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Suresh Paul J, T AR, Raghavan S, Kesavadas C. Comparative analysis of quantitative susceptibility mapping in preclinical dementia detection. Eur J Radiol 2024; 178:111598. [PMID: 38996737 DOI: 10.1016/j.ejrad.2024.111598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 06/30/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE This review aims to explore the role of Quantitative Susceptibility Mapping (QSM) in the early detection of neurodegenerative diseases, particularly Alzheimer's disease (AD) and Lewy body dementia (LBD). By examining QSM's ability to map brain iron deposition, we seek to highlight its potential as a diagnostic tool for preclinical dementia. METHODOLOGY QSM techniques involve the advanced processing of MRI phase images to reconstruct tissue susceptibility, employing methods such as spherical mean value filtering and Tikhonov regularization for accurate background field removal. This review discusses how these methodologies enable the precise quantification of iron and other elements within the brain. RESULTS QSM has demonstrated effectiveness in identifying early pathological changes in key brain regions, including the hippocampus, basal ganglia, and substantia nigra. These regions are significantly impacted in the early stages of AD and LBD. Studies reviewed indicate that QSM can detect subtle neurodegenerative changes, providing valuable insights into disease progression. However, challenges remain in standardizing QSM processing algorithms to ensure consistent results across different studies. CONCLUSION QSM emerges as a promising tool for early dementia detection, offering precise measurements of brain iron deposition and other critical biomarkers. The review underscores the importance of refining QSM methodologies and integrating them with other imaging modalities to improve early diagnosis and management of neurodegenerative diseases. Future research should focus on standardizing QSM techniques and exploring their synergistic use with other neuroimaging methods to enhance its clinical utility.
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Affiliation(s)
- Joseph Suresh Paul
- Medical Image Computing and Signal Processing Laboratory, Digital University-Kerala (DUK), Trivandrum, India.
| | - Arun Raj T
- Medical Image Computing and Signal Processing Laboratory, Digital University-Kerala (DUK), Trivandrum, India.
| | | | - Chandrasekharan Kesavadas
- Imaging Science and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, India.
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Mohamed NF, Ab Manan N, Muhammad Firdaus Chan MF, Rahmatullah B, Abd Wahab R, Baharudin SNA, Govindasamy P, Abdulla K. The prevalence of internet gaming disorders and the associated psychosocial risk factors among adolescents in Malaysian secondary schools. Clin Child Psychol Psychiatry 2023; 28:1420-1434. [PMID: 36927134 DOI: 10.1177/13591045231164870] [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] [Indexed: 03/18/2023]
Abstract
Internet Gaming Disorder (IGD) has been placed under the conditions for further study segment in DSM-5. The purpose of the current study was to develop a preliminary psychosocial model as a reference for providing appropriate intervention, particularly for adolescents with IGD. A total of 5290 adolescents from secondary schools in seven states in Malaysia were recruited by using proportionate random sampling. A standardized set of validated questionnaires such as DASS-21, BIS-11, and IGDS9-SF were distributed to participants that fulfilled the inclusion criteria. The prevalence of IGD among Malaysian adolescents was 3.5%. The bivariate analysis summarized that factors such as stress, impulsivity, gender, time spent using the internet, and relationship with parents and friends; have statistically significant associations with IGD. The logistic regression model revealed that adolescents with IGD were 9 times more likely to experience extremely severe stress (p < 0.001). Several psychosocial factors were associated strongly with IGD in the current study, however, mental health shows the most significant issues among adolescents with IGD. Immediate intervention through a psychological approach to internet gaming is needed from parents, schools, and also respective stakeholders. IGD may become one of the addictions diseases that cause deterioration in many aspects of an adolescent's future life without serious intervention.
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Affiliation(s)
- Nor Firdous Mohamed
- Department of Psychology, Faculty of Human Development, Universiti Pendidikan Sultan Idris, Perak, Malaysia
| | - Norhafizah Ab Manan
- Department of Community Medicine, Faculty of Medicine, University of Cyberjaya, Selangor, Malaysia
| | | | - Bahbibi Rahmatullah
- Faculty of Computing and Meta-Technology, Universiti Pendidikan Sultan Idris, Perak, Malaysia
| | - Rasidah Abd Wahab
- Reconstructive and Rehabilitation Centre, Faculty of Medicine and Health Sciences, University of Malaysia of Sarawak, Sarawak, Malaysia
| | | | - Priyalatha Govindasamy
- Department of Psychology, Faculty of Human Development, Universiti Pendidikan Sultan Idris, Perak, Malaysia
- Faculty of Education and Humanities, UNITAR International University, Selangor, Malaysia
| | - Kahar Abdulla
- European Alliance Against Depression, Department of Psychiatry, Psychosomatics, and Psychotherapy, Hospital of the Goethe University Frankfurt, Hesse, Germany
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Khor E, McNamara N, Columb D, McNicholas F. Neuroimaging findings in adolescent gaming disorder: a systematic review. Ir J Psychol Med 2023:1-13. [PMID: 37496266 DOI: 10.1017/ipm.2023.36] [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] [Indexed: 07/28/2023]
Abstract
OBJECTIVES Gaming disorder is a growing concern affecting adolescents, exacerbated by the impact of recent COVID-19 restrictions. The World Health Organization has recently included gaming disorder in the 11th International Classification of Diseases (ICD-11). However, there is still an ongoing debate about the validity and reliability of the proposed clinical criteria, despite growing neurobiological evidence in this cohort. Systematic reviews in this area have focused mainly on adults or mixed adult/adolescent populations. Therefore, this systematic review explored the neuroimaging literature in adolescents (under 18 years old) with gaming disorder. METHODS Using PRISMA 2020 guidelines, 3288 primary studies were identified from PubMed, CINAHL Plus, PsycINFO and Web of Science. After applying inclusion and exclusion criteria (appropriate title, abstract, comparison group used within study, English-language, neuroimaging and mean age under 18), 24 studies were included in this review. RESULTS Functional and structural brain alterations in adolescent gaming disorder were noted across several imaging modalities, including electroencephalogram (EEG), functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (MRI). Compared with healthy controls, adolescents with gaming disorder demonstrated neurological changes comparable to substance addiction, namely impairments in emotional regulation, reward-seeking, inhibition and increased risky decision-making. Positive brain adaptations in the areas of visuospatial processing and memory were observed. CONCLUSIONS A number of key brain regions are affected in adolescent gaming disorder. These findings can help clinicians understand adolescent presentations with gaming disorder from a neurobiological perspective. Future studies should focus on forming a robust neurobiological and clinical framework for adolescent gaming disorder.
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Affiliation(s)
- E Khor
- University College Dublin, Belfield, Dublin 4, Ireland
| | - N McNamara
- Department of Child and Adolescent Psychiatry, St John of God Hospital, Stillorgan, Co Dublin, Ireland
| | - D Columb
- Linn Dara CAMHS North Kildare, Celbridge, Co Kildare, Ireland
| | - F McNicholas
- University College Dublin, Belfield, Dublin 4, Ireland
- Department of Paediatric Liaison Psychiatry, CHI Crumlin, Crumlin, Dublin 12, Ireland
- Lucena CAMHS Rathgar, Orwell Road, Rathgar, Dublin 6, Ireland
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Chen Y, Ide JS, Li CS, Chaudhary S, Le TM, Wang W, Zhornitsky S, Zhang S, Li CR. Gray matter volumetric correlates of dimensional impulsivity traits in children: Sex differences and heritability. Hum Brain Mapp 2022; 43:2634-2652. [PMID: 35212098 PMCID: PMC9057091 DOI: 10.1002/hbm.25810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/25/2022] [Accepted: 02/05/2022] [Indexed: 01/22/2023] Open
Abstract
Previous research investigated the cerebral volumetric correlates of impulsivity largely in moderate-sized samples and few have examined the distinct correlates of dimensions of impulsivity, sex differences, or heritability of the correlates. Here, we performed voxel-based morphometry analysis of data (n = 11,474; 5,452 girls, 9-10 years) curated from the Adolescent Brain Cognition Development project. In a linear regression with all five UPPS-P subscores as regressors and age in months, total intracranial volume, study site, and scanner model as covariates, higher levels of lack of premeditation, and sensation seeking were correlated with larger cortical and subcortical gray matter volumes (GMVs). In contrast, higher positive urgency was correlated with smaller GMVs in many of the same regions. The dimensional impulsivity traits also involved distinct volumetric correlates, with, for instance, sensation seeking and positive urgency specifically implicating bilateral caudate head/mid-cingulate cortex and bilateral lateral orbitofrontal cortex/left precentral gyrus, respectively. Boys relative to girls scored higher in all impulsivity dimensions. Girls relative to boys showed significantly stronger positive and negative correlations between sensation seeking and insula, putamen, and inferior frontal gyrus (IFG) GMVs and between positive urgency and cingulate cortex, insula, and IFG GMVs, respectively. With a subsample of twins, the dimensional impulsivity traits were weakly to moderately heritable in both girls and boys, and the GMV correlates were highly heritable in girls and boys combined. These findings collectively suggest shared and nonshared as well as sex differences in the cerebral volumetric bases of dimensional impulsivity traits and may facilitate research of externalizing psychopathology in children.
