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Brain fMRI study of crave induced by cue pictures in online game addicts (male adolescents)
Abstract
To study crave-related cerebral regions induced by game figure cues in online game addicts. fMRI brain imaging was done when the subjects were shown picture cues of the WoW (World of Warcraft, Version: 4.1.014250) game.
10 male addicts of WoW were selected as addicts' group, and 10 other healthy male non-addicts who were matched by age, were used as non-game addicts' group. All volunteers participated in fMRI paradigms. WoW associated cue pictures and neutral pictures were shown. We examined functional cerebral regions activated by the pictures with 3.0 T Philips MRI. The imaging signals' database was analyzed by SPM5. The correlation between game craving scores and different image results were assessed.
When the game addicts watch the pictures, some brain areas show increased signal activity namely: dorsolateral prefrontal cortex, bilateral temporal cortex, cerebellum, right inferior parietal lobule, right cuneus, right hippocampus, parahippocampal gyrus, left caudate nucleus. But in these same brain regions we did not observe remarkable activities in the control group. Differential image signal densities of the addict group were subtracted from the health control group, results of which were expressed in the bilateral dorsolateral prefrontal cortex, anterior cingulate cortex, inferior parietal lobe and inferior temporal gyrus, cerebellum, right insular and the right angular gyrus. The increased imaging signal densities were significant and positively correlated with the craving scale scores in the bilateral prefrontal cortex, anterior cingulate cortex and right inferior parietal lobe.
Craving of online game addicts was successfully induced by game cue pictures. Crave related brain areas are: dorsolateral prefrontal cortex, anterior cingulate cortex, and right inferior parietal lobe. The brain regions are overlapped with cognitive and emotion related processing brain areas.
... As a consequence, goal-directed processes including planning and decision-making would be activated to get in game (Ko et al., 2013). Consistently, based on prior research, IGDs exhibit hyperactivation both in the frontoparietal network regions, particularly in dorsolateral prefrontal cortex (Ko et al., 2009;Ko et al., 2013;Ma et al., 2019;Sun et al., 2012), and the limbic network (Ma et al., 2019) during game-related cue-reactivity task. Previous evidence has revealed that connection between networks involved in executive control and reward sensitivity plays a critical role in compulsive behavior in substance-use disorder . ...
... The present study aims to integrate the findings of large-scale networks dysfunction in IGDs and investigate the brain mechanisms from the perspective of functional network by conducting a meta-analysis of whole-brain seed-based rsFC studies. Based on the theoretical model and empirical studies in IGD, we hypothesized that compared to HCs, IGDs would exhibit: (1) blunted interaction across the default mode network regions, reflecting poor emotional capability and self-related control (Hampson et al., 2006;Lee et al., 2017;Ma et al., 2010, 2) enhanced connectivity between the ventral attention network and default mode network, revealing increased sensitivity to salient stimuli (i.e., gamingassociated cue) and decreased goal-directed behaviors Menon and Uddin, 2010;Schmaal et al., 2013, 3) stronger connectivity between the ventral attention network and somatomotor network, linked to habitual addictive behaviors and more automatic response to salient stimuli, as a result of "learning to lose control" (Perales et al., 2020); and (4) stronger synchronization between the limbic network and frontoparietal network, associated with stronger gaming-associated motivation, impulsivity and more facilitated decision-making (Ko et al., 2009;Ko et al., 2013;Sun et al., 2012). Particular networks are represented by seed-ROIs selected in rsFC studies. ...
... Recent study has also revealed that the frontoparietal network is a key network to predict and monitor behavioral outcomes (Zubarev and Parkkonen, 2018). According to previous research, IGDs exhibit hyperactivation in regions within the frontoparietal network, particularly in dorsolateral prefrontal cortex during game-related cue-reactivity task (Ko et al., 2009;Ko et al., 2013;Ma et al., 2019;Sun et al., 2012) and addiction stroop task (Zhang et al., 2016a). Hence, the frontoparietal areas may be involved in retrieval of reward-related experience, reward anticipation and executive attention distribution when being confronted with reward stimuli. ...
Internet gaming disorder (IGD) has been defined as a specific behavioral disorder, associated with abnormal interactions among large-scale brain networks. Researchers have sought to identify the network dysfunction in IGD using resting-state functional connectivity (rsFC). However, results across studies have not reached an agreement yet and the mechanism remains unclear.
The present research aimed to investigate network dysfunction in IGD through a meta-analysis of rsFC studies. Twenty-two seed-based voxel-wise rsFC studies from 25 publications (594 individuals with IGD and 496 healthy controls) were included. By categorizing seeds into seed-networks based on their location within a prior functional network parcellations, we performed a Multilevel kernel density analysis (MKDA) within each seed-network to identify which brain systems showed abnormal interaction with particular seed-network in individuals with IGD.
Compared to healthy control groups, individuals with IGD exhibited significant hypoconnectivity within the default mode network, and enhanced connectivity between the default mode network and insula within the ventral attention network. IGD was also associated with increased connectivity between the ventral attention network and somatomotor regions. Furthermore, the IGD groups showed hyperconnectivity between the limbic network and regions of the frontoparietal network.
The results suggest that individuals with IGD show large-scale functional network alteration which underpins their core symptoms including poor emotional competence, cue-reactivity and craving, habitual addictive behaviors and impaired executive control. Whether the compensation mechanism exists in IGD is discussed, and further research is needed. The findings provide a neurocognitive network model of IGD, which may serve as functional biomarkers for IGD and have potentials for development of effective diagnosis and therapeutic interventions.
... Craving may be elicited by addiction-related cues , and cue reactivity may contribute importantly to the development and maintenance of addictive behaviors (Carter and Tiffany, 1999;Goudriaan et al., 2010;Tong and Bovbjerg, 2007) and to relapse into addictive behaviors (Kosten et al., 2006;Marissen et al., 2006). Previous neuroimaging investigations of IGD have implicated involvement of the dorsolateral prefrontal cortex, middle frontal gyrus, anterior cingulate cortex, insula, and precuneus in response to gaming-related cues (Han et al., 2011;Ko et al., 2009;Sun et al., 2012;Wang et al., 2017;Zhang et al., 2016). ...
... The results suggest important roles for these regions in cue-reactivity and are similar to our previous results based on GLM analyses (Zhang et al., 2016). They are also in accordance with other prior findings (Dong et al., 2020a,b;Ko et al., 2009;Sun et al., 2012). The middle frontal gyrus has been implicated in self-regulation, craving, impulse control and reward-related processes in addictions (Goldstein and Volkow, 2011), including IGD (Zheng et al., 2019) and as proposed in theoretical models of IGD (Dong and Potenza, 2014). ...
... It is possible that the MVPA is identifying individual differences in familiarity with the task stimuli rather than IGD per se. However, the results of our study are similar to other prior findings that involved experienced gamers and were based on GLM analysis (Dong et al., 2020a,b;Sun et al., 2012). The results would potentially be strengthened had a group of gamers without IGD been included, and this approach should be used in future studies. ...
Background
Neural mechanisms underlying internet gaming disorder (IGD) are important for diagnostic considerations and treatment development. However, neurobiological underpinnings of IGD remain relatively poorly understood.
Methods
We employed multi-voxel pattern analysis (MVPA), a machine-learning approach, to examine the potential of neural features to statistically predict IGD status and treatment outcome (percentage change in weekly gaming time) for IGD. Cue-reactivity fMRI-task data were collected from 40 male IGD subjects and 19 male healthy control (HC) subjects. 23 IGD subjects received 6 weeks of craving behavioral intervention (CBI) treatment. MVPA was applied to classify IGD subjects from HCs and statistically predict clinical outcomes.
Results
MVPA displayed a high (92.37%) accuracy (sensitivity of 90.00% and specificity of 94.74%) in the classification of IGD and HC subjects. The most discriminative brain regions that contribute to classification were the bilateral middle frontal gyrus, precuneus, and posterior lobe of the right cerebellum. MVPA statistically predicted clinical outcomes in the craving behavioral intervention (CBI) group (r = 0.48, p = 0.0032). The most strongly implicated brain regions in the prediction model were the right middle frontal gyrus, superior frontal gyrus, supramarginal gyrus, anterior/posterior lobes of the cerebellum and left postcentral gyrus.
Conclusions
The findings about cue-reactivity neural correlates could help identify IGD subjects and predict CBI-related treatment outcomes provide mechanistic insight into IGD and its treatment and may help promote treatment development efforts.
... In the proposed model of gaming addiction, it is thought that a dual process occurs through hyperactivity of the brain's reward system (amygdala and corpus striatum) and weaknesses in the activation of the prefrontal cortex, especially the dorsolateral part (right part of the gyrus frontalis inferior and gyrus frontalis medialis) (Sun et al., 2012), which suppresses it (McClure & Bickel, 2014;Wood & Bechara, 2014). Due to gaming addiction, activation disorders can also be observed in the activations of the anterior parts of the cinguli gyrus (ACC), ventromedial prefrontal cortex and orbitofrontal cortex (Turel et al., 2021). ...
... Studies showing that prefrontal cortex activation increases in men under stress also show that gyrus cinguli activation is more intense in women with the same emotion (Fitzgerald et al., 2012). According to Hikosaka, the prefrontal cortex plays a role in setting expectations about reward in stimuli given about reward (Sun et al., 2012) (Sakai et al., 1998). It is possible to divide the prefrontal cortex into two parts: the orbitofrontal cortex, which is related to emotions and motivation, and the dorsolateral prefrontal cortex (DLPFC), which processes working memory or the cognitive process of the expected reward ( Figure 2) S. Q. Park et al., 2010). ...
In neuropsychiatry, addiction is defined as the desire of a person to continue taking the addictive object at repeated intervals despite its many harmful effects. It is possible to observe the factors that can cause addiction in a very different spectrum, from alcohol to narcotic substances, from tobacco products to sexual activities, from social media to online games. We can say that addiction is affected by many developmental, environmental, experiential and genetic factors.
Internet use, which has become a part of our age, the spread of online game networks that require internet use and the space that social media occupies in our lives, have increased the psychological, psychiatric and neurophysiological studies on this situation, which has turned into addiction in terms of its use. The first study on internet use was put forward by Kimberly Young in 1996 and this situation began to be examined in depth in the following period.
“Diagnostic and Statistical Manual of Mental Disorders (DSM-V)” and “International Classification of Diseases and Related Health Problems (ICD-10)” are important references used in the diagnosis, prognosis and treatment of substance addiction. Other addiction types have been defined as “non-substance addiction” by Zou and his colleagues. Among the non-substance addiction types, only gambling addiction is included in the DSM-V. In the DSM-V and ICD-11, gaming addiction, one of the non-substance addiction types, is defined as “gaming disorder” and it has been stated that more explanatory studies should be included on this condition.
This study is a compilation study that evaluates the anatomical basis of social media and online gaming addiction through literature.
... Regarding other structures involved in this cluster, comparatively stronger activation of the IPL and MTG were also evident in response to Chinese food images. The IPL is a core attentional network node (26,49) previously found to have enhanced responsiveness to food (versus non-food) images (78) as well as cues for addictions including gaming and smoking (79). In a recent China-based study, extreme cravers of spicy foods, showed significantly stronger activation to spicy than non-spicy food images compared to non-cravers in several regions including both the bilateral insula and right IPL. ...
... Aside from showing differential responsiveness during exposure to Chinese (versus Western) food images, the cluster comprising the STG, SMG, MTG, IPL, and PI also had significant positive correlations with wanting and difficulty resisting ratings of depicted food images following the scans; these correlations were stronger in relation to ratings of Chinese food images though associations with Western food image ratings were also statistically significant. Despite the lag between viewing and rating the food images, these correlations appear to be consistent with evidence of functions that include taste perception (34,72), cravings (66,79), reward processing and inhibitory control (59,75,88), and attention (26,49). While few past studies have assessed "difficulty resisting" food items or "dietary restraint" (49,95), such research also taps evaluations of whether or not to consume depicted foods. ...
Cross-cultural studies suggest that people typically prefer to eat familiar foods from their own culture rather than foreign foods from other cultures. On this basis, it is plausible that neural responsiveness elicited by palatable food images from one’s own culture differ from those elicited by food depictions from other cultures. Toward clarifying this issue, we examined neural activation and self-report responses to indigenous (Chinese) versus Western food images among young Chinese adults. Participants (33 women, 33 men) viewed Chinese food, Western food and furniture control images during a functional magnetic resonance imaging (fMRI) scan and then rated the images on “liking,” “wanting,” and “difficult resisting.” Analyses indicated there were no significant differences in self-report ratings of Chinese versus Western food images. However, Chinese food images elicited stronger activation in regions linked to cravings, taste perception, attention, reward, and visual processing (i.e., cerebellum crus, superior temporal gyrus, supramarginal gyrus, middle temporal gyrus, inferior parietal lobule, posterior insula, middle occipital gyrus; inferior occipital gyrus). Conversely, Western food images elicited stronger activation in areas involved in visual object recognition and visual processing (inferior temporal gyrus, middle occipital gyrus, calcarine). These findings underscored culture as a potentially important influence on neural responses to visual food cues and raised concerns about the ecological validity of using “standard” Western food images in neuroimaging studies of non-Western samples. Results also provide foundations for designing culturally informed research and intervention approaches in non-Westerns contexts guided by the use of external food cues that are most salient to the cultural group under study.
