensive analyses.

METHODS

On the premise of following the PRISMA statement, the study conducted two systematic reviews and meta-analyses to assess the global prevalence of IGD among AYAs and identify its possible risk factors. To achieve the goals, PubMed and CNKI databases were used to select the concerned studies published up to May 31, 2021. Heterogeneity was assessed using a funnel plot, Begg's test, Egger's test, and trim-and-fil method, followed by sensitivity analysis, subgroup analysis, and meta-regression analysis.

RESULTS

For the meta-analysis of prevalence, 407,620 participants from 155 reports in 33 countries were included. The pooled prevalence of IGD among AYAs was 9.9% (95% CI: 8.6%-11.3%, P = 0.000, I² = 94.4%), including 8.8% (95% CI: 7.5%-10.0%) among adolescents and 10.4% (95% CI: 8.8%-11.9%) among young adults. The following 12 factors are the possible risk factors of IGD among AYAs, which are stress, long average game time, family dysfunction, poor academic performance, being bullied, bullying, interpersonal problems, hyperactivity/inattention, anxiety, depression, emotional distress and low self-esteem.

CONCLUSIONS

This study confirms the prevalence and possible risk factors for IGD among AYAs. It's valuable in understanding the threat of IGD and finding intervention strategies for IGD among AYAs.

Altered large-scale brain network interactions associated with HIV infection and error processing

Altered activity within and between large-scale brain networks has been implicated across various neuropsychiatric conditions. However, patterns of network dysregulation associated with human immunodeficiency virus (HIV), and further impacted by cannabis (CB) use, remain to be delineated. We examined the impact of HIV and CB on resting-state functional connectivity (rsFC) between brain networks and associations with error awareness and error-related network responsivity. Participants (N = 106), stratified into four groups (HIV+/CB+, HIV+/CB-, HIV-/CB+, HIV-/CB-), underwent fMRI scanning while completing a resting-state scan and a modified Go/NoGo paradigm assessing brain responsivity to errors and explicit error awareness. We examined separate and interactive effects of HIV and CB on resource allocation indexes (RAIs), a measure quantifying rsFC strength between the default mode network (DMN), central executive network (CEN), and salience network (SN). We observed reduced RAIs among HIV+ (vs. HIV-) participants, which was driven by increased SN-DMN rsFC. No group differences were detected for SN-CEN rsFC. Increased SN-DMN rsFC correlated with diminished error awareness, but not with error-related network responsivity. These outcomes highlight altered network interactions among participants with HIV and suggest such rsFC dysregulation may persist during task performance, reflecting an inability to disengage irrelevant mental operations, ultimately hindering error processing.

ANKK1 and TH gene variants in combination with paternal maltreatment increase susceptibility to both cognitive and attentive impulsivity

Recent scientific findings suggest that dopamine exerts a central role on impulsivity, as well as that aversive life experiences may promote the high levels of impulsivity that often underlie violent behavior. To deepen our understanding of the complex gene by environment interplay on impulsive behavior, we genotyped six dopaminergic allelic variants (ANKK1-rs1800497, TH-rs6356, DRD4-rs1800955, DRD4-exonIII-VNTR, SLC6A3-VNTR and COMT-rs4680) in 655 US White male inmates convicted for violent crimes, whose impulsivity was assessed by BIS-11 (Barratt Impulsiveness Scale). Furthermore, in a subsample of 216 inmates from the whole group, we also explored the potential interplay between the genotyped dopaminergic variants and parental maltreatment measured by MOPS (Measure of Parental Style) in promoting impulsivity. We found a significant interaction among paternal MOPS scores, ANKK1-rs1800497-T allele and TH-rs6356-A allele, which increased the variance of BIS-11 cognitive/attentive scores explained by paternal maltreatment from 1.8 up to 20.5%. No direct association between any of the individual genetic variants and impulsivity was observed. Our data suggest that paternal maltreatment increases the risk of attentive/cognitive impulsivity and that this risk is higher in carriers of specific dopaminergic alleles that potentiate the dopaminergic neurotransmission. These findings add further evidence to the mutual role that genetics and early environmental factors exert in modulating human behavior and highlight the importance of childhood care interventions.

