Sustained dysfunctional information processing in patients with Internet gaming disorder: 6-month follow-up ERP study

Problematic Gaming and Gambling: A Systematic Review of Task-Specific EEG Protocols

Even though gaming and gambling bear similar problematic behavioral aspects, there are no recognizable neurophysiological biomarkers or features characterizing and/or distinguishing these conditions. A systematic review of the literature with a focus on methods was performed in PubMed, Scopus, Web of Science (Web of Science Core Collection), EBSCOhost Research Databases (APA PsycINFO; APA PsycArticles; OpenDissertations; ERIC) databases. Following search terms were used to search the databases: ERP, "event related potential*", EP, "evoked potential*", SS, "steady state", EEG, electroencephal*; gam*. Data about the participants (total number, gender, age), main aim of the study and information about the experimental setup (experimental task description, stimuli used, ERPs measured (latency windows and placement of the electrodes), process evaluated) was extracted. A total of 24 studies were revised (problematic gaming - 16, pathological gambling - 8). The experimental protocols could be grouped into 3 main target domains (Cue-reactivity, General Information processing and Reward Processes & Risk Assessment). Sample-related limitations (small sample sizes, gender differences, differences between the groups regarding potential confounding variables) and heterogeneity regarding the experimental tasks, implementation and interpretation reviewed. Gambling-related research is highly focused on the investigation of the reward-related processes, whereas gaming-related research is mostly focused on the altered aspects of more general information processing. A vast heterogeneity regarding the ERP experimental paradigms being used and lack of clear guidelines and standardized procedures prevents identification of measures capable to reliably discriminate or characterize the population susceptible to addictive behavior or being able to diagnose and monitor these disorders.

Treatment effects of therapeutic interventions for gaming disorder: A systematic review and meta-analysis

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.

Cardiology and Neurophysiological Stimulation of Internet Gaming Disorders: A Systematic Review

BACKGROUND

Internet Gaming Disorder (IGD) is recognized as a mental health condition associated with excessive video gaming, leading to functional impairments. The inclusion of IGD in the DSM-5 has underscored the importance of comprehensively understanding its physiological and psychological effects.

OBJECTIVE

This systematic review aims to analyze and synthesize existing literature on the cardiophysiological and neurophysiological activities of individuals diagnosed with IGD, with a focus on identifying patterns, trends, and implications for clinical practice and future research.

METHODS

A systematic search was conducted in PubMed and Scopus databases to identify relevant studies published up to 2023. The search strategy included terms related to IGD, cardiophysiology, neurophysiology, and relevant measurement techniques. Inclusion criteria encompassed peer-reviewed research articles and clinical trials examining cardiophysiological (e.g., heart rate variability, blood pressure) and neurophysiological (e.g., brain imaging, electroencephalography) parameters in individuals with IGD. Exclusion criteria were applied to ensure methodological rigor and relevance to the research question.

RESULTS

The initial search yielded 1320 papers related to IGD, of which twenty studies met the eligibility criteria and were included in the review. Data extraction and synthesis focused on key cardiophysiological and neurophysiological outcomes observed in individuals with IGD compared to healthy controls. Findings revealed decreased Heart Rate Variability (HRV), increased sympathetic activity, and executive control deficits in IGD individuals based on Electrocardiogram (ECG) recordings and cognitive assessments. Neuroimaging studies demonstrated heightened brain activation in the lateral and prefrontal cortex, altered reward processing, and impulse control mechanisms among IGD subjects. Gender-specific differences were noted, with males exhibiting distinct thalamic activation striatum and decreased Regional Homogeneity (ReHo) in the right Posterior Cingulate (rPCC) compared to females.

DISCUSSION

The synthesized evidence indicates a complex interplay between excessive gaming and cardiophysiological/neurophysiological changes, highlighting the need for multidimensional assessments in diagnosing and managing IGD. Implications for clinical practice include early detection using ECG, EEG, and advanced neuroimaging techniques, as well as personalized interventions tailored to individual characteristics and gender-specific differences.

CONCLUSION

This systematic review provides a comprehensive overview of the cardiophysiological and neurophysiological activities associated with Internet Gaming Disorder. The findings underscore the need for further research to elucidate underlying mechanisms, develop standardized diagnostic protocols, and optimize targeted interventions for individuals with IGD.