... ( Evren, et al., 2008 ) ( إعداد من العدواني السلوك مقياس Buss, et al., 1992 ) ( Ucheagwu,et al., 2019 ) مقياس ؛ ( Christo, et al., 2003 ) للسلوكيات المختصر دراسة في كما اإلدمانية ( Spensieri, et al., 2016 ( Ucheagwu, et al., 2019 ) . ( Benbrika, et al., 2018;al., Smirni, et al., 2018Ziermans, et ) Dong, et al.,2013;Liu, et al., 2013;Sun, et al.,2012 ) ( Ding, et al., 2014; ( Brand, et al., 2014;Dong& Potenza, 2014, Gowin, Mackey& Paulus,2013 والرابع: الثاني الفرضين نتائج تفسير ( Berking, et al., 2011;Elmas, Cesur& Oral, 2017 .) التنفيذية والوظائف األلكسيثيميا بين العالقة بحث الذي العصبي المنظور من النتائج تفسير ويمكن المخ من األيمن النصف بخلل ارتباطها لاللكسيثيميا العصبي النموذج أشار فقد ( Tabibnia & Zaidel, 2005 ) أكدت ما وهو المخية والقشرة الجبهي الفص بخلل المشاعر عن التعبير في القدرة عجز يرتبط كما ، دراسة عليه ( Allerdings & Alfano, 2001 ،) ويرى Stuss& Levine (2002 ...
The current study aimed at identifying the mediating role of executive dysfunction in the relationship between addiction to electronic games and Alexithymia. The study sample consisted of (160) university students, chosen from students of the Faculties of Education and Humanities Studies, Islamic Law at King Khalid University in the Kingdom of Saudi Arabia, and their average ages Time frame (19,66) years, and the study used a number of tools represented in, the scale of Barkley Deficits in Executive Functioning Scale (BDEFS); researcher Arabization), electronic games addiction scale (researcher preparation), Perth questionnaire of Alexithymia (Preece Preparation, 2017; The Arabization of the researcher), the results of the study resulted in: (1) a positive correlation statistically significant between electronic gaming addiction and executive dysfunction, (2) a positive correlational relationship statistically significant between executive dysfunction and Alexithymia, (3) electronic gaming addiction In predicting the executive dysfunction of university students, (4) The executive dysfunction contributes to the prediction of the Alexithymia of the university students, (5) There are indicative paths of executive dysfunction with The addiction of electronic games and Alexithymia, but as an intermediate variable but as a modified variable in the relationship. In light of this, the results were discussed and some research proposals and recommendations were drawn
... The insula is a key component of the brain's salience network (Menon & Uddin, 2010;Uddin, 2015), involved in representing prediction errors related to reward variance (Preuschoff, Quartz, & Bossaerts, 2008) and processing salient stimuli (Jensen et al., 2007;Seeley et al., 2007). Previous literature reported hyper-connectivity of the salience network in individuals with behavioral addiction during resting state (Tolomeo & Yu, 2022), and also specifically in individuals with IGD during resting state, risky decision making, and executive control tasks (Hong et al., 2015;Lee, Lee, Lee, & Jung, 2017;Sun et al., 2012;Zheng et al., 2019). Consistent Seed: L Insula Fig. 6. Results of psychophysiological interaction (PPI) analysis results of the internet gaming disorder group Using the right insula (MNI-coordinates: À40, 2, À8) and left insula (MNI-coordinates: 46, 2, 2) as seed regions (3 mm spheres), a PPI analysis was conducted with model-based reward prediction error (RPE) as the psychological variable. ...
Background
An imbalance between model-based and model-free decision-making systems is a common feature in addictive disorders. However, little is known about whether similar decision-making deficits appear in internet gaming disorder (IGD). This study compared neurocognitive features associated with model-based and model-free systems in IGD and alcohol use disorder (AUD).
Method
Participants diagnosed with IGD ( n = 22) and AUD ( n = 22), and healthy controls ( n = 30) performed the two-stage task inside the functional magnetic resonance imaging (fMRI) scanner. We used computational modeling and hierarchical Bayesian analysis to provide a mechanistic account of their choice behavior. Then, we performed a model-based fMRI analysis and functional connectivity analysis to identify neural correlates of the decision-making processes in each group.
Results
The computational modeling results showed similar levels of model-based behavior in the IGD and AUD groups. However, we observed distinct neural correlates of the model-based reward prediction error (RPE) between the two groups. The IGD group exhibited insula-specific activation associated with model-based RPE, while the AUD group showed prefrontal activation, particularly in the orbitofrontal cortex and superior frontal gyrus. Furthermore, individuals with IGD demonstrated hyper-connectivity between the insula and brain regions in the salience network in the context of model-based RPE.
Discussion and Conclusions
The findings suggest potential differences in the neurobiological mechanisms underlying model-based behavior in IGD and AUD, albeit shared cognitive features observed in computational modeling analysis. As the first neuroimaging study to compare IGD and AUD in terms of the model-based system, this study provides novel insights into distinct decision-making processes in IGD.
... Interactions between the hippocampus and amygdala are important in emotional memory and learning (Robbins, Ersche, & Everitt, 2008;Volkow et al., 2010). Neuroimaging studies have revealed that the hippocampus and amygdala are associated with cravings in response to addiction-related cues (Childress et al., 1999;Grant et al., 1996;Sun et al., 2012). There is evidence that exposure to drug-related cues is associated with the activation of dopamine transmission in the amygdala and hippocampus (Fotros et al., 2013;Weiss et al., 2000). ...
Background and aims
Resting-state brain activity may be associated with the ability to perform tasks; however, a multimodal approach involving resting-state functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) has not been widely used to investigate addictive disorders.
Methods
We explored resting-state fMRI and auditory oddball ERP values from 26 with internet gaming disorder (IGD) patients and 27 age- and intelligence quotient-matched healthy controls (HCs). To assess the characteristics of resting-state fMRI, we calculated regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and fractional amplitude of low-frequency fluctuation (fALFF); we also calculated the P3 component of the ERPs.
Results
Compared with HCs, the individuals with IGD exhibited significant decreases in ReHo and fALFF values in the left inferior occipital gyrus, increased ReHo and ALFF values in the right precuneus, increased ALFF in the left superior frontal gyrus, and lower P3 amplitudes in the midline centro-parietal area during the auditory ERP task. Furthermore, the regional activity of resting-state fMRI in the right inferior temporal gyrus and the occipital regions were positively correlated with the P3 amplitudes in IGD patients, whereas ReHo values of the left hippocampus and the right amygdala were negatively correlated with P3.
Discussion and conclusions
Our results suggest that IGD patients have difficulty interacting effectively with cognitive function and sensory processing, although its interpretations need some cautions. The findings in this study will broaden the overall understanding of the neurobiological mechanisms that underlie IGD pathophysiology.
... The insula is a key component of the brain's salience network (Menon & Uddin, 2010;Uddin, 2015), involved in representing prediction errors related to reward variance (Preuschoff, Quartz, & Bossaerts, 2008) and processing salient stimuli (Jensen et al., 2007;Seeley et al., 2007). Previous literature reported hyperconnectivity of the salience network in individuals with behavioral addiction during resting state (Tolomeo & Yu, 2022), and also specifically in individuals with IGD during resting state, risky decision making, and executive control tasks (Hong et al., 2015;Lee, Lee, Lee, & Jung, 2017;Sun et al., 2012;Zheng et al., 2019). Consistent with these findings, our results suggest that hyper-sensitivity of the insula, a key component of the salience network, might serve as a distinct neural marker of IGD. ...
Background
An imbalance between model-based and model-free decision-making systems is a common feature in addictive disorders. However, little is known about whether similar decision-making deficits appear in internet gaming disorder (IGD). This study compared neurocognitive features associated with model-based and model-free systems in IGD and alcohol use disorder (AUD).
Method
Participants diagnosed with IGD (n=22) and AUD (n=22), and healthy controls (n=30) performed the two-stage task inside the functional magnetic resonance imaging (fMRI) scanner. We used computational modeling and hierarchical Bayesian analysis to provide a mechanistic account of their choice behavior. Then, we performed a model-based fMRI analysis and functional connectivity analysis to identify neural correlates of the decision-making processes in each group.
Results
The computational modeling results showed similar levels of model-based behavior in the IGD and AUD groups. However, we observed distinct neural correlates of the model-based reward prediction error (RPE) between the two groups. The IGD group exhibited insula-specific activation associated with model-based RPE, while the AUD group showed prefrontal activation, particularly in the orbitofrontal cortex and superior frontal gyrus.
Furthermore, individuals with IGD demonstrated hyper-connectivity between the insula and brain regions in the salience network in the context of model-based RPE.
Discussion and Conclusions
The findings suggest potential differences in the neurobiological mechanisms underlying model-based behavior in IGD and AUD, albeit shared cognitive features observed in computational modeling analysis. As the first neuroimaging study to compare IGD and AUD in terms of the model-based system, this study provides novel insights into distinct decision-making processes in IGD.
... It is worth noting that the coupling between the VMPFC and the hippocampus is essential for memory-guided choices and retrievalmoderated learning processes [109,128]. Consistently, previous studies have found increased activity in the hippocampus and parahippocampal gyrus related to gaming cues [41,68,105]. While there was no difference in WM between IGD individuals and HC in Yoon et al. [125], the increased volume and FC in the aforementioned brain areas in IGD may be compensatory or related to experience-based changes associated with increased memories for game-playing cues. ...
Background: Converging evidence supports that gaming and gambling disorders are associated with executive
dysfunction. The involvement of different components of executive functions (EF) in these forms of behavioural
addiction is unclear.
Aim: In a systematic review, we aim to uncover the association between working memory (WM), a crucial
component of EF, and disordered gaming and gambling. Note that, in the context of this review, gaming has been
used synonymously with video gaming.
Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we
systematically searched for studies published from 2012 onwards.
Results: The search yielded 6081 records after removing duplicates, from which 17 peer-reviewed journal articles
were eligible for inclusion. The association between WM and problem or disordered gaming and gambling have
been categorized separately to observe possible differences. Essentially, problem gaming or gambling, compared
to disorder, presents lesser severity and clinical significance. The results demonstrate reduced auditory-verbal
WM in individuals with gambling disorder. Decreased WM capacity was also associated with problem
gambling, with a correlation between problem gambling severity and decreased WM capacity. Similarly, gaming
disorder was associated with decreased WM. Specifically, gaming disorder patients had lower WM capacity than
the healthy controls.
Conclusion: Working memory seems to be a significant predictor of gambling and gaming disorders. Therefore,
holistic treatment approaches that incorporate cognitive techniques that could enhance working memory may
significantly boost gambling and gaming disorders treatment success.
... In GD, so far only proximal cues (showing game-related content) have been investigated that were either game specific (League of Legends, StarCraft, World of Warcraft) [26,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57], individualized for the specific game preference [27,[58][59][60][61], or they showed game-related contents but were not matched to the games participants were familiar with or individualized to the participants [28,49,62,63]. To our knowledge, there are no studies investigating more distal gaming cues (e.g., starting pages of online games). ...
Background:
Gaming disorder (GD) is a disorder due to addictive behaviors (ICD-11). Cue-reactivity and craving are relevant mechanisms in the development and maintenance of addictive behaviors. When confronted with cues showing in-game content (proximal cues) individuals with higher symptom severity show increased cue-reactivity. Based on conditioning and addiction theories on incentive sensitization, cue-reactivity responses may generalize to more distal cues, e.g. when individuals at risk of developing a GD are confronted with a starting page of an online game. In cue-reactivity paradigms so far, only proximal gaming cues have been used.
Methods:
We investigated the effect of distal gaming cues compared to gaming-unrelated control cues on cue-reactivity and craving in 88 individuals with non-problematic use of online games (nPGU) and 69 individuals at risk for GD (rGD). The distal cues showed the use of an electronic device (e.g., desktop PC or smartphone) whose screen showed starting pages of either games (target cues), shopping- or pornography sites (control cues) from a first-person perspective.
Findings:
We found significantly higher urge and arousal ratings as well as longer viewing times for gaming-related compared to gaming-unrelated control cues in rGD compared to nPGU. Valence ratings did not differ between groups.
Interpretation:
The results demonstrate that already distal gaming-specific cues lead to cue-reactivity and craving in rGD. This finding indicates that based on conditioning processes, cue-reactivity and craving develop during the course of GD and generalize to cues that are only moderately related to the specific gaming activity.
... This has motivated efforts to explore whether craving for video games is in some sense similar to craving for drugs (Antons et al., 2020;Brandtner et al., 2021;Saunders et al., 2017). Some of these studies report neural correlates of craving in different brain regions to be similar to those found in substance use disorders (SUDs; Ko et al., 2009;Sun et al., 2012;Zhang et al., 2016). Furthermore, craving and its neural correlates have been observed only in individuals with IGD symptoms and not in recreational gamers (Dong et al., 2017). ...