Altered resting-state functional connectivity of the dorsal anterior cingulate cortex with intrinsic brain networks in male problematic smartphone users

The excessive use of smartphones is associated with various medical complications and mental health problems. However, existing research findings on neurobiological mechanisms behind problematic smartphone use are limited. In this study, we investigated functional connectivity in problematic smartphone users, focusing on the default mode network (DMN) and attentional networks. We hypothesized that problematic smartphone users would have alterations in functional connectivity between the DMN and attentional networks and that such alterations would correlate with the severity of problematic smartphone use. This study included 30 problematic smartphone users and 35 non-problematic smartphone users. We carried out group independent component analysis (group ICA) to decompose resting-state functional magnetic resonance imaging (fMRI) data into distinct networks. We examined functional connectivity using seed-to-seed analysis and identified the nodes of networks in group ICA, which we used as region of interest. We identified greater functional connectivity of the dorsal anterior cingulate cortex (dACC) with the ventral attention network (VAN) and with the DMN in problematic smartphone users. In seed-to-seed analysis, problematic smartphone users showed atypical dACC-VAN functional connectivity which correlated with the smartphone addiction proneness scale total scores. Our resting-state fMRI study found greater functional connectivity between the dACC and attentional networks in problematic smartphone users. Our findings suggest that increased bottom-up and interoceptive attentional processing might play an important role in problematic smartphone use.

Gaming Disorder Seen Through the Prism of Dual Diagnosis: Prevalence and Associated Factors

INTRODUCTION

Dual diagnosis (DD) is defined as the co-occurrence of at least a psychiatric disorder and at least an addictive disorder. Most studies about DD considered substance use disorders. In 2018, gaming disorder (GD) was recognized as a formal disorder and integrated into the category of addictive disorders in the 11th version of the International Classification of Diseases. Our objectives were to measure DD prevalence among GD patients and to assess factors associated with the presence of DD.

METHODS

As part of the EVALuation of behavioral ADDictions (EVALADD) cohort, 92 patients with GD were included in the present study. Psychiatric disorders, including anxiety, mood, and psychotic disorders, were explored with the Mini International Neuropsychiatric Interview (MINI 5.0.0). Probable adult attention-deficit/hyperactivity disorder (ADHD) was screened with the Wender Utah Rating Scale (WURS) in childhood and with the ADHD Self-Report Scale-V1.1 (ASRS) in adulthood. Finally, personality was assessed using the 125-item version of the Temperament and Character Inventory (TCI-125), motives for gaming with the Videogame Motives Questionnaire (VMQ) and attachment styles with the Relationship Scales Questionnaire (RSQ). To measure the prevalence of DD among GD patients, we considered the occurrence of current GD with current anxiety, mood, or psychotic disorders, or with probable current ADHD. We also performed a multivariate analysis to identify independent factors associated with DD.

RESULTS

More than half (55.4%) of GD patients suffered from DD. We found a high prevalence of probable ADHD (38%) and anxiety disorders (29% suffering from generalized anxiety disorder, social, agoraphobia or panic disorder). Four variables were significantly associated with DD: suicidal thoughts [odds ratio (OR) = 6.83, 95% confidence interval (95%CI) (1.66-28.09)], VMQ "coping" scores [OR = 1.18, 95%CI (1.01-1.38)], TCI-125 "harm avoidance" scores [OR = 1.04, 95%CI (1.01-1.07)] and "novelty seeking" scores [OR = 1.03, 95%CI (1.00-1.06)].

DISCUSSION

The prevalence of certain psychiatric disorders among GD patients far exceeded that observed in the general population. Both ADHD and suicidal ideations should particularly be screened among GD patients. Specific interventions targeting personality dimensions associated with DD but also on the management of negative affect should represent new treatment opportunities.