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Affiliation(s)
- Yu Chen
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Jaime S. Ide
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Clara S. Li
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
- Department of Statistical and Data SciencesSmith CollegeNorthamptonMassachusettsUSA
| | - Shefali Chaudhary
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Thang M. Le
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Wuyi Wang
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Simon Zhornitsky
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Sheng Zhang
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Chiang‐Shan R. Li
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
- Department of NeuroscienceYale University School of MedicineNew HavenConnecticutUSA
- Inter‐department Neuroscience ProgramYale UniversityNew HavenConnecticutUSA
- Wu Tsai InstituteYale UniversityNew HavenConnecticutUSA
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Niu X, Gao X, Zhang M, Yang Z, Yu M, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Meta-analysis of structural and functional brain alterations in internet gaming disorder. Front Psychiatry 2022; 13:1029344. [PMID: 37033880 PMCID: PMC10074425 DOI: 10.3389/fpsyt.2022.1029344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/03/2022] [Indexed: 04/11/2023] Open
Abstract
Background Many neuroimaging studies have reported abnormalities in brain structure and function in internet gaming disorder (IGD). However, the findings were divergent. We aimed to provide evidence-based evidence of structural and functional changes in IGD by conducting a meta-analysis integrating these studies quantitatively. Method A systematic search was conducted in PubMed, ScienceDirect, Web of Science, and Scopus from January 1, 2010 to October 31, 2021, to identify eligible voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies. Brain alternations between IGD subjects and healthy controls (HCs) were compared using the anisotropic seed-based d mapping (AES-SDM) meta-analytic method. Meta-regression analysis was used to investigate the relationship between gray matter volume (GMV) alterations and addiction-related clinical features. Results The meta-analysis contained 15 VBM studies (422 IGD patients and 354 HCs) and 30 task-state fMRI studies (617 IGD patients and 550 HCs). Compared with HCs, IGD subjects showed: (1) reduced GMV in the bilateral anterior/median cingulate cortex, superior/inferior frontal gyrus and supplementary motor area; (2) hyperactivation in the bilateral inferior frontal gyrus, precentral gyrus, left precuneus, right inferior temporal gyrus and right fusiform; (3) hypoactivation in the bilateral lingual and the left middle frontal gyrus; and (4) both decreased GMV and increased activation in the left anterior cingulate. Furthermore, Meta-regression revealed that GMV reduction in left anterior cingulate were positively correlated with BIS-11 score [r = 0.725, p = 0.012(uncorrected)] and IAT score [r = 0.761, p = 0.017(uncorrected)]. Conclusion This meta-analysis showed structural and functional impairments in brain regions related to executive control, cognitive function and reward-based decision making in IGD. Furthermore, multi-domain assessments captured different aspects of neuronal changes in IGD, which may help develop effective interventions as potential therapeutic targets.
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Affiliation(s)
- Xiaoyu Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Xinyu Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Zhengui Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Miaomiao Yu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
- Jingliang Cheng,
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
- Shaoqiang Han,
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Magnetic Resonance and Brain Function, Zhengzhou, China
- Henan Engineering Technology Research Center for Detection and Application of Brain Function, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, Zhengzhou, China
- Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, Zhengzhou, China
- Henan Key Laboratory of Imaging Intelligence Research, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
- *Correspondence: Yong Zhang,
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Hossaini A, Valeriani D, Nam CS, Ferrante R, Mahmud M. A Functional BCI Model by the P2731 working group: Physiology. BRAIN-COMPUTER INTERFACES 2021. [DOI: 10.1080/2326263x.2021.1968665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ali Hossaini
- Department of Engineering, King’s College London, London, UK
| | | | - Chang S. Nam
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, USA
| | | | - Mufti Mahmud
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
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Zhang M, Gao X, Yang Z, Wen M, Huang H, Zheng R, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Shared gray matter alterations in subtypes of addiction: a voxel-wise meta-analysis. Psychopharmacology (Berl) 2021; 238:2365-2379. [PMID: 34313804 DOI: 10.1007/s00213-021-05920-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Numerous studies based on voxel-based morphometry (VBM) have revealed gray matter (GM) alterations in multiple brain regions for addiction. However, findings are poorly replicated, and it remains elusive whether distinct diagnoses of addiction are underpinned by shared abnormalities. Our aim was to conduct a quantitative meta-analysis of structural neuroimaging studies investigating GM abnormalities in two main categories of addiction: substance use disorders (SUD) and behavioral addictions (BA). METHOD A systematic database search was conducted in several databases from Jan 1, 2010, to Oct 23, 2020, to identify eligible VBM studies. Meta-analysis was performed with the seed-based d mapping software package to compare alternations between individuals with addiction-related disorders and healthy controls (HC). RESULTS A total of 59 VBM studies including 2096 individuals with addiction-related disorders and 2637 HC met the inclusion criteria. Individuals with addiction-related disorders showed shared GM volume decrease in bilateral prefrontal cortex, bilateral insula, bilateral rolandic operculum, left superior temporal gyrus, and right Heschl gyrus and GM increase in right lingual gyrus and right fusiform gyrus comparing with HC (p < 0.005). Subgroup analysis found heterogeneity between SUD and BA mainly in left inferior occipital gyrus and right striatum (p < 0.005). Meta-regression revealed that GM atrophy in right anterior cingulate (r = 0.541, p = 0.03 (uncorrected)) and left inferior frontal gyrus (r = 0.595, p = 0.015) were positively correlated with higher impulsivity. CONCLUSIONS This meta-analysis identified a concordance across subtypes of addiction in terms of the brain structural changes in prefrontal and insula areas, which may relate to higher impulsivity observed across addiction diagnoses. This concordance provides an organizing model that emphasizes the importance of shared neural substrates in addiction.