The role of negative and positive urgency in the relationship between craving and symptoms of problematic video game use. Abstract Craving and emotion-driven impulsivity dimensions (positive and negative urgency) have been suggested as factors involved in the progression of different potentially problematic behaviors. However, their role in severity of video gaming-related problems remains unclear. This study aims to assess the differential capacity of negative and positive urgency to predict craving and the number of internet gaming disorder (IGD) symptoms endorsed (as a proxy to severity of video gaming problems) in majoritarily non-pathological video-gamers. Convenience sampling was used to recruit 232 Spanish and 222 Ecuadorian frequent video game players. Mixed-effects generalized linear (GMLE) and mediation modeling were used to test moderation and mediation hypotheses regarding the association between urgency, craving, and endorsement of IGD symptoms. Results show that (1) craving largely overlaps with endorsement of IGD symptoms; (2) craving for video games is linked to positive urgency, but not to negative urgency, which reinforces the idea that craving, at least in mostly non-pathological gamers, is a positively valenced expectancy state; (3) positive urgency exerts an indirect effect (mediated by craving) on the number of symptoms endorsed; (4) negative urgency exerts a direct effect on the number of symptoms endorsed; and (5) urgency traits do not interact with craving to predict the number of symptoms. These findings are consistent with the proposal that craving is an emotional state, and that dysregulation of positive affect (as measured by positive urgency) influences its emergence and control. In addition, they support the idea that craving is a central feature in the emergence of IGD symptoms.
... In the assessment of factors related to IAD from a multidimensional perspective, researchers have often considered demographic factors first , and among these, "gender represents a key factor to explain why individuals are addicted to the internet according to different ways" (Tang et al., 2017). Despite the extensive existing literature on the subject, mixed results still occur (Aylaz et al., 2016;Sun et al., 2012). ...
Internet addiction and its related variables (i.e., internet gaming addiction, social media addiction, fear of missing out, phubbing) have mostly been investigated in the general population without considering possible gender differences. The present study aimed to investigate the specific characteristics of men and women in the possible development of pathological behaviors related to internet addiction. A total of 276 participants (of ages ranging from 18 to 30 years old) were recruited in the study (46.7% were males) and responded to online questionnaires on variables related to internet addiction and psychological traits. The results showed that gender represents a key factor in explaining why individuals are addicted to the internet in different ways. Stepwise linear regression analyses showed that both genders shared social media addiction as the primary predictor of internet addiction but also exclusive predictors for each gender. Knowing the variables underlying the development of internet Addiction can be useful for both prevention and treatment and tailoring intervention for this addictive behavior.
... Adequate inhibition control allows individuals to limit inappropriate responses toward stimuli, including regulating individual involvement in reward-seeking behavior [72,73]. Individuals with PIU were found to experience inhibition control disruption resulting in difficulties in controlling urges and impulses to surf the internet [74,75], thus making it harder for them to control their internet use duration and preoccupation [76]. The aIns administers input of auditory, visual, behaviorally relevant, and self-referential stimuli and converge the signal with other regions, e.g., the amygdala and ventral striatum, to process the emotional and reward saliency of the stimuli. ...
Problematic internet use (PIU) is increasingly recognized as a mental health concern, particularly among adolescents. The resting-state functional connectivity (rsFC) of the triple-network model has been described inconsistently in PIU. Using resting-state fMRI (rsFMRI) and hypothesizing a lower rsFC between default mode (DMN) and central executive networks (CEN) but a higher rsFC within the salience network (SN), this study scrutinized the neural substrates of PIU adolescents. A total of 30 adolescents with PIU and 30 control subjects underwent rsFMRI. The severity of PIU was evaluated by the Internet Addiction Test. Additionally, personality traits as well as emotional and behavioral problems were evaluated by the Temperament and Character Inventory (TCI) and the Strength and Difficulties Questionnaire (SDQ), respectively. Focusing on the DMN, SN, and CEN, we compared rsFC values between PIU and the control. Subsequently, within the combined group of subjects, TCI and SDQ correlation and mediation effects were investigated. Higher rsFC values of the left lateral prefrontal cortex (LPFC(L)) with the left anterior insula (aIns(L)) were observed for PIU than for the control, while rsFCs of the LPFC(L) with the medial PFC (MPFC), LPFC(L), as well as with the right lateral parietal cortex (LP(R)) were lower for PIU. Among these significant group differences, the rsFC between the LPFC(L) and MPFC was mediated by emotional symptoms (standardized β = −0.12, 95% CI −0.29, −0.0052). The dysfunctional attention switching and incentive salience regulated by the SN were implicated as being a neural correlate of PIU, and this relationship would in part be explained by the emotional dysregulation associated with PIU in adolescents.
... An interesting observation in this study was the right-lateralization of dynamically active regions across the three contrasts. Some evidence exists that the right hemisphere may be more important in response inhibitory and attentional control processes 83,84 , and right lateralization of dynamic response to salient stimuli has been observed in the right amygdala, inferior parietal lobule, and hippocampus 31,85 . It has been argued that while the left amygdala is involved in sustained stimulus evaluation, the right amygdala might be more specialized for dynamic stimulus processing 34 . ...
Abstract Cue-induced drug craving and disinhibition are two essential components of continued drug use and relapse in substance use disorders. While these phenomena develop and interact across time, the temporal dynamics of their underlying neural activity remain under-investigated. To explore these dynamics, an analysis of time-varying activation was applied to fMRI data from 62 men with methamphetamine use disorder in their first weeks of recovery in an abstinence-based treatment program. Using a mixed block-event, factorial cue-reactivity/Go-NoGo task and a sliding window across the task duration, dynamically-activated regions were identified in three linear mixed effects models (LMEs). Habituation to drug cues across time was observed in the superior temporal gyri, amygdalae, left hippocampus, and right precuneus, while response inhibition was associated with the sensitization of temporally-dynamic activations across many regions of the inhibitory frontoparietal network. Methamphetamine-related response inhibition was associated with temporally-dynamic activity in the parahippocampal gyri and right precuneus (corrected p-value
... Compared with controls, IGD showed increased signal activity in brain areas mainly in the bilateral DLPFC, ACC, right insular/angular gyri, cerebellum, inferior parietal lobe, and ITG. Enhanced imaging signal densities had a positive correlation with the scale scores for craving in the bilateral PFC, ACC, and right IPL, which overlap with emotion-related and cognitive processing brain regions (Yueji Sun et al., 2012). During monetary reward tasks, there was decreased FC between the vmPFC and the left caudate, but vmPFC connectivity was increased for the right NAc. ...
ABSTRACT
Background and aims: Recently, there has been significantly increased participation in online gaming and other addictive behaviors particularly in adolescents. Tendencies to avoid social interaction and become more involved in technology-based activities pose the danger of creating unhealthy addictions. Thus, the presence of relatively immature cognitive control and high risk-taking properties makes adolescence a period of major changes leading to an increased rate of emotional disorders and addiction. Internet gaming disorder (IGD) and nicotine addiction are currently becoming more and
more serious. In the light of neuroimaging, the similarity between brain mechanisms causing substance use disorder (SUD) and IGD have been described in previous literature. In particular, two distinct brain systems affect the way we act accounting for uncharacteristic neural function in addiction: the affective system comprises of the striatum driven by emotional, reward-related, and internal stimuli, and a cognitive system consisting of the prefrontal cortex (PFC) supporting the ventral affective system’s
actions via inhibitory control. The critical roles of frontostriatal circuits in addiction have become the primary focus associated with reward in the striatum and cognitive control in the PFC. Discussion and Conclusion: Therefore, as a novel concept, we focused on the implication of frontostriatal circuits in nicotine addiction and IGD by reviewing the main findings from our studies compared to those of others. We hope that all of these neuroimaging findings can lead to effective intervention and treatment for addiction especially during this critical period.
KEYWORDS
nicotine addiction, internet gaming disorder, frontal cortex, striatum, reward, cognitive control
... Bilateral fusiform was important in the present classifier. Previous neuroimaging studies [22][23][24] have reported similar findings and indicated that the activated fusiform gyrus is associated with game craving, semantic processing, disembodiment, and working memory [22]. Local alterations in thickness may further reflect inner impaired function. ...
Purpose To identify cerebral radiomic features related to the diagnosis of Internet gaming disorder (IGD) and construct a radiomics-based machine-learning model for IGD diagnosis. Methods A total of 59 treatment-naïve subjects with IGD and 69 age- and sex-matched healthy controls (HCs) were recruited and underwent anatomic and diffusion-tensor magnetic resonance imaging (MRI). The features of the morphometric properties of gray matter and diffusion properties of white matter were extracted for each participant. After excluding the noise feature with single-factor analysis of variance, the remaining 179 features were included in an all-relevant feature selection procedure within cross-validation loops to identify features with significant discriminative power. Random forest classifiers were constructed and evaluated based on the identified features. Results No overall differences in the total brain volume (1,555,295.64 ± 152316.31 mm3 vs. 154,491.19 ± 151,241.11 mm3), total gray (709,119.83 ± 59,534.46 mm3 vs. 751,018.21 ± 58,611.32 mm3) and white (465,054.49 ± 51,862.65 mm3 vs. 470,600.22 ± 47,006.67 mm3) matter volumes, and subcortical region volume (63,882.71 ± 5110.42 mm3 vs. 64,764.36 ± 4332.33 mm3) between the IGD and HC groups were observed. The mean classification accuracy was 73%. An altered cortical shape in the bilateral fusiform, left rostral middle frontal (rMFG), left cuneus, left parsopercularis (IFG), and regions around the right uncinate fasciculus (UF) and left internal capsule (IC) contributed significantly to group discrimination. Conclusions: Our study found the brain morphology alterations between IGD subjects and HCs through a radiomics-based machine-learning method, which may help revealing underlying IGD-related neurobiology mechanisms.
... Literature suggests an overlap between various addictions is quite common [58] and addictive behaviors cooccur. Problematic computer (game) use could coexist with pornography [59] , substance use [60] or gambling [61,62] . History of pornographic use from individuals is difficult to procure, as it is a personal and sensitive subject. ...
Introduction
With the presence of the internet in daily life, it has become crucial to explore its purposes, implications, and effects on the mental health of users. As adolescents are a vulnerable age group, this study was conducted on Indian medical students in late adolescence to learn how the internet impacts their lives. We aim to explore the severity of problematic internet use (PIU) in Indian medical students. We intend to assess its effects on psychological health and loneliness and correlate PIU with the purpose of using the internet.
Methods
A total of 185 first-year MBBS students of Bangalore Medical College and Research Institute (mean age: 18.07 years) were recruited and administered four questionnaires: Young’s internet addiction test (YIAT20), UCLA loneliness questionnaire (version 3), general health questionnaire (GHQ12), and a self-administered questionnaire (to assess the purpose of internet usage).
Results
Out of 185 students, 67 were average users with complete control of their internet use, and 118 had PIU (113 with frequent, 5 with significant problems). PIU showed a significant positive correlation with psychological morbidity (r=0.34, P<0.0001) and loneliness (r=0.20, P=0.01). Daily mean use of the internet was mostly for social media (51.2%), followed by academics (20%), others (20%), and gaming (8.2%). PIU was significantly and positively correlated to social media usage (r=0.27, P=0.00) and negatively correlated to academics (r=−0.37, P<0.0001).
Conclusion
In our study, PIU was positively correlated to poor psychological health, loneliness, and use of social media. It showed a negative correlation with academics. This situation may suggest that PIU is linked to psychosocial implications. It may be worthwhile to correlate the purpose of use with the severity of PIU. Social media seems important in India as opposed to China, where gaming is the major concern. As some activities could be more addictive than others and result in a dysfunctional lifestyle, internet use must be regulated and used judiciously.
... 23 Executive functions are usually localised to the brain area of "prefrontal cortex", and specifically to the "dorsolateral prefrontal cortex". Imaging studies have shown activation mainly in frontal cortex, anterior cingulate cortex and parahippocampal regions, 24,25 when people with internet addiction cravings were tested on online gaming tasks. Studies have shown that excessive internet users have poor decision-making abilities, 26 choose more risky and disadvantageous choices, 27 indicating poor executive functions. ...
Excessive use of online technology brings with it the risk of problematic digital behaviour like over-use of social media, online gambling, webinar fatigue, digital burnout, and in extreme cases doom surfing, and doom scrolling. In addition, digital failures can cause significant mental health distress to people, and unhealthy interactions on social media can also lead to deviant behaviour such as cyber bullying and cybercrime. This paper discusses the various vulnerabilities an individual is predisposed to on the internet, and highlights the importance of “Digital Resilience”. Digital resilience is a new concept which refers to the learning, recovery, and bouncing back process after having negative or adverse experiences online. A comprehensive and holistic model to introduce Digital Resilience to everyone through a multitier approach that includes Individual, Societal, and Community intervention is formulated and elaborated. The importance of addressing these concerns from both a psychological and legal perspective is also discussed.
... In the case of r-MFG, static activity without dynamic activity was unexpected, as the MFG (and DLPFC) would hypothetically activate only in the final stages of the cue-induced craving process for craving inhibition and perhaps top-down attention. However, lateral asymmetry in MFG activation has been noted in several cue-reactivity studies before (Diggs et al. 2013;Nestor, McCabe, Jones, Clancy, & Garavan, 2011;Sun et al., 2012) and a functional difference between the two MFGs is possible. The IFG is another region which we expected to activate dynamically, considering its role in response inhibition (Prisciandaro et al., 2014) and emotion regulation (Goldstein et al., 2007). ...
