Blunted reward prediction error signals in internet gaming disorder

The effect of reward learning on inhibitory control in internet gaming disorder: Evidence from behavioral and ERP

Reward dysregulation and deficits in inhibitory control significantly contribute to the development of internet gaming disorder (IGD). While prior research demonstrates that reward history influences individuals' inhibitory control, it remains unclear whether this effect extends to individuals with IGD. The primary aim of this study was to investigate whether individuals with IGD exhibit impairments in reward learning and whether prior reward learning influences their inhibitory control, using both behavioral and event-related potential (ERP) measures. This study first employed a probability selection task to examine potential impairments in reward learning among individuals with IGD. Next, a stop-signal task incorporating reward- and punishment-associated stimuli was used to further investigate the behavioral and electroencephalographic effects of prior reward learning on subsequent inhibitory control. Results revealed that during the reward-learning phase, the IGD group exhibited significantly longer response times than the control group in both the learning and transfer phases. Additionally, the feedback-related negativity amplitude in the IGD group was significantly lower than that in the control group. Conversely, the P3 wave amplitude induced by positive and negative feedback in the IGD group were significantly higher than in the control group. In the inhibitory control phase following reward learning, the Nogo-P3 wave amplitude in response to reward cues was significantly greater in the IGD group than in the control group. Moreover, within the IGD group, the Nogo-P3 wave amplitude evoked by reward cues was significantly larger than the amplitude evoked by loss cues. These findings suggest that reward learning is impaired in individuals with IGD and that stimuli with a prior reward history may compromise inhibitory control, potentially serving as a critical factor in addiction development in this population.

Differential neural reward processes in internet addiction: A systematic review of brain imaging research

OBJECTIVES

This systematic review aims to examine the neural correlates of reward processing in various forms of Internet Addiction (IA) among adults, including generalized IA and specific conditions such as Internet Gaming Disorder (IGD). The study seeks to identify distinct patterns of altered connectivity and activation in reward-related brain regions across different IA subtypes.

METHODS

We analyzed findings from 44 neuroimaging studies, aligning with the Research Domain Criteria (RDoC) framework. The review focused on three key aspects of reward processing: responsiveness, learning, and valuation. Studies included both structural and functional neuroimaging data from adult populations with various forms of IA.

RESULTS

Findings suggest distinct patterns of altered connectivity and activation in reward-related brain regions across different IA subtypes. IGD is associated with widespread abnormalities in both structural and functional connectivity within the reward network, whereas excess social media use primarily affects the amygdala-striatal system. However, methodological limitations, including variability in IA definitions, lack of comparative studies between IA subtypes, and predominance of cross-sectional designs, hinder definitive conclusions.

CONCLUSION

This review underscores the need for a nuanced approach to IA, recognizing potentially distinct neural mechanisms across subtypes. Such insights could inform the development of targeted interventions and enhance the clinical utility of IA research and treatment. Future research should address current methodological limitations to provide more definitive conclusions about the neurobiological underpinnings of various forms of IA.

The hemispheric differences in prefrontal function of Internet game disorder and non-Internet game disorder: an activation likelihood estimation meta-analysis

This study explored the differences in brain activation between individuals with and without Internet gaming disorder (IGD) through activation likelihood estimation analysis. In total, 39 studies were included based on the inclusion and exclusion criteria by searching the literature in the PubMed and Web of Science databases, as well as reading other reviews. The analysis revealed that the activated brain regions in IGD were the right inferior frontal gyrus, left cingulate gyrus, and left lentiform nucleus. In comparison, the activated brain regions in non-IGD were the left middle frontal, left inferior frontal, left anterior cingulate, left precentral, and right precentral gyri. The results of the present study on differences in activation further confirm existing theoretical hypotheses. Future studies should explore hemispheric differences in prefrontal brain function between IGD and non-IGD.

Influence of reinforcement learning on the inhibitory control of Internet gaming disorder

Reward processing dysfunction and inhibition control deficiency have been observed in Internet gaming disorder (IGD). However, it is still unclear whether the previous reinforcement learning depends on reward/punishment feedback influences on the cognitive inhibitory control of IGD. This study compared the differences between an IGD group and healthy people without game experiences in the probability selection task and the subsequent stop signal task by the method of behavioral experiments, in order to explore whether the reward learning ability is impaired in the IGD group. We also discuss the influence of previous reward learning on subsequent inhibition control. The results showed that (1) during the reward learning phase, the IGD group's accuracy was significantly lower than that of the control group; (2) compared with the control group, the IGD group's reaction times were longer in the transfer phase; (3) for no-go trials of the inhibitory control phase after reward learning, the accuracy of the reward-related stimulation in the IGD group was lower than that of punishment-related or neutral stimulation, but there was no significant difference among the three conditions in the control group. These findings indicated that the reinforcement learning ability of the IGD group was impaired, which further caused the abnormal response to reinforcement stimuli.