Large-scale network dysfunction in youths with Internet gaming disorder: a meta-analysis of resting-state functional connectivity studies

Internet gaming disorder (IGD) has been defined as a specific behavioral disorder, associated with abnormal interactions among large-scale brain networks. Researchers have sought to identify the network dysfunction in IGD using resting-state functional connectivity (rsFC). However, results across studies have not reached an agreement yet and the mechanism remains unclear. The present research aimed to investigate network dysfunction in IGD through a meta-analysis of rsFC studies. Twenty-two seed-based voxel-wise rsFC studies from 25 publications (594 individuals with IGD and 496 healthy controls) were included. By categorizing seeds into seed-networks based on their location within a prior functional network parcellations, we performed a Multilevel kernel density analysis (MKDA) within each seed-network to identify which brain systems showed abnormal interaction with particular seed-network in individuals with IGD. Compared to healthy control groups, individuals with IGD exhibited significant hypoconnectivity within the default mode network, and enhanced connectivity between the default mode network and insula within the ventral attention network. IGD was also associated with increased connectivity between the ventral attention network and somatomotor regions. Furthermore, the IGD groups showed hyperconnectivity between the limbic network and regions of the frontoparietal network. The results suggest that individuals with IGD show large-scale functional network alteration which underpins their core symptoms including poor emotional competence, cue-reactivity and craving, habitual addictive behaviors and impaired executive control. Whether the compensation mechanism exists in IGD is discussed, and further research is needed. The findings provide a neurocognitive network model of IGD, which may serve as functional biomarkers for IGD and have potentials for development of effective diagnosis and therapeutic interventions.

Resting-state connectome-based support-vector-machine predictive modeling of internet gaming disorder

Internet gaming disorder (IGD), a worldwide mental health issue, has been widely studied using neuroimaging techniques during the last decade. Although dysfunctions in resting-state functional connectivity have been reported in IGD, mapping relationships from abnormal connectivity patterns to behavioral measures have not been fully investigated. Connectome-based predictive modeling (CPM)-a recently developed machine-learning approach-has been used to examine potential neural mechanisms in addictions and other psychiatric disorders. To identify the resting-state connections associated with IGD, we modified the CPM approach by replacing its core learning algorithm with a support vector machine. Resting-state functional magnetic resonance imaging (fMRI) data were acquired in 72 individuals with IGD and 41 healthy comparison participants. The modified CPM was conducted with respect to classification and regression. A comparison of whole-brain and network-based analyses showed that the default-mode network (DMN) is the most informative network in predicting IGD both in classification (individual identification accuracy = 78.76%) and regression (correspondence between predicted and actual psychometric scale score: r = 0.44, P < 0.001). To facilitate the characterization of the aberrant resting-state activity in the DMN, the identified networks have been mapped into a three-subsystem division of the DMN. Results suggest that individual differences in DMN function at rest could advance our understanding of IGD and variability in disorder etiology and intervention outcomes.

Sex difference in neural responses to gaming cues in Internet gaming disorder: Implications for why males are more vulnerable to cue-induced cravings than females

BACKGROUND

Although drug addiction studies have shown that females are more likely to become addicted and sensitive to drug cues, this feature seems reversed in Internet gaming disorder (IGD), of which males are more likely to be sufferers. Given the prevalence of IGD in the male population, the current study was set to examine the potential effect of sex on IGD's craving using a cue reactivity task.

METHODS

Sixty-five (32 males) IGD subjects underwent fMRI scanning during exposure to visual gaming cues and neutral cues. Brain responses to gaming cues relative to neutral cues were examined within two groups separately. In addition, Granger causal analysis (GCA) was conducted to investigate how the effective connectivity patterns were altered in male and female IGD subjects.