Objective: Cue-induced craving is central to addictive disorders. Most cue-reactivity fMRI studies are analysed statically and report averaged signals, disregarding the dynamic nature of craving and task fatigue. Methods: Thirty-two early abstinent methamphetamine users underwent fMRI-scanning while viewing visual methamphetamine cues. A Craving>Neutral contrast was obtained in regions of interest. To explore changes over time, the pre-processed signal was divided into three intervals. Contrast estimates were calculated within each interval, and were compared using ANOVA followed by post hoc t-tests. The results were compared with those from a static analysis across all blocks. Results: A priori expected activations in the prefrontal cortex, insula and striatum not detected by static analysis were discovered by the dynamic analysis. Post hoc tests revealed distinct temporal activation patterns in several regions. Most showed rapid activation (including both ventral/dorsal striata and most regions in the prefrontal, insular and cingulate cortices) whereas some had delayed activation (the right anterior insula, left middle frontal gyrus, and left dorsal anterior cingulate cortex). Conclusions: This study provides preliminary insights into the temporal dynamicity of cue-reactivity, and the potential of a conventional blocked-design task to consider it using a simple dynamic analysis. We highlight regional activations that were only uncovered by a dynamic analysis, and discuss the interesting and theoretically expected early versus late regional activation patterns. Rapidly activated regions are mostly those involved in the earlier stages of cue-reactivity, while regions with later activation participate in cognitive functions relevant later, such as reappraisal, interoception and executive control.
... Weinstein (19) has shown that individuals who are addicted to video-game playing obtain much pleasure during play because of extensive dopamine release. In addition, functional magnetic resonance imaging (fMRI) studies of the reward circuit showed hyperactivity in the bilateral dorsolateral prefrontal cortex (DLPFC), caudate nucleus, the supplementary motor cortex (SMA), and ACC among IGD people (2,20). Moreover, people with IGD have abnormal structural alterations that include reduced gray matter volume (GMV) in the bilateral ACC, OFC, SMA, right putamen, and left dorsolateral prefrontal cortex through different studies (17,21,22). ...
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).
... Violent video games produced a lower activation of limbic and temporal areas in the brain [6]. In several fMRI scans, the arousal can be shown in brains of video game addicts [8] as well as internet addicts [5]. A craving-related isolated brain pathway related in response to internet cue could not be identified [5]. ...
Online or internet gaming disorder (IGD) is currently not recognized as a mental disorder in the actual Diagnostic and Statistical Manual of Mental Disorders (DSM-5), although it is an emerging disease. Non-substance-related addictions often have similarities with substance addictions. It is therefore important to have a good understanding of the client but also to have a good endurance. Due to the rise of e-sports, there is an anticipated and therefore possible trend to have many more patients with a non-substance addiction. There are many parallels, for instance tolerance, withdrawal and social problems, resulting from an increasing investment of time spent on the internet. Case presentation: To reduce possible inhibition in treating a patient with IGD, we present a case of a 19-year-old adolescent man who exhibited IGD and showed social problems
associated with his addiction. Conclusions: This paper shows the importance and the effects of treating a non-substance addiction with cognitive behavioral therapy (CBT). After having successfully coped with an addiction, several shifts in addiction were often reported. In this case, no shifts were reported.
The absence of such shifts makes our case a distinct and unique case. This is not a multimorbidity case, and that is the reason why we think this is an excellent example to show what we achieved, how we achieved it, and what we could establish. Of course, additional research and manuals are urgently needed.
... After playing game, the dynamic FC between the left caudate gyrus and the right middle frontal gyrus in the GD was significantly lower than that in the RGU (group II), while the dynamic FC between the left triangular inferior frontal gyrus and the right middle frontal gyrus in the GD was obviously higher than that in the RGU [54]. When the GD was exposed to online game (game cues) stimulation, the right inferior parietal lobule and left caudate nucleus showed stronger signal activity than the HC [55]. Moreover, the activation of the right superior parietal lobule in the GD was stronger than that in the HC [56]. ...
Excessive gaming can lead to gaming disorder, which affects the function and structure of the brain. In order to diagnose gaming disorders, it is of importance to understand how gaming behavior affects brain activity patterns and whether there exist differences in the effects on different individuals. Electroencephalogram (EEG) microstate reflects a transiently stable brain topological structure with spatiotemporal characteristics, and the spatial characteristic microstate classes and temporal parameters provide insight into the brain’s functional activities in gaming disorders. In order to explore the feasibility of using EEG microstate parameters as markers of gaming addiction, in the present study, resting-state EEG data were acquired before and after playing video game for 30 minutes from 38 participants, containing gaming disorder individual (GD), recreational game users (RGU), and healthy controls (HC). Our study compared the microstate parameters before and after playing game among three groups. According to the results, the resting-state EEG microstate parameters exert no significant difference before playing game among three groups. However, we found significant difference in microstate B and D parameters among three groups after playing game. Additionally, compared with the pre-gaming, the post-gaming data showed that the variation trend of microstate B and D parameters of the three groups was similar. Moreover, these discoveries provide the first causal evidence of a microstate modification following gaming behavior interference, suggesting that microstates B and D are closely associated with gaming behavior, which can be used as EEG markers for distinguishing gaming addiction.
... During the outcome monitoring phase, the IGD group exhibited stronger activation for positive outcomes in the right NAcc and bilateral caudate than the HC group. These findings are in accordance with the findings of studies showing that individuals with IGD exhibited greater striatal activity than HC when presented with gains in a cardguessing task (Dong et al., 2017) as well as greater neural responses to addiction-related rewards (i.e., gaming cues) in the striatum during a cue-reactivity task (Ko et al., 2009;Sun et al., 2012) and that individuals with cocaine or alcohol dependence showed increased striatal activity in a monetary incentive delay task (Bjork, Smith, & Hommer, 2008;Jia et al., 2011). In addition to being involved in reward anticipation, the NAcc has also been suggested to be implicated in the outcome monitoring phase. ...
Background and aims:
Internet gaming disorder (IGD) has become a global health problem. The self-regulation model noted that a shift to reward system, whether due to overwhelming reward-seeking or impaired control, can lead to self-regulation failures, e.g., addiction. The present study focused on the reward processing of IGD, aiming to provide insights into the etiology of IGD. Reward processing includes three phases: reward anticipation, outcome monitoring and choice evaluation. However, it is not clear which phases of reward processing are different between individuals with IGD and healthy controls (HC).
Methods:
To address this issue, the present study asked 27 individuals with IGD and 26 HC to complete a roulette task during a functional MRI scan.
Results:
Compared with HC, individuals with IGD preferred to take risks in pursuit of high rewards behaviorally and showed exaggerated brain activity in the striatum (nucleus accumbens and caudate) during the reward anticipation and outcome monitoring but not during the choice evaluation.
Discussion:
These results reveal that the oversensitivity of the reward system to potential and positive rewards in college students with IGD drives them to approach risky options more frequently although they are able to assess the risk values of options and the correctness of decisions properly as HC do.
Conclusions:
These findings provide partial support for the application of the self-regulation model to the IGD population. Moreover, this study enriches this model from the perspective of three phases of reward processing and provides specific targets for future research regarding effective treatment of IGD.
... High AnG BOLD activation and concomitant low-levels of BOLD activation in the vmPFC during a Go-No Go response inhibition task predicted high levels of substance use and symptoms of dependency in adolescents [52]. Furthermore, the AnG has been correlated with craving scores in gaming and internet addiction [53][54][55]. The involvement of the AnG may also be in line with a preprint [56] that found that multi-day rTMS treatment increased FC across distinct non-targeted networks while it decreased FC within targeted networks [57]. ...
Background
Cocaine use disorder (CUD) is a global condition lacking effective treatment. Repeated magnetic transcranial stimulation (rTMS) may reduce craving and frequency of cocaine use, but little is known about its efficacy and neural effects.
Objective/Hypothesis
We sought to elucidate short- and long-term clinical benefits of 5-Hz rTMS as an add-on to standard treatment in CUD patients and discern underlying functional connectivity (FC) effects using magnetic resonance imaging.
Methods
Forty-four CUD patients were randomly assigned to complete the 2-week double-blind randomized controlled trial (acute phase) [Sham (n=20, 2 female) and Active (n=24, 4 female)], in which they received 2 daily sessions of rTMS on the left dorsolateral prefrontal cortex. Subsequently, 20 CUD patients continued to an open-label maintenance phase for 6 months (2 weekly sessions for up to 6 months).
Results
rTMS plus standard treatment for 2 weeks significantly reduced craving (T0: 3.9 ± 3.6, T1: 1.5 ± 2.4, p = 0.013, d=0.77) and impulsivity (T0: 64.8 ± 16.8, T1: 53.1 ± 17.4, p = 0.011, d=0.79) in the Active group. We also found increased FC between lDLPFC-vmPFC and vmPFC-right angular gyrus Clinical and functional connectivity effects were maintained for 3 months but they dissipated by 6 months. We did not observe reduction of positive cocaine urine tests, however, self-reported frequency and grams consumed for 6 months were reduced.
Conclusions
With this RCT we show that 5-Hz rTMS has potential promise as an adjunctive treatment for CUD and merits further research.
... ( Evren, et al., 2008 ) ( إعداد من العدواني السلوك مقياس Buss, et al., 1992 ) ( Ucheagwu,et al., 2019 ) مقياس ؛ ( Christo, et al., 2003 ) للسلوكيات المختصر دراسة في كما اإلدمانية ( Spensieri, et al., 2016 Dovis, et al.,2015;Hollis, 2016 ) في قصور إلى أخرى نتائج توصلت بينما ؛ اإللكترونية األلعاب ممارسة في اإلفراط نتيجة التنفيذية الوظائف ( Zhou, et al., 2016 ورأت ،) أخرى نظر وجهة ا الوظائف على اإللكترونية األلعاب إلدمان تأثير وجود عدم إلى لتنفيذية ( Ucheagwu, et al., 2019 ) . ( Benbrika, et al., 2018;al., Smirni, et al., 2018Ziermans, et ) Dong, et al.,2013;Liu, et al., 2013;Sun, et al.,2012 ) ( Ding, et al., 2014; ( Brand, et al., 2014;Dong& Potenza, 2014, Gowin, Mackey& Paulus,2013 والرابع: الثاني الفرضين نتائج تفسير ( Pathak, et al., 2011;Ybarra, 2012 .) ( مع النتائج وتتفق ( Berking, et al., 2011;Elmas, Cesur& Oral, 2017 .) ...
... The fMRI can illustrate the in vivo brain activations from the 'Response to Reward' conditions and contributes to the neurobiological understanding of this type of addiction (Kim et al. 2014;Sun et al. 2012;Zhang et al. 2016). Task-based fMRI employs blood oxygen leveldependent imaging (BOLD) to measure the hemodynamic response function (HRF), i.e. outshoot of oxygenated blood to local brain areas, which is activated during tasks such as viewing pictures, videos and decision-making in the cerebral cortex (Glover 2011;Huettel et al. 2014;Lindquist et al. 2009;Sharifat et al. 2018). ...
Problematic Instagram Use (PIGU) is a specific Internet addiction disorder observed among the youth of today. Functional magnetic resonance imaging (fMRI) can objectively assess regional brain activation in response to addiction-specific rewards, e.g. viewing picture flashcards. Pictures that were uploaded onto Instagram by users with PIGU issue have often been associated with risky behaviors in their efforts to gain more 'Likes'. Thus, it was hypothesized that individuals with PIGU issue are more drawn to negative emotional cues. To date, no literature on addiction-specific cues found on the local database. The objective of this study was to conduct an out-of-scanner validation study to create a database of pictures with negative emotional cues that evoke responses of arousal among individuals with PIGU issue. Forty-four Malaysian undergraduates (20 undergraduates in the PIGU group, 24 undergraduates in the control group) were randomly recruited as the subjects in the present study. They were grouped into PIGU or control groups based on the evaluation using the Smartphone-Addiction-Scale-Malay version (SAS-M) and modified Instagram Addiction Test (IGAT) and whether they fulfilled the definition of addiction according to Lin et al. (2016). They were administered with 200 content-specific pictures that were multidimensional, i.e. arousal (excitation or relaxation effects), approach-avoidance (motivational direction) and emotional valence (positive or negative feelings) to describe their perceptions on the psychological properties of the pictures using a 9-point Likert scale. The results showed that the subjects with PIGU issue, who viewed the negative emotional cues, demonstrated significant positive correlations between arousal and valence (z = 4.834, p < .001, effect size = 0.69) and arousal and avoidance-approach (z = 4.625, p < .001, effect size = 0.66) as compared to the controls and were more frequently aroused by negative emotional type of stimuli. As a conclusion, a database of validated, addiction-specific pictures can be developed to potentiate any future cue-induced response to reward fMRI studies for assessing PIGU.