Alterations of gray matter asymmetry in internet gaming disorder

Structural asymmetry is a subtle but pervasive property of the human brain, which has been found altered in various psychiatric and neurocognitive disorders. However, little is known regarding potential alterations of structural asymmetry underlying internet gaming disorder (IGD). Therefore, this study aimed to investigate the structural features of gray matter asymmetry in IGD. High-resolution structural magnetic resonance imaging data were collected from 104 individuals with IGD and 104 recreational game users (RGUs). We applied a whole-brain voxel-based asymmetry (VBA) approach to determine the asymmetrical aberrations of gray matter in relation to IGD. Furthermore, the local abnormalities of structural asymmetry were employed as features to examine the effect of classification using a support vector machine (SVM). The results indicated that individuals with IGD as compared to RGUs showed asymmetrical alterations of gray matter in the medial prefrontal cortex (mPFC), orbitofrontal cortex, precuneus, middle temporal gyrus, superior parietal lobule and inferior temporal gyrus, regions implicated in hedonic motivation, self-reflection, information integration and visuospatial attention processing. Moreover, these atypical asymmetrical features can distinguish IGD subjects from RGUs with high accuracy. These results suggested that disrupted structural asymmetry of motivational reward, visuospatial and default mode circuits might be potential biomarkers for identifying pathological gaming dependence. These findings extended our understanding of structural underpinnings of IGD and provided new insights for developing effective interventions to alleviate compulsive gaming usage.

Biomarkers of Internet Gaming Disorder-A Narrative Review

Since game mechanics and their visual aspects have become more and more addictive, there is concern about the growing prevalence of Internet gaming disorder (IGD). In the current narrative review, we searched PubMed and Google Scholar databases for the keywords "igd biomarker gaming" and terms related to biomarker modalities. The biomarkers we found are grouped into several categories based on a measurement method and are discussed in the light of theoretical addiction models (tripartite neurocognitive model, I-PACE). Both theories point to gaming-related problems with salience and inhibition. The first dysfunction makes an individual more susceptible to game stimuli (raised reward seeking), and the second negatively impacts resistance to these stimuli (decreased cognitive control). The IGD patients' hypersensitivity to reward manifests mostly in ventral striatum (VS) measurements. However, there is also empirical support for a ventral-to-dorsal striatal shift and transition from goal-directed to habitual behaviors. The deficits in executive control are demonstrated in parameters related to the prefrontal cortex (PFC), especially the dorsolateral prefrontal cortex (DLPFC). In general, the connection of PFC with reward under cortex nuclei seems to be dysregulated. Other biomarkers include reduced P3 amplitudes, high-frequency heart rate variability (HRV), and the number of eye blinks and saccadic eye movements during the non-resting state. A few studies propose a diagnostic (multimodal) model of IGD. The current review also comments on inconsistencies in findings in the nucleus accumbens (NAcc), anterior cingulate cortex (ACC), and precuneus and makes suggestions for future IGD studies.

Learning and memory processes in behavioural addiction: A systematic review

Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks implicated in learning and memory. Therefore, this review sought to understand how different learning and memory processes relate to behavioural addictions and to unravel their underlying neural mechanisms. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched four databases - PsycINFO, PubMed, Scopus, and Web of Science using the agreed-upon search string. Findings suggest altered executive function-dependent learning processes and enhanced habit learning in behavioural addiction. Whereas the relationship between working memory and behavioural addiction is influenced by addiction type, working memory aspect, and task nature. Additionally, long-term memory is incoherent in individuals with addictive behaviours. Consistently, neurophysiological evidence indicates alterations in brain areas and networks implicated in learning and memory processes in behavioural addictions. Overall, the present review argues that, like substance use disorders, alteration in learning and memory processes may underlie the development and maintenance of behavioural addictions.