RESULTS

When facing gaming cues, lower regions of brain activation were observed in males compared to females, including the left anterior cingulate cortex (ACC), the superior frontal gyrus and the posterior cingulate cortex (PCC); GCA results, using the PCC as the ROI, showed higher middle temporal gyrus-PCC-right ACC/parahippocampal gyrus effective connectivity in males as compared with females, when exposed to gaming cues.

CONCLUSION

The results indicate that gaming cues could more severely disturb male IGD subjects' inhibition control function over game-elicited cravings compared to females, which might make it hard for males to control their game cravings and stop their gaming behaviors. This conclusion is valuable in understanding why males are more vulnerable to IGD than females.

A Review of the Default Mode Network in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

Functional magnetic resonance imaging (fMRI) has been widely used to examine the relationships between brain function and phenotypic features in neurodevelopmental disorders. Techniques such as resting-state functional connectivity (FC) have enabled the identification of the primary networks of the brain. One fMRI network, in particular, the default mode network (DMN), has been implicated in social-cognitive deficits in autism spectrum disorders (ASD) and attentional deficits in attention deficit hyperactivity disorder (ADHD). Given the significant clinical and genetic overlap between ASD and ADHD, surprisingly, no reviews have compared the clinical, developmental, and genetic correlates of DMN in ASD and ADHD and here we address this knowledge gap. We find that, compared with matched controls, ASD studies show a mixed pattern of both stronger and weaker FC in the DMN and ADHD studies mostly show stronger FC. Factors such as age, intelligence quotient, medication status, and heredity affect DMN FC in both ASD and ADHD. We also note that most DMN studies make ASD versus ADHD group comparisons and fail to consider ASD+ADHD comorbidity. We conclude, by identifying areas for improvement and by discussing the importance of using transdiagnostic approaches such as the Research Domain Criteria (RDoC) to fully account for the phenotypic and genotypic heterogeneity and overlap of ASD and ADHD.

Associations Between Attention Deficit/Hyperactivity Disorder and Internet Gaming Disorder Symptoms Mediated by Depressive Symptoms and Hopelessness Among College Students

PURPOSE

The mediating role of depressive symptoms and hopelessness on the relationship between attention deficit/hyperactivity disorder (ADHD) and internet gaming disorder (IGD) symptoms has not yet been elucidated. This study assessed this mediating effect in college students.

PARTICIPANTS AND METHODS

Participants consisted of 1236 freshmen recruited at a local university. Symptoms of ADHD, IGD, depression and hopelessness were measured using self-report scales. The effect of ADHD on IGD mediated by depression and hopelessness was analyzed by Haye's PROCESS macro for SPSS (Model 6) using the bias-corrected percentile bootstrap method with 5000 bootstrapped samples.

RESULTS

Symptoms of ADHD, depression and hopelessness were common in college students and were strongly associated with the appearance of IGD symptoms. ADHD symptoms of college students impacted their IGD symptoms directly and indirectly via depressive symptoms and hopelessness. The total effect of ADHD symptoms on IGD symptoms was 0.075 (standard error [SE]: 0.009, 95% confidence interval [CI] 0.057, 0.093), with a direct effect of 0.037 (SE: 0.010, 95% CI 0.018, 0.056, effect ratio: 49.3%), and total indirect effect was 0.038 (SE: 0.005, 95% CI 0.029, 0.050, effect ratio: 50.7%).

CONCLUSION

Depressive symptoms and hopelessness can mediate the relationship between ADHD and IGD symptoms among college students. These findings point to the importance of evaluating ADHD, depressive and hopelessness symptoms for the prevention and treatment of adult IGD.