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Affiliation(s)
- Mengzhe Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xinyu Gao
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhengui Yang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengmeng Wen
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiyu Huang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Weijian Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Shaoqiang Han
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Metacognitions as a predictor of online gaming in adolescents: Psychometric properties of the metacognitions about online gaming scale among Iranian adolescents. Addict Behav 2021; 118:106904. [PMID: 33743493 DOI: 10.1016/j.addbeh.2021.106904] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/13/2022]
Abstract
The Metacognitions about Online Gaming Scale (MOGS) measures maladaptive metacognitions about online gaming. The purpose of the present study was to evaluate psychometric properties of the MOGS, including its factor structure, reliability, and predictive validity among Iranian adolescents. The scale was administered to 769 Iranian adolescents (577 male, mean age = 16.39 ± 1.68 years) with an age range of 15-19 years. The participants completed the Persian-translated version of the MOGS, the Big Five Inventory-10, the Depression, Anxiety and Stress Scale 21, the Video-Game Related Cognitions Scale, the Motives for Online Gaming Questionnaire, and the Problematic Online Gaming Questionnaire. The results of the Exploratory Factor Analysis (n = 350) and Confirmatory Factor Analysis (n = 419) confirmed three-factors similar to the parent version, including "negative metacognitions about uncontrollability of online gaming" (N-MOGU), "negative metacognitions about dangers of online gaming" (N-MOGD), and "positive metacognitions about online gaming" (P-MOG). The Persian MOGS's reliability showed a suitable internal consistency for the P-MOG, the N-MOGU, the N-MOGD, and the total score in both confirmatory and exploratory samples (range 0.79 to 0.93). A hierarchical regression analysis showed that the Persian MOGS predicted 33.9% of the variance in problematic online gaming independently of personality traits, anxiety, depression, stress, and both gaming-related cognitions and gaming motives. Furthermore, the results of analyses of variance with follow-up Bonferroni pairwise comparisons showed that interaction between the factors of MOGS and types of game and tools of gaming was significant. The findings provide evidence that the Persian MOGS among Iranian adolescents appears psychometrically appropriate to be used by researchers and practitioners dealing with the prevention and treatment of problematic online gaming.
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Braegelmann KM, Meza A, Agbeh AE, Fields DP, Baker TL. Retinoic acid receptor alpha activation is necessary and sufficient for plasticity induced by recurrent central apnea. J Appl Physiol (1985) 2021; 130:836-845. [PMID: 33411644 DOI: 10.1152/japplphysiol.00287.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Reductions in respiratory-related synaptic inputs to inspiratory motor neurons initiate a form of plasticity that proportionally enhances inspiratory motor output, even in the absence of changing blood gases. This form of plasticity is known as inactivity-induced inspiratory motor facilitation (iMF). iMF triggered by brief, recurrent reductions in respiratory neural activity requires local retinoic acid (RA) synthesis, but receptor subtypes activated by RA are unknown. To test the hypothesis that retinoic acid receptor alpha (RARα) is necessary for iMF, RAR subtype-specific inhibitors were delivered intrathecally above the phrenic motor pool in urethane-anesthetized, ventilated rats before 5, ∼1 min central apneas (without hypoxia; separated by 5 min) while monitoring phrenic inspiratory output. Pretreatment with a spinal RARα inhibitor impaired the capacity for recurrent central apnea to trigger long-lasting increases in phrenic inspiratory output, but plasticity was expressed in rats pretreated with an RARβ/γ inhibitor. Intrathecal RA application in the absence of reduced respiratory neural activity elicited an increase in phrenic inspiratory output, which was prevented by pretreatment with an RARα inhibitor. These data indicate that spinal RARα activation is necessary for iMF triggered by recurrent reductions in respiratory neural activity, and that RARα activation in/near the phrenic motor pool in the absence of respiratory neural activity deprivation is sufficient to elicit phrenic inspiratory motor facilitation. Understanding cellular cascades underlying plasticity induced by reductions in respiratory neural activity may define avenues for pharmacological intervention in disorders in which endogenous compensatory mechanisms that defend ongoing inspiratory motor output are impaired.NEW & NOTEWORTHY Local mechanisms near phrenic motor neurons respond to reductions in respiratory-related synaptic inputs by triggering a chemoreflex-independent, proportional enhancement in inspiratory output, a form of plasticity called inactivity-induced inspiratory motor facilitation (iMF). Here, we show that activation of spinal retinoic acid receptor alpha (RARα) is necessary to trigger phrenic iMF, and that spinal RARα activation in the absence of respiratory neural activity deprivation is sufficient to elicit phrenic inspiratory facilitation.
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Affiliation(s)
- Kendra M Braegelmann
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Armand Meza
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Abiye E Agbeh
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Daryl P Fields
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Tracy L Baker
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin
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Kim SJ, Kim MK, Shin YB, Kim HE, Kwon JH, Kim JJ. Differences in resting-state functional connectivity according to the level of impulsiveness in patients with internet gaming disorder. J Behav Addict 2021; 10:88-98. [PMID: 33625381 PMCID: PMC8969862 DOI: 10.1556/2006.2021.00005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 06/30/2020] [Accepted: 01/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Impulsiveness is an important factor in the pathophysiology of Internet gaming disorder (IGD), and regional brain functions can be different depending on the level of impulsiveness. This study aimed to demonstrate that different brain mechanisms are involved depending on the level of impulsiveness among patients with IGD. METHODS Resting-state functional MRI data were obtained from 23 IGD patients with high impulsivity, 27 IGD patients with low impulsivity, and 22 healthy controls, and seed-based functional connectivity was compared among the three groups. The seed regions were the ventromedial prefrontal cortex (vmPFC), dorsolateral prefrontal cortex, nucleus accumbens (NAcc), and amygdala. RESULTS Connectivity of the vmPFC with the left temporo-parietal junction (TPJ) and NAcc-left insula connectivity were significantly decreased in the patients with high impulsivity, compared with the patients with low impulsivity and healthy controls. On the other hand, amygdala-based connectivity with the left inferior frontal gyrus showed decreases in both patient groups, compared with the healthy controls. CONCLUSION These findings may suggest a potential relationship between impulsivity and deficits in reward-related social cognition processes in patients with IGD. In particular, certain interventions targeted at vmPFC-TPJ connectivity, found to be impulsivity-specific brain connectivity, are likely to help with addiction recovery among impulsive patients with IGD.
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Affiliation(s)
- Soo-Jeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yu-Bin Shin
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hesun Erin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jun Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
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11
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Pan N, Wang S, Zhao Y, Lai H, Qin K, Li J, Biswal BB, Sweeney JA, Gong Q. Brain gray matter structures associated with trait impulsivity: A systematic review and voxel-based meta-analysis. Hum Brain Mapp 2021; 42:2214-2235. [PMID: 33599347 PMCID: PMC8046062 DOI: 10.1002/hbm.25361] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/27/2020] [Accepted: 01/22/2021] [Indexed: 02/05/2023] Open
Abstract
Trait impulsivity is a multifaceted personality characteristic that contributes to maladaptive life outcomes. Although a growing body of neuroimaging studies have investigated the structural correlates of trait impulsivity, the findings remain highly inconsistent and heterogeneous. Herein, we performed a systematic review to depict an integrated delineation of gray matter (GM) substrates of trait impulsivity and a meta‐analysis to examine concurrence across previous whole‐brain voxel‐based morphometry studies. The systematic review summarized the diverse findings in GM morphometry in the past literature, and the quantitative meta‐analysis revealed impulsivity‐related volumetric GM alterations in prefrontal, temporal, and parietal cortices. In addition, we identified the modulatory effects of age and gender in impulsivity‐GM volume associations. The present study advances understanding of brain GM morphometry features underlying trait impulsivity. The findings may have practical implications in the clinical diagnosis of and intervention for impulsivity‐related disorders.
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Affiliation(s)
- Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Yajun Zhao
- School of Education and Psychology, Southwest Minzu University, Chengdu, China
| | - Han Lai
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Jingguang Li
- College of Teacher Education, Dali University, Dali, China
| | - Bharat B Biswal
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
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12
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Hippocampal cerebral blood flow increased following low-pressure hyperbaric oxygenation in firefighters with mild traumatic brain injury and emotional distress. Neurol Sci 2021; 42:4131-4138. [PMID: 33532950 DOI: 10.1007/s10072-021-05094-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/27/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recent evidence suggests that hyperbaric oxygenation (HBO), which has been used as an effective treatment for certain types of tissue injury, may change neural activities in the human brain and subsequently improve symptoms of psychiatric disorders. To scrutinize the neural mechanism of HBO in the human brain, we investigated whether 20 sessions of HBO changed regional cerebral blood flow (rCBF) of the limbic system in firefighters with mild traumatic brain injury (mTBI) and subjective emotional distress. METHODS Twenty firefighters with mTBI and mild emotional distress were treated with HBO at a relatively low pressure of 1.3 atmospheres absolute for 45 min a day for 20 consecutive days (the mild emotional distress group). The rCBF of the limbic system was measured using an arterial spin labeling perfusion magnetic resonance imaging before and after the HBO. Analyses were performed on the data from fourteen individuals who completed the study and 14 age- and sex-matched healthy firefighters (the comparison group). RESULTS Firefighters in the mild emotional distress group showed increase rCBF following HBO in a cluster encompassing the right hippocampal and parahippocampal regions (peak t = 4.31; cluster size = 248 mm3)(post-hoc analysis, z = 5.92, p < 0.001) that had lower rCBF relative to the comparison group at baseline (post-hoc analysis, t = -2.20, p = 0.04). CONCLUSION The current study demonstrated that low-pressure HBO might increase rCBF of the hippocampal and parahippocampal regions, suggesting a potential underpinning mechanism of HBO in the human brain.
