Abstract
Internet gaming disorder (IGD) and gambling disorder (GD) share similar clinical characteristics but show different brain functional connectivity patterns. Bupropion is known to be effective for the treatment of patients with IGD and GD. We hypothesized that bupropion may be effective for the treatment of Internet-based gambling disorder (ibGD) and IGD and that the connections between the default mode network (DMN) and cognitive control network (CCN) would be different between ibGD and IGD patients after 12 weeks of bupropion treatment. 16 patients with IGD, 15 patients with ibGD, and 15 healthy subjects were recruited in this study. At baseline and after 12 weeks of bupropion treatment, the clinical symptoms of patients with IGD or ibGD were assessed, and brain activity was evaluated using resting state functional magnetic resonance imaging. After the 12-week bupropion treatment, clinical symptoms, including the severity of IGD or GD, depressive symptoms, attention, and impulsivity improved in both groups. In the IGD group, the functional connectivity (FC) within the posterior DMN as well as the FC between the DMN and the CCN decreased following treatment. Moreover, the FC within the DMN in the IGD group was positively correlated with changes in Young Internet Addiction Scale scores after the bupropion treatment period. In the ibGD group, the FC within the posterior DMN decreased while the FC within the CCN increased after the bupropion treatment period. Moreover, the FC within the CCN in the ibGD group was significantly greater than that in the IGD group. Bupropion was effective in improving clinical symptoms in patients with IGD and ibGD. However, there were differences in the pharmacodynamics between the two groups. After 12 weeks of bupropion treatment, the FC within the DMN as well as between the DMN and CCN decreased in patients with IGD, whereas the FC within the CCN increased in patients with ibGD.
Highlights
Internet-based gambling is a modified form of gambling using Internet-enabled devices, including computers, mobile phones, and digital television [1, 2]
Due to the similarities between Internet gaming disorder (IGD) and internet-based gambling disorder with respect to the clinical symptoms of excessive use and the potential adverse effects, several studies have suggested that IGD may be diagnostically similar to ibGD [4]
There were no significant differences in age, education years, and intelligence quotient (IQ) between IGD patients, ibGD patients, and healthy comparison subjects
Summary
Internet-based gambling is a modified form of gambling using Internet-enabled devices, including computers, mobile phones, and digital television [1, 2]. Due to the similarities between IGD and internet-based gambling disorder (ibGD) with respect to the clinical symptoms of excessive use and the potential adverse effects, several studies have suggested that IGD may be diagnostically similar to ibGD [4]. Because of these diagnostic similarities, medications for gambling disorder (GD), including escitalopram and bupropion, have been applied to IGD [5,6,7,8]. A comparison of the effects of medication on the two diseases is warranted
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