Dorsal striatal functional connectivity changes in Internet gaming disorder: A longitudinal magnetic resonance imaging study

Internet gaming disorder (IGD) is a behavioral addiction involving excessive online game use despite negative psychosocial consequences. Unrestricted online gaming may lead to changes in striatal activity and the relationship between the striatum and other cortical regions. This study investigated structural and functional abnormalities involving the striatum through longitudinal follow-up magnetic resonance imaging (MRI) assessments. Eighteen young males with IGD (mean age: 23.8 ± 2.0 years) and 18 controls (mean age: 23.9 ± 2.7 years) were evaluated. Subjects were reassessed ≥1 year after the first visit (mean follow-up duration: 22.8 ± 6.7 months), using voxel-based morphometry and seed-based resting-state functional connectivity (FC) analyses in seed regions of the dorsal and ventral striatum. Subjects with IGD had smaller gray matter volume (GMV) in the anterior/middle cingulate cortex compared with controls during initial and follow-up assessments. They exhibited decreased FC between the left dorsal putamen and left medial prefrontal cortex (mPFC) compared with controls. They exhibited increased FC strength between the right dorsal putamen and right middle occipital gyrus (MOG) during follow-up. Subjects with IGD showed a significant correlation between changes in the dorsal putamen-MOG FC and gaming time per day. Young males with IGD showed an altered FC pattern in the dorsal striatum during follow-up. FC of the dorsal striatum in IGD increased in the mPFC and decreased in the MOG. These findings showed that IGD was accompanied by weakening of prefrontal control and strengthening of the sensorimotor network, suggesting that uncontrolled gaming may be related with functional neural changes in the dorsal striatum.

Neurobiological influence of comorbid conditions in young patients diagnosed with gaming disorder: A whole-brain functional connectivity study based on a data driven method

Gaming disorder, which is characterized by multiple cognitive and behavioral symptoms, often has comorbid psychiatric conditions such as depression and attention-deficit hyperactivity disorder. Neurobiological effects of the comorbid disorders so far reported are not converging, exhibiting positive and negative alterations of the connectivity in brain networks. In this study, we conducted resting-state functional magnetic-resonance imaging and whole brain functional connectivity analyses for young participants consisting of 40 patients diagnosed with the gaming disorder, with and without comorbid conditions, and 29 healthy controls. Compared to healthy controls, the gaming disorder-alone patients had partially diminished connectivities in the reward system and executive control network, within which there existed central nodes that served as a hub of diminished connections. In the gaming disorder patients who had comorbidity of autism spectrum disorder, the diminished connections were enlarged, with alteration of the hub nodes, to the entire brain areas involved in the reward system including cortical, subcortical and limbic areas that are crucial for reward processing, and to the whole cortical areas composing the executive control network. These observations suggest that the neurodevelopmental condition coexisting with the gaming disorder induced substantial impairment of the neural organizations associated with executive/cognitive and emotional functions, which are plausibly causal to the behavioral addiction, by rearranging and diminishing functional connectivities in the network.

Associations Between Altered Cerebral Activity Patterns and Psychosocial Disorders in Patients With Psychogenic Erectile Dysfunction: A Mediation Analysis of fMRI

Previous studies had illustrated the significant neural pathological changes in patients with psychogenic erectile dysfunction (pED), while few works focused on the neural underpinning of the psychosocial status in patients with pED. This study aimed to investigate the associations among the altered cerebral activity patterns, impaired erectile function, and the disrupted psychosocial status in patients with pED. Thirty-two patients with pED and 28 healthy controls (HCs) were included. The amplitude of low-frequency fluctuations (ALFF), region-of-interest-based functional connectivity (FC), as well as Pearson correlation analyses and mediation analyses between neuroimaging outcomes and clinical outcomes were performed. Compared to HCs, patients with pED manifested lower erectile function, disrupted psychosocial status, as well as decreased ALFF in the left dorsolateral prefrontal cortex (dlPFC) and reduced FC between the left dlPFC and left angular gyrus, and left posterior cingulate cortex (PCC) and precuneus, which belonged to the default mode network (DMN). Moreover, both the ALFF of the left dlPFC and FC between the left dlPFC and left PCC and precuneus were significantly correlated with the sexual function and psychosocial status in patients with pED. The disrupted psychosocial status mediated the influence of atypical FC between dlPFC and DMN on decreased erectile function. This study widened our understanding of the important role of psychosocial disorders in pathological neural changes in patients with pED.