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13
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Gao X, Zhang M, Yang Z, Wen M, Huang H, Zheng R, Wang W, Wei Y, Cheng J, Han S, Zhang Y. Structural and Functional Brain Abnormalities in Internet Gaming Disorder and Attention-Deficit/Hyperactivity Disorder: A Comparative Meta-Analysis. Front Psychiatry 2021; 12:679437. [PMID: 34276447 PMCID: PMC8281314 DOI: 10.3389/fpsyt.2021.679437] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/21/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Patients with Internet gaming disorder (IGD) and attention-deficit/hyperactivity disorder (ADHD) have high comorbidity but it is still unknown whether these disorders have shared and distinctive neuroimage alterations. Objective: The aim of this meta-analysis was to identify shared and disorder-specific structural, functional, and multimodal abnormalities between IGD and ADHD. Methods: A systematic literature search was conducted for whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies comparing people with IGD or ADHD with healthy controls. Regional gray matter volume (GMV) and fMRI differences were compared over the patient groups and then a quantitative comparison was performed to find abnormalities (relative to controls) between IGD and ADHD using seed-based d mapping meta-analytic methods. Result: The meta-analysis contained 14 IGD VBM studies (contrasts covering 333 IGDs and 335 HCs), 26 ADHD VBM studies (1,051 patients with ADHD and 887 controls), 30 IGD fMRI studies (603 patients with IGD and 564 controls), and 29 ADHD fMRI studies (878 patients with ADHD and 803 controls). Structurally, VBM analysis showed disorder-specific GMV abnormality in the putamen among IGD subjects and orbitofrontal cortex in ADHD and shared GMV in the prefrontal cortex. Functionally, fMRI analysis discovered that IGD-differentiating increased activation in the precuneus and shared abnormal activation in anterior cingulate cortex, insular, and striatum. Conclusion: IGD and ADHD have shared and special structural and functional alterations. IGD has disorder-differentiating structural alterations in the putamen and ADHD has alterations in the orbitofrontal cortex. Disorder-differentiating fMRI activations were predominantly observed in the precuneus among IGD subjects and shared impairing function connection was in the rewards circuit (including ACC, OFC, and striatum).
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Affiliation(s)
- Xinyu Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Zhengui Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Mengmeng Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Huiyu Huang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
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14
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Nuyens FM, Kuss DJ, Lopez-Fernandez O, Griffiths MD. The Potential Interaction Between Time Perception and Gaming: A Narrative Review. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00121-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Abstract
Compromised time control is a variable of interest among disordered gamers because time spent on videogames can directly affect individuals’ lives. Although time perception appears to be closely associated with this phenomenon, previous studies have not systematically found a relationship between time perception and gaming. Therefore, the purpose of this narrative review is to explore how gaming disorder may be associated with time perception. It has been found that gamers exhibit a stronger attentional focus as well as an improved working memory compared with non-gamers. However, gamers (and especially disordered gamers) exhibit a stronger reaction to gaming cues which—coupled with an altered emotion regulation observed among disordered gamers—could directly affect their time perception. Finally, “'flow states”' direct most of the attentional resources to the ongoing activity, leading to a lack of resources allocated to the time perception. Therefore, entering a flow state will result in an altered time perception, most likely an underestimation of duration. The paper concludes that the time loss effect observed among disordered gamers can be explained via enhanced emotional reactivity (facilitated by impaired emotion regulation).
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15
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Moreau A, Chauchard É, Sévigny S, Giroux I. Tilt in Online Poker: Loss of Control and Gambling Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5013. [PMID: 32668576 PMCID: PMC7400001 DOI: 10.3390/ijerph17145013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022]
Abstract
Online poker is a form of gambling where an element of skill may influence the outcome of the game. 'Tilt' in poker describes an episode during which the player can no longer control their game by rational decisions. It leads to a loss of control over the game, a loss of emotional regulation, higher cognitive distortion, and a loss of money. This phenomenon, experienced by most players, could be the gateway to excessive gambling. The aim of this study was to assess the links between the frequency of tilt episodes, cognitive distortion, anxiety, depression, sensation seeking and excessive online poker gambling. Our sample is composed of 291 online poker players, with a mean age of 33.8 years (SD = 10.6). Participants completed an online self-assessment questionnaire, measuring the frequency of tilt episodes, cognitive distortion, anxiety, depression and impulsivity. The findings indicated that the frequency of tilt episodes and cognitive distortion were the only significant predictors of excessive online gambling (respectively, r = 0.49 and r = 0.20). Tilt frequency and cognitive distortion were strongly correlated (GRCS, r = 0.60), moderate to low correlations were found for tilt and anxiety (HADS, r = 0.40), and positive and negative urgency (UPPS, r = 0.27). To date, tilt has seldom been studied, and could improve our understanding of online poker gamblers. It could be a new means of identifying at risk gamblers, and thus facilitating preventive measures specifically adapted to this population.
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Affiliation(s)
- Axelle Moreau
- École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, Québec, QC G1V 0A6Q, Canada;
- Institut Universitaire sur les Dépendances, Montréal, QC H2M 2E8, Canada
| | - Émeline Chauchard
- Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, 44035 Nantes, France;
| | - Serge Sévigny
- Département des Fondements et Pratiques en Éducation, Faculté des Sciences de L’éducation, Pavillon des Sciences de L’éducation, Québec, QC G1V 0A6, Canada;
| | - Isabelle Giroux
- École de Psychologie, Université Laval, Pavillon Félix-Antoine-Savard, Québec, QC G1V 0A6Q, Canada;
- Institut Universitaire sur les Dépendances, Montréal, QC H2M 2E8, Canada
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16
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Altered coupling of default-mode, executive-control and salience networks in Internet gaming disorder. Eur Psychiatry 2020; 45:114-120. [DOI: 10.1016/j.eurpsy.2017.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/27/2017] [Accepted: 06/27/2017] [Indexed: 01/01/2023] Open
Abstract
AbstractBackground:Recently, a triple-network model suggested the abnormal interactions between the executive-control network (ECN), default-mode network (DMN) and salience network (SN) are important characteristics of addiction, in which the SN plays a critical role in allocating attentional resources toward the ECN and DMN. Although increasing studies have reported dysfunctions in these brain networks in Internet gaming disorder (IGD), interactions between these networks, particularly in the context of the triple-network model, have not been investigated in IGD. Thus, we aimed to assess alterations in the inter-network interactions of these large-scale networks in IGD, and to associate the alterations with IGD-related behaviors.Methods:DMN, ECN and SN were identified using group-level independent component analysis (gICA) in 39 individuals with IGD and 34 age and gender matched healthy controls (HCs). Then alterations in the SN-ECN and SN-DMN connectivity, as well as in the modulation of ECN versus DMN by SN, using a resource allocation index (RAI) developed and validated previously in nicotine addiction, were assessed. Further, associations between these altered network coupling and clinical assessments were also examined.Results:Compared with HCs, IGD had significantly increased SN-DMN connectivity and decreased RAI in right hemisphere (rRAI), and the rRAI in IGD was negatively associated with their scores of craving.Conclusions:These findings suggest that the deficient modulation of ECN versus DMN by SN might provide a mechanistic framework to better understand the neural basis of IGD and might provide novel evidence for the triple-network model in IGD.