... The pallidum is a key node in corticostriatal circuits involved in response inhibition function associated with addiction(Aston-Jones 2015). Meanwhile, as an important projected brain region of the mesolimbic pathway, the hippocampus showed abnormal brain activation with craving processing in IGD individuals (Sun et al. 2012). The hippocampus accepts the dopaminergic projection from the VTA to process sensory information and detect the novelty and familiarity of stimulation (Keleta and Martinez 2012). ...
Objective neuroimaging markers are imminently in need for more accurate clinical diagnosis of Internet gaming disorder (IGD). Recent neuroimaging evidence suggested that IGD is associated with abnormalities in the mesolimbic dopamine (DA) system. As the key nodes of the DA pathways, ventral tegmental area (VTA) and substantia nigra (SN) and their connected brain regions may serve as potential markers to identify IGD. Therefore, we aimed to develop optimal classifiers to identify IGD individuals by using VTA and bilateral SN resting-state functional connectivity (RSFC) patterns. A dataset including 146 adolescents (66 IGDs and 80 healthy controls (HCs)) was used to build classification models and another independent dataset including 28 subjects (14 IGDs and 14 HCs) was employed to validate the generalization ability of the models. Multi-voxel pattern analysis (MVPA) with linear support vector machine (SVM) was used to select the features. Our results demonstrated that the VTA RSFC circuits successfully identified IGD individuals (mean accuracy: 86.1%, mean sensitivity: 84.5%, mean specificity: 86.6%, the mean area under the receiver operating characteristic curve: 0.91). Furthermore, the independent generalization ability of the VTA RSFC classifier model was also satisfied (accuracy = 78.5%, sensitivity = 71.4%, specificity = 85.8%). The VTA connectivity circuits that were selected as distinguishing features were mainly included bilateral thalamus, right hippocampus, right pallidum, right temporal pole superior gyrus and bilateral temporal superior gyrus. These findings demonstrated that the potential of the resting-state neuroimaging features of VTA RSFC as objective biomarkers for the IGD clinical diagnosis in the future.
... The results were partly inconsistent across the two meta-analyses as they differ regarding the inclusion of studies. Beyond cue reactivity, the first results indicate that also craving may be associated with increased activity in reward, salience, and executive control network, and habit networks in GD [61][62][63][64]. The results should be interpreted as preliminary because they base on only few studies with small sample sizes [16]. ...
Purpose of Review
Gaming disorder (GD), meanwhile classified as a mental disorder in both DSM-5 and ICD-11, is a current public health issue. Theoretical models assume core psychological processes, such as cue reactivity, craving, reward processing, decision-making, cognitive biases, inhibitory control, and stress relief, to be crucially involved in the development and maintenance of GD. This review summarizes neuroscientific findings on these processes in the context of GD as well as treatments and intervention programs addressing these processes.
Recent Findings
We identified overlaps regarding the involvement of neural structures and networks related to psychological processes which may be targeted by public health programs. Complex interactions between executive control, salience, reward, and habit networks are crucially linked to processes involved in GD and public health programs respectively.
Summary
We point at the difficulties of making one to one assignments of neural networks to psychological processes or interventions. Furthermore, new treatment and prevention programs of GD are discussed pointing at possible future directions for neuroscientific research and treatment programs for GD.
... High AnG BOLD activation and concomitant low-levels of BOLD activation in the vmPFC during a go-nogo response inhibition task predicted high levels of substance use and symptoms of dependency in adolescents (46) . Furthermore, the AnG has been correlated with craving scores in gaming and internet addiction (47)(48)(49) . The involvement of the AnG may . ...
BACKGROUND: Cocaine use disorder (CUD) is a global condition lacking effective treatment. Repeated magnetic transcranial stimulation (rTMS) may reduce craving and frequency of cocaine use, but little is known about its efficacy and neural effects.
METHODS: Using a double-blind placebo-controlled randomized clinical trial (RCT) [NCT02986438], we sought to elucidate short- and long-term clinical benefits of 5-Hz rTMS as an add-on to standard treatment in CUD patients and discern underlying functional connectivity effects using magnetic resonance imaging. Forty-four randomly assigned CUD patients completed the 2-week double-blind acute phase [Sham (n=20, 2f/18m) and Active (n=24, 4f/20m)], in which they received 2 daily sessions of rTMS (5,000 pulses) on the left dorsolateral prefrontal cortex. Subsequently, n=20 CUD patients continued to open-label maintenance (2 weekly sessions for up to 6 months). Measures were acquired at baseline, 2 weeks, 3 months and 6 months.
RESULTS: Overall, 5-Hz rTMS plus standard treatment for 2 weeks significantly reduced craving and impulsivity in the Active group; decreased impulsivity correlated with improvements in functional connectivity in executive control and default mode networks. Clinical and functional connectivity effects were maintained for 3 months but they dissipated by 6 months. We did not observe reduction of positive cocaine urine tests, however, self-reported frequency and grams consumed for 6 months were reduced.
CONCLUSIONS: With this RCT we show that 5-Hz rTMS has potential promise as an adjunctive treatment for CUD and merits further research.
Recent studies increasingly highlight involvement of the cerebellum in drug craving and addiction. However, its exact role, that is, whether the cerebellum is a critical component of a brain network underlying addictive behaviour, or whether it rather is a facilitator or mediator, is still unclear. Findings concerning the newly recognized internet gaming disorder (IGD) suggest that changes in cerebellar connectivity and functioning are associated with behavioural/non‐substance addiction. Here, we systematically review the literature on IGD and cerebellar involvement following the PRISMA guidelines. A total of 13 neuroimaging studies met the inclusion criteria. Studies utilized a broad range of diagnostic instruments and resulting cut‐off criteria, rendering it difficult to compare findings. Results on altered cerebro‐cerebellar connectivity in patients with IGD are mixed; most studies report altered or increased functional connectivity. Moreover, decreased cerebellar grey matter volume is reported. Studies have further indicated that differential activation patterns in the cerebellum may enable discrimination between healthy subjects and subjects with IGD, even allowing for prediction of treatment outcomes. Given the strong connectivity between the cerebellum and cerebral regions, the cerebellum may act as an intermediary between regions involved in craving and addiction and consequently affect symptoms of IGD. Results suggest differential involvement of the cerebellar lobes, emphasizing a need for high‐resolution parcellation of the cerebellum in future studies. However, the studies included in the present review have small sample sizes and include mostly male participants. Thus, results may have limited generalizability yet highlight a crucial role of the cerebellum in IGD that needs further investigation.
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.
Background
Studies have proven that individuals with internet gaming disorder (IGD) show impaired cognitive control over game craving; however, the neural mechanism underlying this process remains unclear. Accordingly, the present study aimed to investigate the dynamic features of brain functional networks of individuals with IGD during rest, which have barely been understood until now.
Methods
Resting-state fMRI data were collected from 333 subjects (123 subjects with IGD (males/females: 73/50) and 210 healthy controls (males/females: 135/75)). First, the data-driven methodology, named co-activation pattern analysis, was applied to investigate the dynamic features of nucleus accumbens (the core region involved in craving/reward processing and addiction)-centered brain networks in IGD. Further, machine learning analysis was conducted to investigate the prediction effect of the dynamic features on participants' addiction severity.
Results
Compared to controls, subjects in the IGD group showed decreased resilience, betweenness centrality and occurrence in the prefrontal-striatal neural circuit, and decreased in-degree in the striatal-default mode network circuit. Moreover, these decreased dynamic features could significantly predict participants' addiction severity.
Limitations
The causal relationship between IGD and the abnormal dynamic features cannot be identified in this study. All the subjects were university students.
Conclusions
The present results revealed the underlying brain networks of uncontrollable craving and game-seeking behaviors in individuals with IGD during rest. The decreased dynamics of the prefrontal-striatal and striatal-default mode network neural circuits might be potential biomarkers for predicting the addiction severity of IGD and potential targets for effective interventions to reduce game craving of this disorder.
This introductory chapter reviews Cyberpsychology research considering the effect of digital technologies on psychological wellbeing. Whilst there are clear benefits that come from being digitally connected, our reliance on them brings its own problems. This chapter explores the downsides of habitual involvement in terms of stress, depression, anxiety and dependency. Current explanations for these negative effects focus on the displacement of healthy behaviour as being the root cause but here an alternative approach is proposed that focuses on the displacement of attention. The attentional challenge of digital technologies is explored by looking at our innate attentional capacities and the demands placed upon them by the expectations of computational interfaces, multitasking and deliberate exploitation by digital designers.KeywordsMindfulnessDigital interactionTechnostressDisplacement effectDigital dependencyDigital wellbeingDigital addictionAttentionDisplacement of attentionMultitaskingAttention economyMindlessnessDigital mediaSocial media
This chapter reviews evidence of the relationships between digital media use habits and brain development. Much of this evidence comes from studies using magnetic resonance imaging (MRI), which allows the characterization of brain structure, function, and connectivity patterns differentiating groups of individuals more enmeshed with forms of digital media from those less inclined towards digital habits. Corroborative data from brain electrical activity patterns (electroencephalography) informs interpretation of the MRI-based findings. Work using brain imaging methods is scant for earlier periods of development (childhood and early adolescence), challenging the construction of detailed developmental timeline. Evidence on links between digital media behaviors and the brain in late adolescence and young adulthood identify brain systems relevant in forming and maintaining digital media habits. The findings draw attention to neural networks and brain regions integral to exert self-regulatory control over behavior, interpreting the reinforcement of environmental rewards, and forming mental representations of social interactions.
Background
Internet gaming disorder (IGD) has become a worldwide mental health concern; however, the neural mechanism underlying this disorder remains unclear. Multivoxel pattern analysis (MVPA), a newly developed data-driven approach, can be used to investigate the neural features of IGD based on massive neural data.
Methods
Resting-state fMRI data from four hundred and two participants with varying levels of IGD severity were recruited. Regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF) were calculated and subsequently decoded by applying MVPA. The highly weighted regions in both predictive models were selected as regions of interest for further graph theory and Granger causality analysis (GCA) to explore how they affect IGD severity.
Results
The results revealed that the neural patterns of ReHo and ALFF can independently and significantly predict IGD severity. The highly weighted regions that contributed to both predictive models were the right precentral gyrus and left postcentral gyrus. Moreover, topological properties of the right precentral gyrus were significantly correlated with IGD severity; further GCA revealed effective connectivity from the right precentral gyrus to left precentral gyrus and dorsal anterior cingulate cortex, both of which were significantly associated with IGD severity.
Conclusions
The present study demonstrated that IGD has distinctive neural patterns, and this pattern could be found by machine learning. In addition, the neural features in the right precentral gyrus play a key role in predicting IGD severity. The current study revealed the neural features of IGD and provided a potential target for IGD interventions using brain modulation.
Background
Observation of real-time neural characteristics during gameplay would provide distinct evidence for discriminating the currently controversial diagnosis of internet gaming disorder (IGD), and elucidate neural mechanisms that may be involved in addiction. We aimed to provide preliminary findings on possible neural features of IGD during real-time internet gaming using functional near-infrared spectroscopy (fNIRS).
Methods
Prefrontal cortical activations accompanying positive and negative in-game events were investigated. Positive events: (1) participant’s champion slays or assists in slaying an opponent without being slain. (2) the opposing team’s nexus is destroyed. Negative events: (1) participant’s champion is slain without slaying or assisting in slaying any opponent. (2) the team’s nexus is destroyed. Collected data were compared between the IGD group and control group, each with 15 participants.
Results
The IGD group scored significantly higher than the CTRL group on the craving scale. Following positive events, the IGD group displayed significantly stronger activation in the DLPFC. Following negative events, the IGD group displayed significantly weaker activation in the lateral OFC.
Discussion and Conclusions
Individuals scoring high on the IGD scale may crave for more internet gaming after encountering desired events during the game. Such observations are supported by the correlation between the craving scale and DLPFC activation. The IGD group may also show diminished punishment sensitivity to negative in-game experiences rendering them to continue playing the game. The present study provides preliminary evidence that IGD may demonstrate neural characteristics observed in other addictive disorders and suggests the use of fNIRS in behavioral addiction studies.
Internet gaming disorder (IGD) has been classified by the DSM-5 as a condition for further study, and many studies have shown that the occurrence and maintenance of IGD and the automatic detection bias to gaming cues of individuals with IGD may be significantly related. However, whether abstinence, a common intervention method in behavioral addiction, can adjust the automatic detection bias in individuals with IGD and its underlying neural mechanisms is unclear. In this study, we investigated the effects of 7 days of abstinence from gaming on automatic detection bias, negative affect and craving in individuals with IGD with event-related potential technology. A total of 50 IGD subjects were recruited in this study and randomly divided into abstinence and control groups. Visual mismatch negativity (vMMN) was induced using a standard-deviant reversed oddball paradigm, and differences in automatic detection bias, negative affect, and craving between the two groups were recorded and compared at baseline, day 3, and day 7. The results showed that compared with baseline, vMMN, negative affect and craving were significantly enhanced on day 3 and significantly diminished on day 7 in the abstinence group but not in the control group, and the changes in vMMN were significantly correlated with changes in negative affect and craving in both groups. This study demonstrates that abstinence can restore automatic detection bias in individuals with IGD and that abstinence has to last for 7 days to have a significant effect, while recovery may be related to the negative affect and craving.