Preliminary evidence of altered gray matter volume in subjects with internet gaming disorder: associations with history of childhood attention-deficit/hyperactivity disorder symptoms

Attention-deficit/hyperactivity disorder (ADHD) is commonly comorbid with Internet gaming disorder (IGD). Although childhood ADHD symptoms may decline during late brain maturation, structural alterations in some brain areas may persist into adulthood. This study investigated whether young adults with IGD and a history of childhood ADHD symptoms had gray matter volume (GMV) alterations that were distinct from subjects without a history of childhood ADHD. As an exploratory investigation, we conducted a whole-brain voxel-based morphometry with the diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm and applied an uncorrected threshold at the voxel level for multiple comparisons. GMVs of IGD subjects with a history of childhood ADHD (IGD_ADHD+ group; n = 20; 24.5 ± 2.5 years) were compared to those of subjects without a history of childhood ADHD (IGD_ADHD- group; n = 20; 23.9 ± 2.5 years) and controls (n = 20; 22.7 ± 2.4 years). Compared with controls, both IGD groups had a smaller GMV in the right anterior cingulate cortex, the left inferior frontal gyrus, and the left insula, yet had a larger GMV in the right angular gyrus. The IGD_ADHD+ group had a larger GMV in the right precuneus than the IGD_ADHD- group and controls. When controlling for other comorbid psychiatric symptoms, the IGD_ADHD+ group also had a smaller GMV in the right inferior frontal gyrus. In conclusion, we found that young adults with IGD and a history of childhood ADHD symptoms had characteristic GMV alterations, which may be linked with their manifestation of childhood ADHD.

Lipidomic profiles disturbed by the internet gaming disorder in young Korean males

Internet Gaming Disorder (IGD) is characterized by uncontrollable and persistent playing of internet games despite the occurrence of negative consequences. Although there is a worldwide treatment demand, IGD still doesn't have an explicit biomarker. The primary goal of the study is to characterize lipidomic profiles specific to internet gaming disorder (IGD) based on liquid-chromatography Orbitrap mass-spectrometry (LC Orbitrap MS). Primarily, a total of 19 lipids were significantly dys-regulated in the IGD group compared to healthy controls. The lipidomic feature was mainly characterized by various types of phosphatidylcholines (PCs) and lyso-phosphatidylcholines (LysoPCs). Subsequent multivariate statistical model and linear regression model prioritized two LysoPCs (C16:0 and C18:0) for potential biomarker. Receiver operating characteristic (ROC) analysis demonstrated excellent performance of the combined lipid set for discriminating the IGD group from healthy controls (AUC: 0.981, 95% confidence interval: 0.958-1.000). Additional evaluation with potential confounders and clinical parameters suggested robustness and potential applicability of the outcome as biomarkers which may aid diagnosis.

Impulsive Internet Game Play Is Associated With Increased Functional Connectivity Between the Default Mode and Salience Networks in Depressed Patients With Short Allele of Serotonin Transporter Gene