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17
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Mohammadi B, Szycik GR, Te Wildt B, Heldmann M, Samii A, Münte TF. Structural brain changes in young males addicted to video-gaming. Brain Cogn 2020; 139:105518. [PMID: 31954233 DOI: 10.1016/j.bandc.2020.105518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 12/23/2022]
Abstract
Excessive video gaming has a number of psychological and social consequences. In this study, we looked at possible changes in gray and white matter and asked whether these changes are correlated to psychological measures. Twentynine players of violent videogames (mean daily playing time 4.7 h) and age matched controls were subjected to a battery of questionnaires assessing aggression, empathy, hostility, internet addiction and psychological well-being. Diffusion tensor and 3D T1-weighted MR images were obtained to examine gray (via voxel-based morphometry) and white (via tract-based spatial statistics) matter changes. Widespread regions of decreased gray matter in the players were found but no region showed increased intensity of gray matter. Density of gray matter showed a negative correlation with the total length of playing in years in the right posterior cingulate gyrus, left pre- and postcentral gyrus, right thalamus, among others. Furthermore, fractional anisotropy, a marker for white matter structure, was decreased in the left and right cingulum in the players. Both, gray and white matter changes correlated with measures of aggression, hostility, self esteem, and the degree of internet addiction. This study thus shows profound changes of brain structure as a function of excessive playing of violent video games.
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Affiliation(s)
- Bahram Mohammadi
- Dept. of Neurology, University of Lübeck, Lübeck, Germany; CNS-lab, International Neuroscience Institute, Hannover, Germany
| | - Gregor R Szycik
- Dept. of Psychiatry, Hannover Medical School, Hannover, Germany
| | | | - Marcus Heldmann
- Dept. of Neurology, University of Lübeck, Lübeck, Germany; Institute of Psychology II, University of Lübeck, Lübeck, Germany
| | - Amir Samii
- CNS-lab, International Neuroscience Institute, Hannover, Germany
| | - Thomas F Münte
- Dept. of Neurology, University of Lübeck, Lübeck, Germany; Institute of Psychology II, University of Lübeck, Lübeck, Germany
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18
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Şalvarlı Şİ, Griffiths MD. The Association Between Internet Gaming Disorder and Impulsivity: A Systematic Review of Literature. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00126-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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19
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Shin D, Choi AR, Lee J, Chung SJ, Kim B, Park M, Jung MH, Kim DJ, Choi JS. The Mediating Effects of Affect on Associations between Impulsivity or Resilience and Internet Gaming Disorder. J Clin Med 2019; 8:jcm8081102. [PMID: 31349640 PMCID: PMC6723401 DOI: 10.3390/jcm8081102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022] Open
Abstract
Internet gaming disorder (IGD) is a new disease proposed by the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), and has been studied extensively in relation to depression and impulsivity. The relationship between resilience and disease has been found in a variety of addictive disorders, but studies on IGD are lacking. In this study, 71 IGD patients and 78 healthy controls (HCs) were recruited. Impulsivity, resilience, affects, and the degree of internet game addiction were measured using formal tools. The measured values were analyzed by mediation analysis to evaluate the mediating role of affects on resilience and impulsivity related to IGD symptoms. The IGD group showed higher impulsivity, lower resilience, lower positive affect, and higher negative affect than the HC group. The mediation analysis showed that a positive affect was a mediator between impulsivity and the severity of addiction in both groups. Negative affect mediated impulsivity/resilience and the severity of addiction only in the IGD group. Although the results of this study are based on a narrow category of subjects, who are young male adults around 25 years of age, the results suggest that positive affect can be strengthened to prevent the IGD illness, and that illness symptoms may be alleviated by reducing negative affect.
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Affiliation(s)
- Daun Shin
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Korea
| | - A Ruem Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea
| | - Jiyoon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea
| | - Sun Ju Chung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea
| | - Bomi Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea
| | - Myung Hun Jung
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea
| | - Dai Jin Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul 06591, Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea.
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul 03080, Korea.
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20
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Clinical Characteristics of Diagnosis for Internet Gaming Disorder: Comparison of DSM-5 IGD and ICD-11 GD Diagnosis. J Clin Med 2019; 8:jcm8070945. [PMID: 31261841 PMCID: PMC6678371 DOI: 10.3390/jcm8070945] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/27/2022] Open
Abstract
The American Psychiatric Association (APA) included internet game disorder (IGD) in section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) on the condition that it guaranteed more clinical research and experience. The World Health Organization (WHO) also included Game Disorder (GD) in the 11th final revision of the International Classification of Diseases (ICD-11) and recently recognized it as a diagnosis code. This study aims to compare clinical characteristics and gaming behavior patterns between the IGD diagnosis criteria proposed by the DSM-5 and the GD diagnosis criteria proposed by the ICD-11 based on clinical cohort data (c-CURE: clinic-Cohort for Understanding of internet addiction Rescue factors in Early life) obtained in the Republic of Korea. Psychologists and psychiatrists conducted semi-structured interviews with children/adolescents and their caregivers to identify IGD (Diagnostic Interview for Internet, Game, SNS, etc. Addiction, DIA), and comorbid psychiatric disorders (Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean version, K-SADS-PL). The cohort was divided into three IGD diagnosis groups (Normal, DSM5, DSM5 + ICD11) based on DSM-5 and ICD-11 diagnosis criteria. Internet usage pattern and addiction characteristics and psychiatric comorbidities were compared among the three IGD diagnosis groups. The Normal group consisted of 115 subjects, the DSM5 group contained 61 subjects, and the DSM5 + ICD11 group amounted to 12 subjects. The DSM5 + ICD11 group had a lower age of starting use of Internet/games/smartphones than other groups and the average time of Internet/game/smartphone use during weekdays/weekends was the highest. Also, in the eight items scored, excluding ‘deceiving’ and ‘craving’, the rate of threshold was highest in the DSM5 + ICD11 group, followed by the DSM5 group and the Normal group. On the other hand, ‘deceiving’ and ‘craving’ were the highest in DSM5, followed by DSM5 + ICD11 and Normal. The DSM5 + ICD11 group had significantly higher rates of depressive disorder, oppositional defiant disorder (ODD) and conduct disorder (CD) compared to other groups. This study provides implications for the clinical characteristics of IGD diagnosis in the field by comparing the DSM-5 IGD diagnosis criteria with the ICD-11 GD diagnosis criteria. Furthermore, this study provides empirical evidence that ICD-11 GD emphasizes serious symptoms such as functional impairment caused by excessive Internet/game/smartphone use over a long time, and it supports the validity of the ICD-11 GD diagnosis.
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21
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Besteher B, Gaser C, Nenadić I. Brain structure and trait impulsivity: A comparative VBM study contrasting neural correlates of traditional and alternative concepts in healthy subjects. Neuropsychologia 2019; 131:139-147. [PMID: 31071323 DOI: 10.1016/j.neuropsychologia.2019.04.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/08/2019] [Accepted: 04/24/2019] [Indexed: 12/16/2022]
Abstract
Impulsivity as a trait modulates a range of cognitive functions, e.g. planning, decision-making, or response inhibition. Recent behavioural and psychometric findings challenge both the neurobiological models as well as the conceptualisation of psychometric measures of impulsivity. In the present study, we aimed to test the association of brain structure with the Barratt Impulsiveness Scale (BIS-11), a commonly applied self-rating instrument for impulsivity, using both the classical three-factor-model for impulsive behaviour (motor (IM), attentional (IA) and non-planning impulsivity (INP)), as well as the recently proposed alternative model contrasting inability to wait for reward (IWR) as an index of impulsive choice and rapid response style (RRS) as an index of impulsive action. We analysed brain structural data in a community sample of 85 healthy individuals, who completed the BIS-11, using voxel-based morphometry (CAT12: Computational Anatomy Toolbox 12). Regional volumes were correlated with the three traditional BIS-11 subscales, as well as IWR and RRS. BIS-11 total score was positively correlated with right inferior parietal, postcentral, and supramarginal grey matter (p < 0.05, FWE cluster-level corrected). Attentional impulsivity (IA) was also positively correlated with right inferior and superior parietal and supramarginal gyri. Comparison of the other scales did show some divergence, but most correlations did not survive correction for multiple comparisons. Our findings suggest that difference facets of trait impulsivity might be related to different brain areas, and might thus dissociate along distinct but overlapping neural networks. In contrast to lesion or patient studies, these analyses delineate physiological variance, and can thus help to conceptualise network models in the absence of pathology.