Cue-induced drug craving and disinhibition are two essential components of continued drug use and relapse in substance use disorders. While these two phenomena develop and interact across time, the temporal dynamics of their underlying neural activity and their interaction remain under-investigated. To explore these dynamics, an analysis of time-varying activation was applied to fMRI data from 62 men with methamphetamine use disorder in their first weeks of recovery in abstinence-based treatment program. Using a mixed block-event, factorial cue-reactivity/Go-NoGo task, and a sliding window across the task duration, dynamically-activated regions were identified in linear mixed effects models (LMEs). Habituation to drug cues across time was observed in the superior temporal gyri, amygdalae, left hippocampus, and right precuneus, while response-inhibition was associated with the sensitization of temporally-dynamic activations across many regions of the inhibitory frontoparietal network. Cue-reactivity and response-inhibition dynamically interact in the parahippocampal gyri and right precuneus (corrected p-value < 0.001) regions, which show a declining cue-reactivity contrast and an increasing response-inhibition contrast. Overall, the declining craving-related activations (habituation) and increasing inhibition-associated activations (sensitization) along the task duration suggest the gradual recruitment of response-inhibition process and the concurrent habituation to drug cues in areas with significant dynamic interaction. This exploratory study demonstrates the time-variance of the neural activations undergirding cue-reactivity, response-inhibition, and their interaction, and suggests potentials to assess this dynamic interaction. This preliminary evidence provides justifications for new avenues in biomarker development and interventions using cue exposure paradigms, which could promote habituation to drug cues and sensitization in inhibitory control regions.
Introduction: Internet addiction can be explained by various factors, including executive functions as multifunctional neuropsychological structures.
Aim: The purpose of this study is to predict internet addiction through executive functions among students of Allameh Tabataba'i University.
Method: The present study is a correlational study and its statistical population consists of students of Allameh Tabataba’i University who have studied in the second semester of the 2019 academic year. The statistical sample of the study included 206 Undergraduate Student who were selected by available sampling in this study. In order to measure Internet addiction, the Young Internet Addiction Questionnaire was used and to evaluate the executive functions Go/No Go Task, N-Back Task and Wisconsin Card Classification Task (WCST) were used. Correlation and regression analysis were used to analyze the data. Data were analyzed using SPSS 25 statistical software.
Results: The results of the analyzed data show that there was no relationship between working memory components (N-Back Test Series n2) and Internet addiction (P
Background
Previous studies have shown that gaming-related cues could induce gaming cravings and bring about changes in brain activities in subjects with Internet gaming disorder (IGD). However, little is known about the brain network organizations in IGD subjects during a cue-craving task and the relationship between this network organization and IGD severity.
Methods
Sixty-one IGD subjects and 61 matched recreational game users (RGUs) were scanned while performing a cue-craving task. We calculated and compared the participation coefficient (PC) among brain network modules between IGD subjects and RGUs. Based on the results, further group comparison analyses were performed to explain the PC changes and to explore the relationship between PCs and IGD severity.
Results
While performing a cue-craving task, compared with RGUs, IGD subjects showed significantly decreased PCs in the default-mode network (DMN) and the frontal-parietal network (FPN). Specifically, the number of connections between nodes in the ventromedial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex and other nodes in the DMN of IGD subjects was much larger than that in RGUs. Correlation results showed that the number of DMN intra-modular connections was positively correlated with addiction severity and craving degree.
Conclusions
These results provide neural evidence that can explain why cognitive control, emotion, attention and other functions are impaired in IGD subjects in the face of gaming cues, which leads to compulsive behavior toward games. These findings extend our understanding of the neural mechanism of IGD and have important implications for developing effective interventions to treat IGD subjects.
Internet is essential part of everyday life and certainly facilitate it on several levels. It is a helpful information tool, and knowledge, but its unlimited range often is risky for users. The behaviors and outcomes of internet abuse have already been well‐documented in the literature; less is known about the role of personal factors that reinforce internet addiction. Based on the Interaction of Person‐Affect‐Cognition‐Execution model (I‐PACE), the current study investigates the role of trait emotional intelligence and self‐esteem, age, and gender in relation to addictive internet behaviors. We conducted an online investigation among respondents. The participants were Italian university students who voluntarily completed the Abuse Internet Addiction scale (UADI) and the Rosenberg Self‐esteem scale. Path analysis results revealed that both trait emotional intelligence and self‐esteem had a protective direct effect on addictive internet behaviors. Age negatively affects addictive internet behaviors; younger are more likely to develop addictive internet behaviors than older individuals. Finally, we did not find an effect of gender on addictive internet behaviors. Our results suggest the need to develop prevention plans for addictive internet behaviors and educational programs to increase emotional intelligence and self‐esteem components to help younger to improve interpersonal and emotional management skills to better handle their internet use.
cognitive function. We recorded EEG(resting state, short term memory task, working memory task, spatial cognition task) from 20(digital textbook group) and 21(paper textbook group), 5th elementary school volunteers. The results of behavioral tasks(short term memory and spatial cognition task), revealed no significant differences between digital textbook and paper textbook group. The results of an EEG, the digital textbook group that negative oscillate more than the paper textbook group around the right frontal(delta range) and paper textbook group that higher sensitivity more than the digital textbook group appears around the frontal area performing the tasks in spatial cognition. The results of this study provide effects of using a digital textbook on cognitive function and suggest that the directions for development of digital textbook and further research based on analysis results.
The purpose of this study is to identify brain activations when learning digital learning contents of biology using smartpad by measuring functional Magnetic Resonance Imaging. Twenty male students in a general high school of Chungbuk province were recruited for BOLD fMRI measurement while learning about the structure of biological organism with traditional fixed learning image and digital learning contents, respectively, based on interaction. SPM8 software was applied to analyze the acquired MR images and identify the brain regions which are specific on using digital learning contents compared with fixed learning images and on using fixed learning images compared with digital learning contents, respectivly. During learning with digital learning contents, high brain activations were identified in middle temporal gyrus, inferior temporal gyrus, middle occipital gyrus, cuneus and cerebellar tonsil that are associated with connections between visual image information and lingual information and regulation of the spatial attention. During learning with fixed learning images, precentral gyrus, postcentral gyrus, transverse temporal gyrus, cingulate gyrus and caudate tail that are related with perception of visual word, experience of successful learning and regulation of finger movement were observed active. These results can suggest a possibility to elaborate the development of digital textbook on biology.
Background: Internet gaming disorder (IGD) has become a worldwide mental health concern; however, the neural mechanism underlying this disorder remains unclear. Multivoxel pattern analysis (MVPA), a newly developed data-driven approach, can be used to investigate the neural features of IGD based on massive neural data.
Methods: Resting-state functional magnetic resonance imaging data from four hundred and two participants with varying levels of IGD severity were recruited. Regional homogeneity (ReHo) and the amplitude of low-frequency fluctuation (ALFF) were calculated and subsequently decoded by applying MVPA. The highly weighted regions in both predictive models were selected as regions of interest (ROIs) for further graph theory and Granger causality analysis (GCA) to explore how they affect IGD severity.
Results: The results revealed that the neural patterns of ReHo and ALFF can independently and significantly predict IGD severity. The highly weighted brain regions that contributed to both predictive models were the right precentral gyrus and the left postcentral gyrus. Moreover, the topological properties of the right precentral gyrus were significantly correlated with IGD severity; further GCA analyses revealed effective connectivity from the right precentral gyrus to the left precentral gyrus and the dorsal anterior cingulate cortex, both of which were significantly associated with IGD severity.
Conclusions: The present study demonstrated that IGD has distinctive neural patterns, and this pattern could be found by machine learning. In addition, the neural features in the right precentral gyrus play a key role in predicting IGD severity. The current study revealed the neural features of IGD and provided a potential target for IGD interventions using brain modulation.
Exaggerated reactivity to drug‐cues and emotional dysregulations represent key symptoms of early stages of substance use disorders. The diagnostic criteria for (Internet) gaming disorder strongly resemble symptoms for substance‐related addictions. However, previous cross‐sections studies revealed inconsistent results with respect to neural cue reactivity and emotional dysregulations in these populations. To this end, the present fMRI study applied a combined cross‐sectional and longitudinal design in regular online gamers (n = 37) and gaming‐naïve controls (n = 67). To separate gaming‐associated changes from predisposing factors, gaming‐naive subjects were randomly assigned to 6 weeks of daily Internet gaming or a non‐gaming condition. At baseline and after the training, subjects underwent an fMRI paradigm presenting gaming‐related cues and non‐gaming–related emotional stimuli. Cross‐sectional comparisons revealed gaming‐cue specific enhanced valence attribution and neural reactivity in a parietal network, including the posterior cingulate in regular gamers as compared to gaming naïve‐controls. Longitudinal analysis revealed that 6 weeks of gaming elevated valence ratings as well as neural cue‐reactivity in a similar parietal network, specifically the posterior cingulate in previously gaming‐naïve controls. Together, the longitudinal design did not reveal supporting evidence for altered emotional processing of non‐gaming associated stimuli in regular gamers whereas convergent evidence for increased emotional and neural reactivity to gaming‐associated stimuli was observed. Findings suggest that exaggerated neural reactivity in posterior parietal regions engaged in default mode and automated information processing already occur during early stages of regular gaming and probably promote continued engagement in gaming behavior.
Non-substance addictive behaviors may involve repetitive rewarding behaviors including gambling, gaming, sexual activities, internet-use, and buying-shopping. In addictions, there exists diminished control over participation in the behaviors and continuation of the behaviors despite experiencing negative consequences. Addictive participation in behaviors typically results in distress and functional impairment in personal, relational, occupational, educational or other life domains. Increases in cue-reactivity and craving and decreases in inhibitory control may represent pivotal mechanisms in addictions, especially when behavior-specific cues are present. Similar to substance-use disorders, alterations in brain networks related to reward processing, executive functioning, salience attribution, and habit formation and in neurochemical pathways that may include dopamine, serotonin, opioids and other neurotransmitters may represent neurobiological factors involved in the development and maintenance of addictive behaviors. Although there has been substantial progress in research on the neurobiologies of addictive behaviors, science is still at an early stage of understanding the potential neurobiological mechanisms related to specific non-substance addictive behaviors. Considerations for future directions in research on non-substance addictive behaviors, with a view on common and distinct neurobiological foundations of specific disorders, are discussed.
This paper reports the results from two waves of studies on the development of Chinese Internet Addiction Scale (CIAS) and its revision (CIAS-R). Based upon the conception framework adapted from other traditional addiction disorders such like pathological gambling and substance addictions, the tendency of Internet addiction was presumably characterized with two aspects of behavioral manifestation, i.e., core symptoms and related problems. In study 1, the original items of the CIAS depicting core symptoms and related problems of the Internet addiction were thus generated through focused interview and derived from the diagnostic criteria of other well-defined addiction disorders. The CIAS, background questionnaire eliciting data on basic demographics, weekly on-line hours, habitual domains, and experience of Internet utilization were administered in a traditional paper and pencil manner to a random sample of students of National Taiwan University (N=1336) Factor analysis, correlation analysis, and t-test were utilized to analyze data. The results show that: The CIAS is an appealing and reliable test with satisfactory test-retest reliability and internal consistency. Correlation analyses yield significantly positive correlation of total scale and subscale scores of CIAS with weekly Internet hours, but not with experience of Internet utilization. Moreover, high-risk students show different attitudes toward Internet use and addiction from the normal. In study 2, the CIAS-R, with modification of item wording as well as addition and elimination of some items, were administered to another wave of random subjects at National Taiwan University (N=1975). Same procedure and analyses were applied. It results in a better factor structure in CIAS-R, with similarly satisfactory psychometric properties. Future research concerning scale revision as well as possible psychopathological approach to Internet addiction will be discussed accordingly.
Le trouble déficitaire d’attention avec ou sans hyperactivité (TDAH) est l’une des problématiques la plus fréquemment rencontrée chez les enfants d’âge scolaire. Les difficultés du contrôle cognitif et de l’inhibition sont souvent rapportées dans la littérature sur le TDAH. Les études en neuropsychologie supportent de façon générale l’hypothèse que l’absence première de contrôle de l’inhibition comportementale explique les déficits dans les fonctions exécutives et les comportements impulsifs du TDAH (2). Les résultats de plusieurs études en neuro-imagerie, neuropsychologie, génétique et neurochimie convergent vers l’implication d’une dysfonction du réseau neuronal frontostriatal comme cause probable du TDAH (4, 8, 16, 17, 18). Ces dysfonctions se retrouvent dans des régions comme le cortex préfrontal dorsolatéral et ventrolatéral, le cortex cingulaire dorsoantérieur et le néostriatum. L’étude de ces régions, ainsi que du corps calleux et du cervelet, est aujourd’hui plus facilement réalisable grâce à l’imagerie par résonance magnétique fonctionnelle (IRMf) et structurelle. Les hypothèses et conclusions des études en neuro-imagerie du TDAH font l’objet du présent relevé. De plus, de futures questions de recherche dans ce domaine sont proposées au long du texte.
Individuals with alexithymia have a reduced ability to use their feelings to guide their behavior appropriately in social situations. To reveal the capacity to use emotional signals in alexithymia under conditions of uncertainty, this study investigates neural substrates and performance on the Iowa Gambling Task (IGT), which was developed to assess decision making based on emotion-guided evaluation.