Measurement of craving among gamers with internet gaming disorder using repeated presentations of game videos: a resting-state electroencephalography study

BACKGROUND

Internet gaming disorder (IGD) is receiving increasing attention owing to its effects on daily living and psychological function.

METHODS

In this study, electroencephalography was used to compare neural activity triggered by repeated presentation of a stimulus in healthy controls (HCs) and those with IGD. A total of 42 adult men were categorized into two groups (IGD, n = 21) based on Y-IAT-K scores. Participants were required to watch repeated presentations of video games while wearing a head-mounted display, and the delta (D), theta (T), alpha (A), beta (B), and gamma (G) activities in the prefrontal (PF), central (C), and parieto-occipital (PO) regions were analyzed.

RESULTS

The IGD group exhibited higher absolute powers of D_C, D_PO, T_C, T_PO, B_C, and B_PO than HCs. Among the IGD classification models, a neural network achieves the highest average accuracy of 93% (5-fold cross validation) and 84% (test).

CONCLUSIONS

These findings may significantly contribute to a more comprehensive understanding of the neurological features associated with IGD and provide potential neurological markers that can be used to distinguish between individuals with IGD and HCs.

Effective interventions for gaming disorder: A systematic review of randomized control trials

Objective

To identify effective intervention methods for gaming disorder (GD) through a rigorous assessment of existing literature.

Methods

We conducted a search of six databases (PubMed, Embase, PsycINFO, CNKI, WanFang, and VIP) to identify randomized controlled trials (RCTs) that tested GD interventions, published from database inception to December 31, 2021. Standardized mean differences with 95% confidence intervals were calculated using a random effects model. Risk of bias was assessed with the Risk of Bias 2 (RoB 2) tool.

Results

Seven studies met the inclusion criteria. Five interventions were tested in these studies: group counseling, craving behavioral intervention (CBI), transcranial direct current stimulation (tDCS), the acceptance and cognitive restructuring intervention program (ACRIP), and short-term cognitive behavior therapy (CBT). Four of the five interventions (the tDCS was excluded) were found to have a significant effect on GD. The results of the quality assessment showed that the included studies had a medium to high risk in the randomization process and a medium to high risk of overall bias.

Conclusion

Rigorous screening identified that four interventions are effective for GD: group counseling, CBI, ACRIP, and short-term CBT. Additionally, a comprehensive review of the literature revealed that improvements could be made in the conceptualization of GD, experimental design, sample representativeness, and reporting quality. It is recommended that future studies have more rigorous research designs and be based on established standards to provide more credible evidence to inform the development of GD interventions.

Effect of alternate nostril breathing on evoked potentials among internet addicts

Increased availability of smartphones and easy access to the internet among adolescents has resulted in Internet Addiction (IA). Effects of IA and Pranayama on evoked potential are available but studies on the comparison of immediate and 6-week effects of alternate nostril breathing on evoked potentials among medicos with internet addiction are not available as per our search in PubMed, hence the study was chosen. In this comparative study 100 male and female medical students aged between 18-25 years, with internet addiction scores ≥ 50 were included as study participants. P300 auditory event-related potential and pattern reversal visual evoked potential (VEP) were recorded before, immediately, and 6 weeks after practicing pranayama. Repeated measure ANOVA shows statistically significant change (P<0.05) in P300 amplitude, P100 latency, N145 latency, and VEP amplitude. The post hoc Bonferroni test shows that P100 latency and N145 latency significantly reduced immediately after 15 minutes of pranayama. P300 amplitude and VEP amplitude significantly increased only after practicing pranayama for 6 weeks. Pranayama has an immediate effect on latency, but it takes 6 weeks of practice to significantly change amplitude.

The relationship between perceptions of school climate and internet gaming disorder of teenage students: A moderated mediation model

Background

In recent years, teenage students' internet gaming disorder has raised widespread concern in the society. The current study aims to explore how perceptions of school climate, maladaptive cognition, and belief in a just world impact teenage students' internet gaming disorder and seek the suitable intervention to prevent teenage students' internet gaming disorder tendency.

Methods

A total of 1,164 teenage students (age: 19.62 ± 3.14 years) were evaluated using the Perceived School Climate Scale (PSCS), Maladaptive Cognition Scale (MCS), Belief in a Just World Scale (BJWS), and Internet Gaming Disorder Scale (IGDS).

