Language processing in Internet use disorder: Task-based fMRI study

Effects of internet and smartphone addiction on cognitive control in adolescents and young adults: A systematic review of fMRI studies

BACKGROUND

Internet Addiction (IA) refers to excessive or uncontrolled behaviors related to Internet access, causing impairment or distress. Similarly, Smartphone Addiction (SPA) involves the excessive use of smartphones, disrupting users' daily lives. Cognitive control plays a relevant role in the development of IA and SPA, with executive functions and rewards processing being particularly important.

OBJECTIVE

This study aims to provide a synthesis of scientific evidence on the differential effects of IA and SPA on cognition in young adults and adolescents, using fMRI.

METHODS

Relevant articles published between 2013 and May 2023 were identified following the PRISMA protocol.

RESULTS

Included studies (n = 21) revealed that both behavioral addictions were associated with impairments in cognitive control related to reward processing (ACC, insula, amygdala) and executive function (DLPFC, frontal, parietal lobes) in adolescents and young adults.

CONCLUSION

These findings provide evidence for neuroanatomical similarities between IA and SPA in young adults and adolescents related to executive functions and rewards processing. However, differential effects of SPA and IA on cognitive control were not found in this study. Future research should explore the relationship between these addictions with other cognitive domains to further expand our understanding within this field. While both IA and SPA involve the excessive use of online technology, SPA could involve a higher risk, given that smartphones allow internet connectivity anytime.

Neural correlates of impulsive compulsive behaviors in Parkinson's disease: A Japanese retrospective study

BACKGROUND

Impulsive compulsive behaviors (ICBs) often disturb patients with Parkinson's Disease (PD), of which impulse control disorder (ICD) and dopamine dysregulation syndrome (DDS) are two major subsets. The nucleus accumbens (NAcc) is involved in ICB; however, it remains unclear how the NAcc affects cortical function and defines the different behavioral characteristics of ICD and DDS.

OBJECTIVES

To identify the cortico-striatal network primarily involved in ICB and the differences in these networks between patients with ICD and DDS using structural and resting-state functional magnetic resonance imaging.

METHODS

Patients with PD were recruited using data from a previous cohort study and divided into those with ICB (ICB group) and without ICB (non-ICB group) using the Japanese version of the Questionnaire for Impulsive Compulsive Disorders in Parkinson's Disease (J-QUIP). From these two groups, we extracted 37 pairs matched for age, sex, disease duration, and levodopa equivalent daily dose of dopamine agonists. Patients with ICB were further classified as having ICD or DDS based on the J-QUIP subscore. General linear models were used to compare gray matter volume and functional connectivity (FC) of the NAcc, caudate, and putamen between the ICB and non-ICB groups and between patients with ICD and those with DDS.

RESULTS

We found no significant differences in gray matter volumebetween the ICB and non-ICB groups or between patients with ICD and those with DDS. Compared with the non-ICB group, the FC of the right NAcc in the ICB group was lower in the bilateral ventromedial prefrontal cortex and higher in the left middle occipital gyrus. Furthermore, patients with DDS showed higher FC between the right putamen and left superior temporal gyrus and higher FC between the left caudate and bilateral middle occipital gyrus than patients with ICD. In contrast, patients with ICD exhibited higher FC between the left NAcc and the right posterior cingulate cortex than patients with DDS.

CONCLUSIONS

The functionally altered network between the right NAcc and ventromedial prefrontal cortex was associated with ICB in PD. In addition, the surrounding cortico-striatal networks may differentiate the behavioral characteristics of patients with ICD and those with DDS.

Verbal Communication with the Patient Is Not Enough: The Six Languages of the Sick

Evidence shows that verbal communication is just one of the ways patients indicate their wishes. For a sufficiently careful communication, we should also grasp other five unusual though evident languages: (a) body language, (b) the way patients manage their environment, (c) unconscious language, (d) lab-evidenced language, and (e) the way they master technology. So, we have six languages that should be intertwined to understand the real language of the sick. Grasping these languages helps health professionals frame the patient’s mood, their level of suffering or mental growth, and understand what words alone cannot express. Words cannot express completely what a patient senses: for subjection, shyness, because some patients are still non-verbal or because verbal communication is just a useful way of freezing concept but has not the same fluidity and liberty of the other above-described languages. It is mandatory for caregivers to wonder how many of these languages they are actually decrypting during an interview with the patient. On the other hand, caregivers unconsciously communicate much through two unexpected languages: the architectural language and the language of medical procedures. The way they welcome or obstruct the patient, their hesitations across a treatment, or in showing a serene collegiality are forms of subtle communication. A paradigmatic scenario where all these languages should be implemented is the “informed consent” process, which should be turned into a “shared therapeutic pathway”, summing up all the communicative modes illustrated in the text.