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Affiliation(s)
- Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg / Marburg University Hospital - UKGM, Marburg, Germany
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22
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Liu SJ, Lan Y, Wu L, Yan WS. Profiles of Impulsivity in Problematic Internet Users and Cigarette Smokers. Front Psychol 2019; 10:772. [PMID: 31019482 PMCID: PMC6458249 DOI: 10.3389/fpsyg.2019.00772] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/20/2019] [Indexed: 01/13/2023] Open
Abstract
Problematic Internet use (PIU) has been gradually recognized as a mental health issue among adolescents and young students. PIU shows many similarities with substance use disorders, but the shared and distinct mechanisms underlying them are unclear. The purpose of the current study was to explore the relationships between impulsive traits and PIU as well as cigarette smoking behaviors among young adults. Two independent samples of university students (N 1 = 1281, N 2 = 1034, respectively) over 3 years were assessed with multiple measurements of impulsivity, including the Barratt Impulsiveness Scale-11 (BIS-11), the UPPSP Impulsive Behaviors Scale (UPPSP), and the Delay-discounting Test (DDT). Logistic regression models revealed that across the two independent samples, BIS-11 Attentional Impulsiveness was the common trait positively predicting both PIU and cigarette smoking. While BIS-11 Motor Impulsiveness as well as UPPSP Lack of Perseverance, Lack of Premeditation, and Negative Urgency were the typical traits linked to PIU as positive predictors, UPPSP Sensation Seeking was the unique trait linked to cigarette smoking as a positive predictor. These results suggested that specific dimensions of impulsivity might be concurrently implicated in PIU and cigarette smoking among young adults, putatively representing important trait marks for addictive behaviors.
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Affiliation(s)
- Su-Jiao Liu
- Department of Psychology, School of Philosophy and Sociology, Jilin University, Changchun, China
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| | - Yan Lan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
| | - Lin Wu
- Department of Sociology, Wuhan University, Wuhan, China
| | - Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, Guiyang, China
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Zsidó AN, Darnai G, Inhóf O, Perlaki G, Orsi G, Nagy SA, Lábadi B, Lénárd K, Kovács N, Dóczi T, Janszky J. Differentiation between young adult Internet addicts, smokers, and healthy controls by the interaction between impulsivity and temporal lobe thickness. J Behav Addict 2019; 8:35-47. [PMID: 30739462 PMCID: PMC7044605 DOI: 10.1556/2006.8.2019.03] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND AND AIMS Internet addiction is a non-substance-related addiction disorder with progressively growing prevalence. Internet addiction, like substance-related addictions, has been linked with high impulsivity, low inhibitory control, and poor decision-making abilities. Cortical thickness measurements and trait impulsivity have been shown to have a distinct relationship in addicts compared to healthy controls. Thus, we test whether the cortical correlates of trait impulsivity are different in Internet addicts and healthy controls, using an impulsive control group (smokers). METHODS Thirty Internet addicts (15 females) and 60 age- and gender-matched controls (30 smokers, all young adults aged 19-28 years) were scanned using a 3T MRI scanner and completed the Barratt Impulsiveness Scale. RESULTS Internet addicts had a thinner left superior temporal cortex than controls. Impulsivity had a significant main effect on the left pars orbitalis and bilateral insula, regardless of group membership. We identified divergent relationships between trait impulsivity and thicknesses of the bilateral middle temporal, right superior temporal, left inferior temporal, and left transverse temporal cortices between Internet addicts and healthy controls. Further analysis with smokers revealed that the left middle temporal and left transverse temporal cortical thickness change might be exclusive to Internet addiction. DISCUSSION The effects of impulsivity, combined with a long-term exposure to some specific substance or stimuli, might result in different natures of relationships between impulsivity and brain structure when compared to healthy controls. CONCLUSION These results may indicate that Internet addiction is similar to substance-related addictions, such that inefficient self-control could result in maladaptive behavior and inability to resist Internet use.
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Affiliation(s)
- András N. Zsidó
- Institute of Psychology, University of Pécs, Pécs, Hungary,Corresponding author: Andras N. Zsidó; Institute of Psychology, University of Pécs, 6 Ifjusag Street, Pécs, Baranya H 7624, Hungary; Phone/Fax: +36 72 501 516; E-mail:
| | - Gergely Darnai
- Institute of Psychology, University of Pécs, Pécs, Hungary,Department of Neurology, Medical School, University of Pécs, Pécs, Hungary,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Orsolya Inhóf
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Gábor Perlaki
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary,Pécs Diagnostic Centre, Pécs, Hungary,Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Gergely Orsi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary,Pécs Diagnostic Centre, Pécs, Hungary,Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - Szilvia Anett Nagy
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary,Pécs Diagnostic Centre, Pécs, Hungary,Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary,MTA-PTE Neurobiology of Stress Research Group, Szentágothai Research Center, Pécs, Hungary
| | - Beatrix Lábadi
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Kata Lénárd
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Norbert Kovács
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Tamás Dóczi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary,Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary
| | - József Janszky
- Department of Neurology, Medical School, University of Pécs, Pécs, Hungary,MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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24
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Sugaya N, Shirasaka T, Takahashi K, Kanda H. Bio-psychosocial factors of children and adolescents with internet gaming disorder: a systematic review. Biopsychosoc Med 2019; 13:3. [PMID: 30809270 PMCID: PMC6374886 DOI: 10.1186/s13030-019-0144-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/29/2019] [Indexed: 12/24/2022] Open
Abstract
Previous large-scale studies suggest that internet gaming disorder (IGD) among children and adolescents has become an important public concern. Minors are known to be particularly susceptible to problematic internet gaming use owing to age-related underdevelopment of cognitive control. It has been shown that precursors of addictions appear during adolescence; therefore, prevention efforts must be established targeting minors who have their first experience with addictive substances and behaviors during pubescence. Since the DSM-5 classification of IGD in 2013, studies on IGD have drastically increased in number. Thus, we performed an updated review of studies of IGD in children and adolescents to assess the clinical implications of IGD. The search included all publication years, using PubMed, MEDLINE, and PsycINFO. Across studies, the presence of IGD had a negative effect on sleep and schoolwork in minors. Additionally, family factors, including the quality of parent-child relationships, were important social factors in minors with IGD. Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum. Persistent pathological online game use from childhood may aggravate abnormal brain function; therefore, preventive care and early intervention are increasingly important. Although extant research supports the effectiveness of cognitive behavioral therapy for minors with IGD, effective psychological intervention for minors with IGD is an urgent issue that requires further research. This review, which presents updated findings of IGD in minors, is expected to contribute to the development of future research and be useful in clinical practice in the field of child and adolescent psychiatry.