Problematic Internet game play is often accompanied by major depressive disorder (MDD). Depression seems to be closely related to altered functional connectivity (FC) within (and between) the default mode network (DMN) and salience network. In addition, serotonergic neurotransmission may regulate the symptoms of depression, including impulsivity, potentially by modulating the DMN. We hypothesized that altered connectivity between the DMN and salience network could mediate an association between the 5HTTLPR genotype and impulsivity in patients with depression. A total of 54 participants with problematic Internet game play and MDD completed the research protocol. We genotyped for 5HTTLPR and assessed the DMN FC using resting-state functional magnetic resonance imaging. The severity of Internet game play, depressive symptoms, anxiety, attention and impulsivity, and behavioral inhibition and activation were assessed using the Young Internet Addiction Scale (YIAS), Beck Depressive Inventory, Beck Anxiety Inventory (BAI), Korean Attention Deficit Hyperactivity Disorder scale, and the Behavioral Inhibition and Activation Scales (BIS-BAS), respectively. The SS allele was associated with increased FC within the DMN, including the middle prefrontal cortex (MPFC) to the posterior cingulate cortex, and within the salience network, including the right supramarginal gyrus (SMG) to the right rostral prefrontal cortex (RPFC), right anterior insular (AInsular) to right SMG, anterior cingulate cortex (ACC) to left RPFC, and left AInsular to right RPFC, and between the DMN and salience network, including the MPFC to the ACC. In addition, the FC from the MPFC to ACC positively correlated with the BIS and YIAS scores in the SS allele group. The SS allele of 5HTTLPR might modulate the FC within and between the DMN and salience network, which may ultimately be a risk factor for impulsive Internet game play in patients with MDD.

Comparing the Effects of Bupropion and Escitalopram on Excessive Internet Game Play in Patients with Major Depressive Disorder

Objective

Several studies have suggested the efficacy of bupropion and escitalopram on reducing the excessive internet game play. We hypothesized that both bupropion and escitalopram would be effective on reducing the severity of depressive symptoms and internet gaming disorder (IGD) symptoms in patients with both major depressive disorder and IGD. However, the changes in brain connectivity between the default mode network (DMN) and the salience network were different between bupropion and escitalopram due to their different pharmacodynamics.

Methods

This study was designed as a 12-week double blind prospective trial. Thirty patients were recruited for this research (15 bupropion group+15 escitalopram group). To assess the differential functional connectivity (FC) between the hubs of the DMN and the salience network, we selected 12 regions from the automated anatomical labeling in PickAtals software.

Results

After drug treatment, the depressive symptoms and IGD symptoms in both groups were improved. Impulsivity and attentional symptoms in the bupropion group were significantly decreased, compared to the escitalopram group. After treatment, FC within only the DMN in escitalopram decreased while FC between DMN and salience network in bupropion group decreased. Bupropion was associated with significantly decreased FC within the salience network and between the salience network and the DMN, compared to escitalopram.

Conclusion

Bupropion showed greater effects than escitalopram on reducing impulsivity and attentional symptoms. Decreased brain connectivity between the salience network and the DMN appears to be associated with improved excessive IGD symptoms and impulsivity in MDD patients with IGD.

An Update Overview on Brain Imaging Studies of Internet Gaming Disorder

There are a growing number of studies on structural and functional brain mechanisms underlying Internet gaming disorder (IGD). Recent functional magnetic resonance imaging studies showed that IGD adolescents and adults had reduced gray matter volume in regions associated with attention motor coordination executive function and perception. Adolescents with IGD showed lower white matter (WM) integrity measures in several brain regions that are involved in decision-making, behavioral inhibition, and emotional regulation. IGD adolescents had also disruption in the functional connectivity in areas responsible for learning memory and executive function, processing of auditory, visual, and somatosensory stimuli and relay of sensory and motor signals. IGD adolescents also had decreased functional connectivity of PFC-striatal circuits, increased risk-taking choices, and impaired ability to control their impulses similar to other impulse control disorders. Recent studies indicated that altered executive control mechanisms in attention deficit hyperactivity disorder (ADHD) would be a predisposition for developing IGD. Finally, patients with IGD have also shown an increased functional connectivity of several executive control brain regions that may related to comorbidity with ADHD and depression. The behavioral addiction model argues that IGD shows the features of excessive use despite adverse consequences, withdrawal phenomena, and tolerance that characterize substance use disorders. The evidence supports the behavioral addiction model of IGD by showing structural and functional changes in the mechanisms of reward and craving (but not withdrawal) in IGD. Future studies need to investigate WM density and functional connectivity in IGD in order to validate these findings. Furthermore, more research is required about the similarity in neurochemical and neurocognitive brain circuits in IGD and comorbid conditions such as ADHD and depression.