Outcome assessment of different reward stimuli in Internet gaming disorder by event-related potentials

An imbalance in sensitivity to different types of reward stimuli may be an important cause of addiction that is mainly manifested in high sensitivity to addictive substance rewards and blunting of natural rewards. However, contradictions remain in the research results on the sensitivity of individuals with Internet gaming disorder (IGD) to different reward stimuli. Based on participants' neural responses to win and loss feedback (in door task), the event-related potential (ERP) technique was used to investigate the effects of different types of reward stimuli on the assessment of reward-processing outcomes in individuals with IGD. The results showed that in the gain condition, the FB-P3 amplitude induced by game stimuli in the IGD group was significantly higher than that in the control group, and the FN amplitude induced by money stimuli was significantly lower than that in the control group. However, the FB-P3 and FN amplitudes induced by food were not significantly different from those in the control group. In the loss condition, there were no between-group differences in the FB-P3 and FN amplitudes evoked by the three reward stimuli. This indicates that the IGD group showed increased hedonic responses to game stimuli and decreased hedonic responses to money but no differences in hedonic responses to food during the reward assessment phase. Therefore, heightened sensitivity to game rewards and diminished sensitivity to monetary rewards during outcome assessment may play a crucial role in the development of IGD.

Identification of patients with internet gaming disorder via a radiomics-based machine learning model of subcortical structures in high-resolution T1-weighted MRI

It is of vital importance to establish an objective and reliable model to facilitate the early diagnosis and intervention of internet gaming disorder (IGD). A total of 133 patients with IGD and 110 healthy controls (HCs) were included. We extracted radiomic features of subcortical structures in high-resolution T1-weighted MRI. Different combinations of four feature selection methods (analysis of variance, Kruskal-Wallis, recursive feature elimination and relief) and ten classification algorithms were used to identify the most robust combined models for distinguishing IGD patients from HCs. Furthermore, a nomogram incorporating radiomic signatures and independent clinical factors was developed. Calibration curve and decision curve analyses were used to evaluate the nomogram. The combination of analysis of variance selector and logistic regression classifier identified that the radiomic model constructed with 20 features from the right caudate nucleus and amygdala showed better IGD screening performance. The radiomic model produced good areas under the curves (AUCs) in the training, validation and test cohorts (AUCs of 0.961, 0.903 and 0.895, respectively). In addition, sex, internet addiction test scores and radiomic scores were included in the nomogram as independent risk factors for IGD. Analysis of the correction curve and decision curve showed that the clinical-radiomic model has good reliability (C-index: 0.987). The nomogram incorporating radiomic features of subcortical structures and clinical characteristics achieved satisfactory classification performance and could serve as an effective tool for distinguishing IGD patients from HCs.

Reward prediction error in learning-related behaviors

Learning is a complex process, during which our opinions and decisions are easily changed due to unexpected information. But the neural mechanism underlying revision and correction during the learning process remains unclear. For decades, prediction error has been regarded as the core of changes to perception in learning, even driving the learning progress. In this article, we reviewed the concept of reward prediction error, and the encoding mechanism of dopaminergic neurons and the related neural circuities. We also discussed the relationship between reward prediction error and learning-related behaviors, including reversal learning. We then demonstrated the evidence of reward prediction error signals in several neurological diseases, including Parkinson's disease and addiction. These observations may help to better understand the regulatory mechanism of reward prediction error in learning-related behaviors.

Impulsivity-related right superior frontal gyrus as a biomarker of internet gaming disorder

Background

Internet gaming disorder (IGD) is a mental health issue that affects individuals worldwide. However, the lack of knowledge about the biomarkers associated with the development of IGD has restricted the diagnosis and treatment of this disorder.

Aims

We aimed to reveal the biomarkers associated with the development of IGD through resting-state brain network analysis and provide clues for the diagnosis and treatment of IGD.

Methods

Twenty-six patients with IGD, 23 excessive internet game users (EIUs) who recurrently played internet games but were not diagnosed with IGD and 29 healthy controls (HCs) performed delay discounting task (DDT) and Iowa gambling task (IGT). Resting-state functional magnetic resonance imaging (fMRI) data were also collected.