Results

(1) Perceptions of school climate could predict teenage students' internet gaming disorder [β = -0.15, p < 0.001, 95% CI = (-0.20, -0.11)]. (2) Teenage students' maladaptive cognition exerts a partial mediating effect between their perceptions of school climate and internet gaming disorder [ab = -0.13, boot SE = 0.01, 95% CI = (-0.16, -0.11)]. (3) The direct effect of perceptions of school climate on internet gaming disorder [β = -0.07, p < 0.01, 95% CI = (-0.11, -0.02)], the first half of the mediation model "perceptions of school climate → maladaptive cognition" [β = -0.08, p < 0.01, 95% CI = (-0.12, -0.03)], and the second half of the mediation model "maladaptive cognition → internet gaming disorder" [β = 0.10, p < 0.001, 95% CI = (0.06, 0.14)] are all moderated reciprocally by teenage students' belief in a just world.

Conclusion

Schools should create a good climate and shape belief in a just world to reduce the maladaptive cognition of teenagers, to effectively prevent teenage students' internet gaming disorder tendency.

Neurophysiological Markers of Internet Gaming Disorder: A Literature Review of Electroencephalography Studies

Pathological online gaming is a relatively newer psychiatric disorder. It is the second behavioral addiction (after internet gambling disorder) included in the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM), 5^th edition as “Internet Gaming Disorder” (IGD). Recent research is showing high morbidity associated with IGD, thus encouraging researchers to find valid and reliable biomarkers of IGD. So that, early diagnosis and proper treatment could limit the high disability level accompanying excessive online gaming. As electroencephalography (EEG) is a non-invasive and relatively easily available diagnostic technique, we aimed at collecting EEG studies that investigated EEG changes associated with IGD, with a specific focus on finding diagnostic and predictive neurophysiological biomarkers of IGD. We searched PubMed and Google Scholar for EEG studies of IGD. We eliminated those EEG studies that were not focused on finding biomarkers. Scale for the Assessment of Narrative Review Articles (SANRA) is followed in the writing of this review article. Our results showed that increased slow-wave resting-state activity and reduced P300 and N100 can serve as useful IGD diagnostic markers of IGD. Moreover, increased resting-state theta activity can be a predictive biomarker of IGD. Lastly, increased late low potentials (LLPs) can be specific trait markers of cue-induced cravings in IGD.

Neurophysiology of Gambling Behavior and Internet Use Vulnerability: A Comparison Between Behavioral and EEG Measures

The present research explored electrophysiological activity (EEG) related to problematic internet use (PIU) vulnerability in a nonclinical population. Vulnerability to PIU was assessed through internet addiction test (IAT) in a sample of 23 participants. Moreover, they underwent a behavioral Iowa gambling task (IGT) for testing decision-making functioning and N2 event-related potentials (ERPs) component was monitored during an attentional inhibitory Go/NoGo task performance with addiction-related background pictures (videogames, online gambling, and neutral stimuli). IAT measure positively correlated with both IGT index and N2 variation at the Go/NoGo task. High-IAT young participants showed specific responses to internet addiction-related cues (pictures representing online gambling) in terms of ERPs amplitude of N2pc for Go trials in Pz. Findings suggested an early attentional facilitation effect for specific addiction-related stimuli, online gambling-related stimuli, suggesting a selective attention bias for salient stimuli in this population. While higher levels of IAT do not seem to correspond to a deficit in decision-making abilities, the selective attention mechanisms show to be partially biased in response to the salience of external cues.

Current diagnostic procedures and interventions for Gaming Disorders: A Systematic Review

Background: Despite the growth in the number of studies on Gaming Disorders (GD), assessing the characteristics of clinical subjects is still limited. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the clinical characteristics of individuals diagnosed with GD.

Objectives: The aim of this systematic review is to provide a broad cross-cultural picture of the current diagnostic procedures and interventions used for GDs in clinical practice.

Methods: A total of 28 studies met the inclusion criteria, and data were synthesized in these categories: (1) the cultural background of the country where the research took place; (2) the instruments used to measure GD; (3) the diagnostic criteria for GD; (4) the diagnostic procedures used; and (5) the treatment protocol applied.

Results: Results of this systematic review suggest that in GD clinical practice, there is a great deal of heterogeneity in the choice of instruments, the diagnostic and intervention processes for GD.

Conclusions: This systematic review indicates that a validation process of standard procedures in clinical populations with GD is necessary to create clear shared guidelines for practitioners.