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Affiliation(s)
- Nagisa Sugaya
- 1Unit of Public Health and Preventive Medicine, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004 Japan
| | - Tomohiro Shirasaka
- 2Department of Psychiatry, Teine Keijinkai Hospital, 1-12-1-40 Maeda, Teine-ku, Sapporo, Hokkaido 006-8555 Japan
| | - Kenzo Takahashi
- 3Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605 Japan
| | - Hideyuki Kanda
- 4Faculty of Medicine, Department of Environmental Medicine and Public Health, Shimane University, 89-1 Enya-cho, Izumo-shi, Shimane 693-8501 Japan
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Ryu H, Lee JY, Choi AR, Chung SJ, Park M, Bhang SY, Kwon JG, Kweon YS, Choi JS. Application of Diagnostic Interview for Internet Addiction (DIA) in Clinical Practice for Korean Adolescents. J Clin Med 2019; 8:jcm8020202. [PMID: 30736373 PMCID: PMC6406814 DOI: 10.3390/jcm8020202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/25/2019] [Accepted: 02/02/2019] [Indexed: 12/19/2022] Open
Abstract
The increased prevalence of Internet Gaming Disorder (IGD) and the inclusion of IGD in DSM-5 and ICD-11 emphasizes the importance of measuring and describing the IGD symptoms. We examined the psychometric properties of the Diagnostic Interview for Internet Addiction (DIA), a semi-structured diagnostic interview tool for IGD, and verified the application of DIA in clinical practice for Korean adolescents. The DIA is conducted in a manner that interviews both adolescents and their caregivers, and each item has a standardized representative question and various examples. It consists of 10 items based on the DSM-5 IGD diagnostic criteria, which is cognitive salience, withdrawal, tolerance, difficulty in regulating use, loss of interest in other activities, persistent use despite negative results, deception regarding Internet/games/SNS use, use of Internet/games/SNS to avoid negative feelings, interference with role performance, and craving. The study included 103 adolescents divided into three subgroups (mild risk, moderate risk, and addicted group) based on the total score of DIA. Demographic and clinical characteristics were compared among the DIA subgroups using the chi-square test and analysis of variance (ANOVA), and correlation analysis was used to examine the associations of IGD symptoms with clinical variables (e.g., impulsivity, aggression, depression, anxiety, self-esteem). The DIA total score was significantly correlated with Internet and smartphone addiction, depression, state anxiety, self-esteem, impulsivity, aggression, and stress. Furthermore, the moderate risk and addicted group showed significantly higher levels of Internet and smartphone addiction, anxiety, depression, impulsivity, aggression, stress, and lower self-esteem compared with the mild risk group. The Junior Temperament and Character Inventory (JTCI), which measures temperament and character traits, revealed that the mild risk group had higher levels of persistence and self-directedness than did the addicted group. Our findings confirmed the psychometric properties of DIA and the application of the DIA classifications in Korean adolescents.
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Affiliation(s)
- Hyera Ryu
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
| | - Ji Yoon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
| | - A Ruem Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
| | - Sun Ju Chung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji General Hospital, Seoul 01830, Korea;
| | - Jun-Gun Kwon
- I Will Center, Seoul Metropolitan Boramae Youth Center, Seoul 07062, Korea;
| | - Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Gyeonggi 11765, Korea
- Correspondence: (Y.-S.K.); (J.-S.C.); Tel.: +82-31-1661-7500 (Y.-S.K.); +82-2-870-2177 (J.-S.C.)
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (H.R.); (J.Y.L.); (A.R.C.); (S.J.C.); (M.P.)
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: (Y.-S.K.); (J.-S.C.); Tel.: +82-31-1661-7500 (Y.-S.K.); +82-2-870-2177 (J.-S.C.)
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26
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Evren B, Dalbudak E, Evren C, Ozen S. The relationship of internet addiction symptom severity with posttraumatic stress disorder symptoms and impulsivity among Turkish university students. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1505422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
| | | | - Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Secil Ozen
- Department of Psychiatry, Gulhane Training and Research Hospital, Ankara, Turkey
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27
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Prevalence and Correlates of Problematic Online Gaming: a Systematic Review of the Evidence Published in Chinese. CURRENT ADDICTION REPORTS 2018. [DOI: 10.1007/s40429-018-0219-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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28
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Guerrero-Apolo JD, Navarro-Pastor JB, Bulbena-Vilarrasa A, Gabarre-Mir J. The slant of the forehead as a craniofacial feature of impulsiveness. ACTA ACUST UNITED AC 2018. [PMID: 29538488 PMCID: PMC6899405 DOI: 10.1590/1516-4446-2017-2339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objective: Impulsiveness has been the subject of much research, but little is known about the possible relationship between craniofacial anatomy and impulsiveness. The present study was designed to investigate the relationship between one aspect of craniofacial structure (the angle of inclination of the forehead) and impulsiveness. Method: Photographs in profile were obtained from 131 volunteers who had been fined for driving at high speed and were undergoing a court-mandated driving license point-recovery course. They completed the Barratt Impulsiveness Scale (BIS-11), the Impulsive Behavior Scale (UPPS-P), and Zuckerman’s Sensation Seeking Scale (V). The angle of the slant of the forehead was measured with a photographic support and a protractor. Results: High positive concordance was found between forehead inclination and 14 out of the 15 impulsiveness factors studied. Conclusions: The angle of inclination of the forehead was significantly associated with self-reported impulsiveness in this sample of traffic violators.
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Affiliation(s)
- J David Guerrero-Apolo
- Departament de Psiquiatria i Medicina Legal, Doctorat en Psiquiatria, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Institute of Craniofacial Psychology, Barcelona, Spain
| | - J Blas Navarro-Pastor
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Facultat de Psicologia, UAB, Barcelona, Spain
| | - Antonio Bulbena-Vilarrasa
- Departament de Psiquiatria i Medicina Legal, Doctorat en Psiquiatria, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Unitat d'Ansietat, Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, UAB, Barcelona, Spain
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29
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Tian M, Tao R, Zheng Y, Zhang H, Yang G, Li Q, Liu X. Internet gaming disorder in adolescents is linked to delay discounting but not probability discounting. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.10.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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30
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Kuss DJ, Pontes HM, Griffiths MD. Neurobiological Correlates in Internet Gaming Disorder: A Systematic Literature Review. Front Psychiatry 2018; 9:166. [PMID: 29867599 PMCID: PMC5952034 DOI: 10.3389/fpsyt.2018.00166] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/11/2018] [Indexed: 12/25/2022] Open
Abstract
Internet Gaming Disorder (IGD) is a potential mental disorder currently included in the third section of the latest (fifth) edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) as a condition that requires additional research to be included in the main manual. Although research efforts in the area have increased, there is a continuing debate about the respective criteria to use as well as the status of the condition as mental health concern. Rather than using diagnostic criteria which are based on subjective symptom experience, the National Institute of Mental Health advocates the use of Research Domain Criteria (RDoC) which may support classifying mental disorders based on dimensions of observable behavior and neurobiological measures because mental disorders are viewed as biological disorders that involve brain circuits that implicate specific domains of cognition, emotion, and behavior. Consequently, IGD should be classified on its underlying neurobiology, as well as its subjective symptom experience. Therefore, the aim of this paper is to review the neurobiological correlates involved in IGD based on the current literature base. Altogether, 853 studies on the neurobiological correlates were identified on ProQuest (in the following scholarly databases: ProQuest Psychology Journals, PsycARTICLES, PsycINFO, Applied Social Sciences Index and Abstracts, and ERIC) and on MEDLINE, with the application of the exclusion criteria resulting in reviewing a total of 27 studies, using fMRI, rsfMRI, VBM, PET, and EEG methods. The results indicate there are significant neurobiological differences between healthy controls and individuals with IGD. The included studies suggest that compared to healthy controls, gaming addicts have poorer response-inhibition and emotion regulation, impaired prefrontal cortex (PFC) functioning and cognitive control, poorer working memory and decision-making capabilities, decreased visual and auditory functioning, and a deficiency in their neuronal reward system, similar to those found in individuals with substance-related addictions. This suggests both substance-related addictions and behavioral addictions share common predisposing factors and may be part of an addiction syndrome. Future research should focus on replicating the reported findings in different cultural contexts, in support of a neurobiological basis of classifying IGD and related disorders.