Results

Patients with IGD exhibited significantly lower hubness in the right medial orbital part of the superior frontal gyrus (ORBsupmed) than both the EIU and the HC groups. Additionally, the hubness of the right ORBsupmed was found to be positively correlated with the highest excessive internet gaming degree during the past year in the EIU group but not the IGD group; this might be the protective mechanism that prevents EIUs from becoming addicted to internet games. Moreover, the hubness of the right ORBsupmed was found to be related to the treatment outcome of patients with IGD, with higher hubness of this region indicating better recovery when undergoing forced abstinence. Further modelling analysis of the DDT and IGT showed that patients with IGD displayed higher impulsivity during the decision-making process, and impulsivity-related parameters were negatively correlated with the hubness of right ORBsupmed.

Conclusions

Our findings revealed that the impulsivity-related right ORBsupmed hubness could serve as a potential biomarker of IGD and provide clues for the diagnosis and treatment of IGD.

Internet addiction in adolescent psychiatric patient population: A hospital-based Study from China

BACKGROUND

Internet is gradually reshaping adolescents' behaviors in China. It is important to identify the prevalence and risk factors to predict Internet addiction among adolescent psychiatric patients.

METHODS

The survey was conducted among inpatient or outpatient adolescent patients with mental disorders. All participants were interviewed face-to-face and completed Young Internet Addiction Test and other relevant assessments. Binary logistic regression analysis was used to exam between-group differences of internet addiction.

RESULT

The prevalence for internet addiction (mild to severe) in adolescent psychiatric patients was 80.2%, where the prevalence for "medium and severe internet addiction was 25.5%. Logistic regression analysis identified two independent predictors for "medium and severe internet addiction" including the total score of Adolescent Non-suicidal-self-injury (NSSI) Behavior Function Assessment Scale (ANBFAS) and the diagnosis of generalized anxiety disorder (GAD) (R² =0.27, p = .02 for total ANBFAS score, p = .01 for GAD) in psychiatric adolescent patients.

CONCLUSION

The prevalence of internet addiction is notably high among adolescent psychiatric patients in China. Coping for Internet addiction in adolescent psychiatric patients should conclude the coping of NSSI and GAD.

Functional Neural Alterations in Pathological Internet Use: A Meta-Analysis of Neuroimaging Studies

Previous resting-state functional MRI (fMRI) studies found spontaneous neural activity in the brains of Pathological Internet Use (PIU) subjects. However, the findings were inconsistent in studies using different neuroimaging analyses. This meta-analytic study aimed to identify a common pattern of altered brain activity from different studies. Resting-state fMRI studies, based on whole-brain analysis methods published before July 1, 2021, were searched in multiple databases (PubMed, EMBASE, MEDLINE, and Web of Science). A voxel-based signed differential mapping (SDM) method was used to clarify brain regions, which showed anomalous activity in PIU subjects compared with healthy controls (HCs). Ten eligible publications consisting of 306 PIU subjects and 314 HCs were included in the SDM meta-analysis. Compared with HCs, subjects with PIU showed increased spontaneous neural functional activity in the left temporal pole of the superior temporal cortex, left amygdala, bilateral median cingulate cortex, and right insula. Meanwhile, a decreased spontaneous neural activity was identified in the left dorsolateral superior frontal gyrus and right middle frontal gyrus in the subjects with PIU. These abnormal brain regions are associated with cognitive executive control and emotional regulation. The consistent changes under different functional brain imaging indicators found in our study may provide important targets for the future diagnosis and intervention of PIU.

Systematic Review Registration:www.crd.york.ac.uk/PROSPERO, identifier: CRD42021258119.

Slow-Wave EEG Activity Correlates with Impaired Inhibitory Control in Internet Addiction Disorder

Impaired inhibitory control is a core feature of internet addiction disorder (IAD). It is therefore of interest to determine the neurophysiological markers associated with it. The present study aimed to find such biomarkers with a resting-state electroencephalogram (EEG). We specifically used scores on the Chinese Internet Addiction Scale revised edition (CIAS-R) to divide 46 participants into two groups: the IAD group (>53, n = 23) and control group (<46, n = 23). Both behavioral aspects (Go/NoGo responses and impulsivity) and EEG were measured in the lab. The results suggest that the IAD group presented a decreased slow-wave (1−8 Hz) absolute power across the whole brain. The slow-wave activities in the frontal areas were also correlated with the commission error rate in the Go/NoGo task in the IAD group. These results imply that the frontal slow-wave EEG activity may serve as a neurophysiological marker of IAD, helping to understand the underlying neural mechanisms of inhibitory control deficits in IAD and point to possible interventions.