The participants were 10 men with alexithymia and 13 without. Alexithymia was assessed by the 20-item Toronto Alexithymia Scale. Regional cerebral blood flow (rCBF) was measured by [¹⁵O]-H₂O positron emission tomography during four trials of the IGT and two visuomotor control tasks.
The participants with alexithymia failed to learn an advantageous decision-making strategy, with performance differing significantly from the nonalexithymic group in the fourth IGT trial (p = .029). Comparing performance between the IGT and the control tasks, both groups showed brain activation in the dorsolateral frontal area, inferior frontal lobe, pre-supplementary motor area, inferior parietal lobe, fusiform gyrus, and cerebellum. Men with alexithymia showed lower rCBF in the medial frontal area (Brodmann area [BA] 10) and higher rCBF in the caudate and occipital areas in the first and second IGT trials, which are within a learning phase according to test performance data. All brain data were significant at p ≤ .001, uncorrected.
BA10 activity may be associated with using internal signals accompanying affective evaluation of the stimuli, which is crucial for successful decision making. Reduced BA10 activity in participants with alexithymia suggests that they may not use an emotion-based biasing signal to lead to advantageous decision making.
Relapse is a highly prevalent phenomenon in addiction. This paper examines the new research on identifying biological factors that contribute to addiction relapse risk. Prospective studies examining relapse risk are reviewed, and clinical, biological, and neural factors that predict relapse risk are identified. Clinical factors, patient-related factors, and subjective and behavioral measures such as depressive symptoms, stress, and drug craving all predict future relapse risk. Among biological measures, endocrine measures such as cortisol and cortisol/corticotropin (ACTH) ratio as a measure of adrenal sensitivity and serum brain-derived neurotrophic factor were also predictive of future relapse risk. Among neural measures, brain atrophy in the medial frontal regions and hyperreactivity of the anterior cingulate during withdrawal were identified as important in drug withdrawal and relapse risk. Caveats pertaining to specific drug abuse type and phase of addiction are discussed. Finally, significant implications of these findings for clinical practice are presented, with a specific focus on determining biological markers of relapse risk that may be used to identify those individuals who are most at risk of relapse in the clinic. Such markers may then be used to assess treatment response and develop specific treatments that will normalize these neural and biological sequelae so as to significantly improve relapse outcomes.
J. Neurochem. (2011) 118, 1101–1112.
To characterize the long-term effects of adolescent marijuana abuse, we performed a proteomic analysis of cerebellar extracts from adult female rats with and without ovariectomy that were treated with Δ9-THC for 40 days during adolescence. Six proteins were found to significantly differ among the four treatment groups, with Δ9-THC and ovariectomy (OVX) decreasing the mitochondrial proteins, pyruvate carboxylase and NADH dehydrogenase, whereas the levels of putative cytosolic molecular chaperones NM23B, translationally controlled tumor protein, DJ-1 and activator of heat-shock 90kDa protein ATPase homolog 1 (AHA1) were increased. We further analyzed the effects of AHA1, a HSP90 co-chaperone, on CB1R and CB2R trafficking and signaling in transfected HEK293T and Neuro-2A cells. In HEK293T cells, AHA1 over-expression enhanced plasma membrane levels of CB1R and increased CB1R-mediated effects on cAMP levels and on MAPK phosphorylation. AHA1 over-expression also enhanced cell surface levels of endogenous CB1R and the effects of Δ9-THC on the cAMP levels in Neuro-2A cells. In contrast, over-expression of AHA1 did not affect the subcellular localization and signaling of CB2R. Our data indicate that chronic Δ9-THC administration in adolescence altered the endogenous levels of specialized proteins in the cerebellum, such as AHA1, and that this protein can change CB1R cell surface levels and signaling.
In the last decade a growing body of data revealed that the cerebellum is involved in the regulation of the affective reactions as well as in forming the association between sensory stimuli and their emotional values. In humans, cerebellar areas around the vermis are activated during mental recall of emotional personal episodes and during learning of a CS-US association. Lesions of the cerebellar vermis may affect retention of a fear memory without altering baseline motor/autonomic responses to the frightening stimuli in both human and animal models. Reversible inactivation of the vermis during the consolidation period impairs retention of fear memory in rodents. Recent findings demonstrate that long-term potentiation (LTP) of synapses in the cerebellar cortex occurs in relation to associative fear learning similar to previously reported data in the hippocampus and amygdala. Plastic changes affect both excitatory and inhibitory synapses. This concomitant potentiation allows the cerebellar cortical network to detect coincident inputs, presumably conveying sensorial stimuli, with better efficacy by keeping the time resolution of the system unchanged. Collectively, these data suggest that the vermis participates in forming new CS-US association and translate an emotional state elaborated elsewhere into autonomic and motor responses.
How does the brain translate information signaling potential rewards into motivation to get them? Motivation to obtain reward is thought to depend on the midbrain [particularly the ventral tegmental area (VTA)], the nucleus accumbens (NAcc), and the dorsolateral prefrontal cortex (dlPFC), but it is not clear how the interactions among these regions relate to reward-motivated behavior. To study the influence of motivation on these reward-responsive regions and on their interactions, we used dynamic causal modeling to analyze functional magnetic resonance imaging (fMRI) data from humans performing a simple task designed to isolate reward anticipation. The use of fMRI permitted the simultaneous measurement of multiple brain regions while human participants anticipated and prepared for opportunities to obtain reward, thus allowing characterization of how information about reward changes physiology underlying motivational drive. Furthermore, we modeled the impact of external reward cues on causal relationships within this network, thus elaborating a link between physiology, connectivity, and motivation. Specifically, our results indicated that dlPFC was the exclusive entry point of information about reward in this network, and that anticipated reward availability caused VTA activation only via its effect on the dlPFC. Anticipated reward thus increased dlPFC activation directly, whereas it influenced VTA and NAcc only indirectly, by enhancing intrinsically weak or inactive pathways from the dlPFC. Our findings of a directional prefrontal influence on dopaminergic regions during reward anticipation suggest a model in which the dlPFC integrates and transmits representations of reward to the mesolimbic and mesocortical dopamine systems, thereby initiating motivated behavior.
Human can flexibly attend to a variety of stimulus dimensions, including spatial location and various features such as color and direction of motion. Although the locus of spatial attention has been hypothesized to be represented by priority maps encoded in several dorsal frontal and parietal areas, it is unknown how the brain represents attended features. Here we examined the distribution and organization of neural signals related to deployment of feature-based attention. Subjects viewed a compound stimulus containing two superimposed motion directions (or colors) and were instructed to perform an attention-demanding task on one of the directions (or colors). We found elevated and sustained functional magnetic resonance imaging response for the attention task compared with a neutral condition, without reliable differences in overall response amplitude between attending to different features. However, using multivoxel pattern analysis, we were able to decode the attended feature in both early visual areas (primary visual cortex to human motion complex hMT+) and frontal and parietal areas (e.g., intraparietal sulcus areas IPS1-IPS4 and frontal eye fields) that are commonly associated with spatial attention. Furthermore, analysis of the classifier weight maps showed that attending to motion and color evoked different patterns of activity, suggesting that different neuronal subpopulations in these regions are recruited for attending to different feature dimensions. Thus, our finding suggests that, rather than a purely spatial representation of priority, frontal and parietal cortical areas also contain multiplexed signals related to the priority of different nonspatial features.
Abnormal cue reactivity is a central characteristic of addiction, associated with increased activity in motivation, attention and memory related brain circuits. In this neuroimaging study, cue reactivity in problem gamblers (PRG) was compared with cue reactivity in heavy smokers (HSM) and healthy controls (HC). A functional magnetic resonance imaging event-related cue reactivity paradigm, consisting of gambling, smoking-related and neutral pictures, was employed in 17 treatment-seeking non-smoking PRG, 18 non-gambling HSM, and 17 non-gambling and non-smoking HC. Watching gambling pictures (relative to neutral pictures) was associated with higher brain activation in occipitotemporal areas, posterior cingulate cortex, parahippocampal gyrus and amygdala in PRG compared with HC and HSM. Subjective craving in PRG correlated positively with brain activation in left ventrolateral prefrontal cortex and left insula. When comparing the HSM group with the two other groups, no significant differences in brain activity induced by smoking cues were found. In a stratified analysis, the HSM subgroup with higher Fagerström Test for Nicotine Dependence scores (FTND M = 5.4) showed higher brain activation in ventromedial prefrontal cortex, rostral anterior cingulate cortex, insula and middle/superior temporal gyrus while watching smoking-related pictures (relative to neutral pictures) than the HSM subgroup with lower FTND scores (FTND M = 2.9) and than non-smoking HC. Nicotine craving correlated with activation in left prefrontal and left amygdala when viewing smoking-related pictures in HSM. Increased regional responsiveness to gambling pictures in brain regions linked to motivation and visual processing is present in PRG, similar to neural mechanisms underlying cue reactivity in substance dependence. Increased brain activation in related fronto-limbic brain areas was present in HSM with higher FTND scores compared with HSM with lower FTND scores.
It has been hypothesized that processing of conflict is facilitated by emotion. Emotional stimuli signal significance in a situation. Thus, when an emotional stimulus is task relevant, more resources may be devoted to conflict processing to reduce the time that an organism is unable to act. In the present electroencephalography and functional magnetic resonance imaging (fMRI) studies, we employed a conflict task and manipulated the emotional content and prosody of auditory target stimuli. In line with our hypothesis, reaction times revealed faster conflict resolution for emotional stimuli. Early stages of event-related potential conflict processing were modulated by emotion as indexed in an enhanced frontocentral negativity at 420 ms. FMRI yielded conflict activation in the dorsal anterior cingulate cortex (dACC), a crucial part of the executive control network. The right ventral ACC (vACC) was activated for conflict processing in emotional stimuli, suggesting that it is additionally activated for conflict processing in emotional stimuli. The amygdala was also activated by emotion. Furthermore, emotion increased functional connectivity between the vACC and activity in the amygdala and the dACC. The results support the hypothesis that emotion speeds up conflict processing and suggest a new role for the vACC in processing conflict in particularly significant situations signaled by emotion.
Patients suffering from addiction persist in consuming substances of abuse, despite negative consequences or absence of positive consequences. One potential explanation is that these patients are impaired at flexibly adapting their behavior to changes in reward contingencies. A key aspect of adaptive decision-making involves updating the value of behavioral options. This is thought to be mediated via a teaching signal expressed as a reward prediction error (PE) in the striatum. However, to exert control over adaptive behavior, value signals need to be broadcast to higher executive regions, such as prefrontal cortex. Here we used functional MRI and a reinforcement learning task to investigate the neural mechanisms underlying maladaptive behavior in human male alcohol-dependent patients. We show that in alcohol-dependent patients the expression of striatal PEs is intact. However, abnormal functional connectivity between striatum and dorsolateral prefrontal cortex (dlPFC) predicted impairments in learning and the magnitude of alcohol craving. These results are in line with reports of dlPFC structural abnormalities in substance dependence and highlight the importance of frontostriatal connectivity in addiction, and its pivotal role in adaptive updating of action values and behavioral regulation. Furthermore, they extend the scope of neurobiological deficits underlying addiction beyond the focus on the striatum.
Where we look is determined both by our current intentions and by the tendency of visually salient items to "catch our eye." After damage to parietal cortex, the normal process of directing attention is often profoundly impaired. Here, we tracked parietal patients' eye movements during visual search to separately map impairments in goal-directed orienting to targets versus stimulus-driven gaze shifts to salient but task-irrelevant probes. Deficits in these two distinct types of attentional selection are shown to be identical in both magnitude and spatial distribution, consistent with damage to a "priority map" that integrates goal- and stimulus-related signals to select visual targets. When goal-relevant and visually salient items compete for attention, the outcome depends on a biased competition in which the priority of contralesional targets is undervalued. On the basis of these findings, we further demonstrate that parietal patients' spatial bias (neglect) in goal-directed visual exploration can be corrected and even reversed by systematically manipulating the spatial distribution of stimulus salience in the visual array.
An optimal choice among alternative behavioral options requires precise anticipatory representations of their possible outcomes. A fundamental question is how such anticipated outcomes are represented in the brain. Reward coding at the level of single cells in the orbitofrontal cortex (OFC) follows a more heterogeneous coding scheme than suggested by studies using functional MRI (fMRI) in humans. Using a combination of multivariate pattern classification and fMRI we show that the reward value of sensory cues can be decoded from distributed fMRI patterns in the OFC. This distributed representation is compatible with previous reports from animal electrophysiology that show that reward is encoded by different neural populations with opposing coding schemes. Importantly, the fMRI patterns representing specific values during anticipation are similar to those that emerge during the receipt of reward. Furthermore, we show that the degree of this coding similarity is related to subjects' ability to use value information to guide behavior. These findings narrow the gap between reward coding in humans and animals and corroborate the notion that value representations in OFC are independent of whether reward is anticipated or actually received.