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Affiliation(s)
- Daria J Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Halley M Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
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31
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Yao YW, Liu L, Ma SS, Shi XH, Zhou N, Zhang JT, Potenza MN. Functional and structural neural alterations in Internet gaming disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2017; 83:313-324. [PMID: 29102686 DOI: 10.1016/j.neubiorev.2017.10.029] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/06/2017] [Accepted: 10/29/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Yuan-Wei Yao
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Lu Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Shan-Shan Ma
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Xin-Hui Shi
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Nan Zhou
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Jin-Tao Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China.
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, Yale University School of Medicine, New Haven, CT, 06519, USA; Connecticut Mental Health Center, New Haven, CT, 06519, USA
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32
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Weckler H, Kong G, Larsen H, Cousijn J, Wiers RW, Krishnan-Sarin S. Impulsivity and approach tendencies towards cigarette stimuli: Implications for cigarette smoking and cessation behaviors among youth. Exp Clin Psychopharmacol 2017; 25:363-372. [PMID: 29048185 PMCID: PMC6849389 DOI: 10.1037/pha0000139] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Impulsivity is associated with smoking, difficulties quitting smoking, and approach tendencies toward cigarette stimuli among adolescents. We examined the effects of impulsivity on (a) the association between approach tendencies and adolescents' smoking status and (b) the effectiveness of Cognitive Bias Modification (CBM), a smoking cessation intervention focused on changing approach tendencies, among adolescent smokers. We conducted a secondary analysis of evidence from 2 previous published studies: Study 1: a cross-sectional study comparing impulsivity and approach tendencies between adolescent smokers (n = 67) and nonsmokers (n = 58); Study 2: a treatment study that randomized 60 adolescent smokers to receive either CBM or sham training. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS) and the Experiential Discounting Task (EDT). We found higher impulsivity, as determined by the BIS but not the EDT, increased adolescents' odds of being smokers. We observed that the interaction between EDT and approach tendencies also significantly predicted smoking status, however post hoc comparisons were not significant. Adolescents with higher BIS scores receiving CBM had increased odds of being abstinent at the end of treatment, but we found no association between EDT and treatment outcome. Our findings suggest that approach-bias modification (a form of CBM) may be more effective in impulsive adolescent smokers. Differences in findings for BIS and EDT highlight the complexity of the construct of impulsivity. Future studies with larger samples are needed to further disentangle the effects of different aspects of impulsivity on smoking behaviors and cessation outcomes among youth. (PsycINFO Database Record
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Affiliation(s)
| | | | - Helle Larsen
- Department of Developmental Psychology, ADAPT Lab, Research Priority Area Yield, University of Amsterdam
| | - Janna Cousijn
- Department of Developmental Psychology, ADAPT Lab, Research Priority Area Yield, University of Amsterdam
| | - Reinout W Wiers
- Department of Developmental Psychology, ADAPT Lab, Research Priority Area Yield, University of Amsterdam
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33
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Du X, Liu L, Yang Y, Qi X, Gao P, Zhang Y, Zhu J, Du G, Dai S, Li X, Zhang Q. Diffusion tensor imaging of the structural integrity of white matter correlates with impulsivity in adolescents with internet gaming disorder. Brain Behav 2017; 7:e00753. [PMID: 28828214 PMCID: PMC5561314 DOI: 10.1002/brb3.753] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 04/13/2017] [Accepted: 05/14/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Internet gaming disorder (IGD) is usually defined as the inability of an individual to control internet gaming resulting in serious negative consequences, and trait impulsivity has been viewed as a hallmark feature of IGD. Recent studies have suggested that the structural integrity of the white matter (WM) plays an important role in the neuromediation of an individual's impulsivity. However, no study has examined the association between WM integrity and impulsivity in IGD adolescents. METHODS In this study, 33 adolescents with IGD and 32 healthy controls (HCs) were recruited, and the intergroup differences in the relationships between impulsivity and fractional anisotropy (FA) values across the whole brain WM were investigated using voxel-wise correlation analyses. RESULTS Our results revealed significant intergroup differences in the correlations between impulsivity and the FA values of the right corticospinal tract (CST) and the right occipital WM. Region of interest-based tests revealed that the FA values of these clusters were positive or insignificantly correlated with impulsivity in the IGD adolescents contrasted to the significantly negative correlation in the HCs. CONCLUSIONS This altered correlations in the IGD adolescents might reflect potential WM microstructural changes which may be associated with the greater impulsivity of IGD adolescents and provide possible therapeutic targets for interventions in this population.
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Affiliation(s)
- Xin Du
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging Tianjin Medical University General Hospital Tianjin China
| | - Linlin Liu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging Tianjin Medical University General Hospital Tianjin China
| | - Yongxin Yang
- Department of Psychology Linyi Fourth People's Hospital Linyi Shandong China
| | - Xin Qi
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging Tianjin Medical University General Hospital Tianjin China
| | - Peihong Gao
- Department of Radiology Linyi People's Hospital Linyi Shandong China
| | - Yang Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging Tianjin Medical University General Hospital Tianjin China
| | - Jiyu Zhu
- Department of Radiology Linyi People's Hospital Linyi Shandong China
| | - Guijin Du
- Department of Radiology Linyi People's Hospital Linyi Shandong China
| | - Shouping Dai
- Department of Radiology Linyi People's Hospital Linyi Shandong China
| | - Xiaodong Li
- Department of Radiology Linyi People's Hospital Linyi Shandong China
| | - Quan Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging Tianjin Medical University General Hospital Tianjin China
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Di Nicola M, Ferri VR, Moccia L, Panaccione I, Strangio AM, Tedeschi D, Grandinetti P, Callea A, De-Giorgio F, Martinotti G, Janiri L. Gender Differences and Psychopathological Features Associated With Addictive Behaviors in Adolescents. Front Psychiatry 2017; 8:256. [PMID: 29249992 PMCID: PMC5716988 DOI: 10.3389/fpsyt.2017.00256] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/13/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The aims of the study were to assess prevalence and gender differences of addictive behaviors (substance- and non-substance-related) in an adolescent population, and their association with psychopathological features and academic performance. MATERIAL AND METHODS A sample of high school Italian students (n = 996; M = 240, F = 756) was examined using a self-report survey concerning sociodemographic characteristics, cigarette smoking, alcohol and substance use, perceived academic performance, activities, and behaviors (Internet use, gambling, and physical exercising). The Internet Addiction Test, the South Oaks Gambling Screen-revised Adolescent, and the Exercise Addiction Inventory-Short Form were administered to identify problematic behaviors. The Barratt Impulsiveness Scale for Adolescent, the Snaith-Hamilton Pleasure Scale, the Dissociative Experience Scale for Adolescent, and the Toronto Alexithymia Scale were used to investigate psychopathological dimensions. RESULTS Frequent alcohol intake and lifetime substances consumption were more common among males. The occurrence of other addictive behaviors was 22.1% for problematic Internet use (M = F), 9.7% for at-risk/problematic gambling (M > F), and 6.2% for maladaptive physical exercise (M = F). We also found an association between substance-/non-substance-related addictive behaviors and psychopathological dimensions. Addictive behaviors were more frequent among students reporting poor school performance. CONCLUSION Our study showed a relevant prevalence of addictive behaviors in a sample of Italian high school students, with specific gender differences. We underlined the cooccurrence of substance and non-substance-related addictive behaviors, and their association with worse school performance. Dissociative proneness, anhedonia, alexithymia, and impulsivity were associated with addictive behaviors in adolescents and might represent vulnerability factors for the development of psychiatric disorders in adulthood. A better understanding of psychopathological features associated with addictive behaviors might be useful for the prevention/early intervention.
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Affiliation(s)
- Marco Di Nicola
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vittoria Rachele Ferri
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Moccia
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Isabella Panaccione
- NESMOS Department, School of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Annamaria Miriam Strangio
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Tedeschi
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Grandinetti
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Fabio De-Giorgio
- Section of Legal Medicine, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
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