Legalized gambling is a growing industry, and is probably a factor in the presently increasing prevalence of pathological gambling. We present a case of a 36-year-old pathological gambler who was treated with fluvoxamine, a selective serotonin reuptake inhibitor, and who was assessed by functional MRI before and after drug administration. During activation periods, the pathological gambler was shown cards as stimuli, and fMRI results in several brain regions showed differential effects before and after medication and a maintenance period. This case demonstrates that the treatment response to fluvoxamine in a pathological gambler was observed not only by subjective self-report, but also by objective fMRI results. Therefore, fMRI may be a useful tool in the diagnosis and prediction of treatment response in patients afflicted with pathological gambling.
Anterior cingulate cortex (ACC) hypoactivations during cognitive processing characterize drug addicted individuals as compared with healthy controls. However, impaired behavioral performance or task disengagement may be crucial factors. We hypothesized that ACC hypoactivations would be documented in groups matched for performance on an emotionally salient task. Seventeen individuals with current cocaine use disorders (CUD) and 17 demographically matched healthy controls underwent functional magnetic resonance imaging during performance of a rewarded drug cue-reactivity task previously shown to engage the ACC. Despite lack of group differences in objective or subjective task-related performance, CUD showed more ACC hypoactivations throughout this emotionally salient task. Nevertheless, intensity of emotional salience contributed to results: (i) CUD with the largest rostroventral ACC [Brodmann Area (BA) 10, 11, implicated in default brain function] hypoactivations to the most salient task condition (drug words during the highest available monetary reward), had the least task-induced cocaine craving; (ii) CUD with the largest caudal-dorsal ACC (BA 32) hypoactivations especially to the least salient task condition (neutral words with no reward) had the most frequent current cocaine use; and (iii) responses to the most salient task condition in both these ACC major subdivisions were positively intercorrelated in the controls only. In conclusion, ACC hypoactivations in drug users cannot be attributed to task difficulty or disengagement. Nevertheless, emotional salience modulates ACC responses in proportion to drug use severity. Interventions to strengthen ACC reactivity or interconnectivity may be beneficial in enhancing top-down monitoring and emotion regulation as a strategy to reduce impulsive and compulsive behavior in addiction.
Attention-deficit hyperactivity disorder (ADHD) is a common and impairing neuropsychiatric disorder with preschool onset. ADHD occurs in approximately 3-9% of the childhood population. There is a much higher incidence rate in boys who are around three times more likely than girls to be diagnosed. Approximately 30-60% of individuals diagnosed with ADHD in youth have symptoms that persist into adulthood.
Three subtypes of the disorder have been proposed in the current clinical view of ADHD: inattentive, hyperactive-impulsive and combined type. Numerous problems are associated with ADHD: poor academic performance, learning disorders, subtle cognitive deficits, conduct disorders, antisocial personality disorder, poor social relationships, and a higher incidence of anxiety and depression symptoms into adulthood. Researchers have emphasized poor behavioural inhibition as the central impairment of the disorder. From the neuropsychological viewpoint, impairment of the "hot" affective aspects of executive functions, like behavioural inhibition and attention and the more cognitive, "cool" aspects of executive functions like self-regulation, working memory, planning, and cognitive flexibility, are often reported by studies on ADHD. The hot executive functions are associated with ventral and medial regions of the prefrontal cortex (including the anterior cingulated cortex) and named "hotbrain" and the cool executive functions are associated with the dorsolateral prefrontal cortex and are called "coolbrain".
Convergent data from neuroimaging, neuropsychology, genetics and neurochemical studies consistently point to the involvement of the frontostriatal network as a likely contributor to the pathophysiology of ADHD. This network involves the lateral prefrontal cortex, the dorsal anterior cingulate cortex, the caudate nucleus and putamen. Moreover, a growing literature demonstrates abnormalities affecting other cortical regions and the cerebellum. The exploratory brain regions of interest in which abnormalities have been identified, but that were not predicted by cognitive models of ADHD, are the temporal lobe, parietal lobe, occipital lobe and lateral ventricles. Anatomical studies suggest widespread reductions in volume throughout the cerebrum and cerebellum, while functional imaging studies suggest that affected individuals activate more diffuse areas than controls during the performance of cognitive tasks. More precisely, reductions in volume have been observed in the total cerebral volume, the prefrontal cortex, the basal ganglia (striatum), the dorsal anterior cingulate cortex, the corpus callosum and the cerebellum. Furthermore, hypoactivation of the dorsal anterior cingulate cortex, the frontal cortex and the basal ganglia (striatum) have also been reported. The paradigms mostly used in functional magnetic resonance imaging (fMRI) are tasks of motor inhibition, interference and attention such as the go/no-go, "stop-signal" and the Stroop.
This review provides an overview of the main imaging studies that investigated the neurobiological substrate of ADHD. Some guidelines for future functional magnetic imaging studies are also suggested.
We studied the neural correlates of visuomotor sequence learning using functional magnetic resonance imaging (fMRI). In the test condition, subjects learned, by trial and error, the correct order of pressing two buttons consecutively for 10 pairs of buttons (2 x 10 task); in the control condition, they pressed buttons in any order. Comparison between the test condition and the control condition revealed four brain areas specifically related to learning: the dorsolateral prefrontal cortex (DLPFC), the presupplementary motor area (pre-SMA), the precuneus, and the intraparietal sulcus (IPS). We found that the time course of activation during learning was different between these areas. To normalize the individual differences in the speed of learning, we classified the performance of each subject into three learning stages: early, intermediate, and advanced stages. Both the relative increase of signal intensity and the number of activated pixels within the four areas showed significant changes across the learning stages, with different time courses. The two frontal areas, DLPFC and pre-SMA, were activated in the earlier stages of learning, whereas the two parietal areas, precuneus and IPS, were activated in the later stages. Specifically, DLPFC, pre-SMA, precuneus, and IPS were most highly activated in the early stage, in both the early and intermediate stages, in the intermediate stage, and in both the intermediate and advanced stages, respectively. The results suggest that the acquisition of visuomotor sequences requires frontal activation, whereas the retrieval of visuomotor sequences requires parietal activation, which might reflect the transition from the declarative stage to the procedural stage.
The orbitofrontal cortex (OFC) plays a central role in human behavior. Anatomically connected with association areas of all sensory modalities, limbic structures, prefrontal cortical regions that mediate executive function and subcortical nuclei, this brain region can serve to integrate the physical and emotional attributes of a stimulusobject and establish a motivational value based on estimation of potential reward. To the extent that addictive disorders reflect a dysregulation of the ability to evaluate potential reward against harm from drug self-administration, it would be anticipated that substance abuse disorder might reflect dysfunction of the OFC. With the application of brain imaging techniques to the study of human substance abuse, evidence has been obtained that activity in the OFC and its connections plays a role in several components of the maladaptive behavior of substance abuse, including expectancy, craving and impaired decision making.
Cocaine-related cues have been hypothesized to perpetuate drug abuse by inducing a craving response that prompts drug-seeking behavior. However, the mechanisms, underlying neuroanatomy, and specificity of this neuroanatomy are not yet fully understood.
To address these issues, experienced cocaine users (N=17) and comparison subjects (N=14) underwent functional magnetic resonance imaging while viewing three separate films that portrayed 1 ) individuals smoking crack cocaine, 2) outdoor nature scenes, and 3) explicit sexual content. Candidate craving sites were identified as those that showed significant activation in the cocaine users when viewing the cocaine film. These sites were then required to show significantly greater activation when contrasted with comparison subjects viewing the cocaine film (population specificity) and cocaine users viewing the nature film (content specificity).
Brain regions that satisfied these criteria were largely left lateralized and included the frontal lobe (medial and middle frontal gyri, bilateral inferior frontal gyrus), parietal lobe (bilateral inferior parietal lobule), insula, and limbic lobe (anterior and posterior cingulate gyrus). Of the 13 regions identified as putative craving sites, just three (anterior cingulate, right inferior parietal lobule, and the caudate/lateral dorsal nucleus) showed significantly greater activation during the cocaine film than during the sex film in the cocaine users, which suggests that cocaine cues activated similar neuroanatomical substrates as naturally evocative stimuli in the cocaine users. Finally, contrary to the effects of the cocaine film, cocaine users showed a smaller response than the comparison subjects to the sex film.
These data suggest that cocaine craving is not associated with a dedicated and unique neuroanatomical circuitry; instead, unique to the cocaine user is the ability of learned, drug-related cues to produce brain activation comparable to that seen with nondrug evocative stimuli in healthy comparison subjects.
The aim of this study was to establish the optimal cut-off points of the Chen Internet Addiction Scale (CIAS), to screen for and diagnose Internet addiction among adolescents in the community by using the well-established diagnostic criteria of Internet addiction. This survey of 454 adolescents used screening (57/58) and diagnostic (63/64) cut-off points of the CIAS, a self-reported instrument, based on the results of systematic diagnostic interviews by psychiatrists. The area under the curve of the receiver operating characteristic curve revealed that CIAS has good diagnostic accuracy (89.6%). The screening cut-off point had high sensitivity (85.6%) and the diagnostic cut-off point had the highest diagnostic accuracy, classifying 87.6% of participants correctly. Accordingly, the screening point of the CIAS could provide a screening function in two-stage diagnosis, and the diagnostic point could serve as a diagnostic criterion in one-stage massive epidemiologic research.
Decision making in an uncertain environment poses a conflict between the opposing demands of gathering and exploiting information. In a classic illustration of this 'exploration-exploitation' dilemma, a gambler choosing between multiple slot machines balances the desire to select what seems, on the basis of accumulated experience, the richest option, against the desire to choose a less familiar option that might turn out more advantageous (and thereby provide information for improving future decisions). Far from representing idle curiosity, such exploration is often critical for organisms to discover how best to harvest resources such as food and water. In appetitive choice, substantial experimental evidence, underpinned by computational reinforcement learning (RL) theory, indicates that a dopaminergic, striatal and medial prefrontal network mediates learning to exploit. In contrast, although exploration has been well studied from both theoretical and ethological perspectives, its neural substrates are much less clear. Here we show, in a gambling task, that human subjects' choices can be characterized by a computationally well-regarded strategy for addressing the explore/exploit dilemma. Furthermore, using this characterization to classify decisions as exploratory or exploitative, we employ functional magnetic resonance imaging to show that the frontopolar cortex and intraparietal sulcus are preferentially active during exploratory decisions. In contrast, regions of striatum and ventromedial prefrontal cortex exhibit activity characteristic of an involvement in value-based exploitative decision making. The results suggest a model of action selection under uncertainty that involves switching between exploratory and exploitative behavioural modes, and provide a computationally precise characterization of the contribution of key decision-related brain systems to each of these functions.
Prior research in substance dependence has suggested potential anti-craving effects of repetitive transcranial magnetic stimulation (rTMS) when applied to the dorsolateral prefrontal cortex (DLPFC). However, no single sham-controlled session studies applied to the right DLPFC have been carried-out in recently detoxified alcohol-dependent patients. Furthermore, no studies examined the effect of a single HF-rTMS session on craving in these patients' natural habitat.
To further investigate the effect of high-frequency (HF)-rTMS of the right DLPFC on alcohol craving, we performed a prospective, single-blind, sham-controlled study involving 36 hospitalized patients with alcohol dependence syndrome. After successful detoxification, patients were allocated receiving one active or one sham HF-rTMS session. The obsessive-compulsive drinking scale (OCDS) was administered to evaluate the extent of craving just before and after the HF-rTMS session (on Friday), on Saturday and Sunday during the weekend at home, and on Monday when the patient returned to the hospital.
One single blind sham-controlled HF-rTMS session applied to the right DLPFC did not result in changes in craving (neither immediately after the stimulation session, nor in patients' natural environment during the weekend).
One HF-rTMS stimulation session applied to the right DLPFC had no significant effects on alcohol craving in alcohol dependent patients. One such session could have been too short to alter alcohol craving in a sample of alcohol dependent patients.
Although self-reported gambling urge intensities have clinical utility in the treatment of pathological gambling (PG), prior studies have not investigated their neural correlates. Functional magnetic resonance imaging (fMRI) was conducted while 10 men with PG and 11 control comparison (CON) men viewed videotaped scenarios of gambling, happy or sad content. Participants rated the intensity of their emotions and motivations and reported the qualities of their responses. Relative to the CON group, the PG group reported similar responses to sad and happy scenarios, but stronger emotional responses and gambling urges when viewing the gambling scenarios. Correlations between self-reported responses and brain activations were typically strongest during the period of reported onset of emotional/motivational response and more robust in PG than in CON subjects for all conditions. During this epoch, corresponding with conscious awareness of an emotional/motivational response, subjective ratings of gambling urges in the PG group were negatively correlated with medial prefrontal cortex activation and positively correlated with middle temporal gyrus and temporal pole activations. Sadness ratings in the PG group correlated positively with activation of the medial orbitofrontal cortex, middle temporal gyrus, and retrosplenial cortex, while self-reported happiness during the happy videos demonstrated largely inverse correlations with activations in the temporal poles. Brain areas identified in the PG subjects have been implicated in explicit, self-referential processing and episodic memory. The findings demonstrate different patterns of correlations between subjective measures of emotions and motivations in PG and CON subjects when viewing material of corresponding content, suggesting in PG alterations in the neural correlates underlying experiential aspects of affective processing.
The cerebellum has traditionally been considered a neuronal system which is an essential par