Identifying Internet Addiction and Evaluating the Efficacy of Treatment Based on Functional Connectivity Density: A Machine Learning Study.

Yang Wang,Yun Qin,Lingrui Zhang,Chenchen Zhang,Hui Li,Tianmin Zhu,Chao Wen,Cheng Luo,Dezhong Yao,Yu Dai,Bo Sun,Jinnan Gong

doi:10.3389/fnins.2021.665578

Abstract

Although mounting neuroimaging studies have greatly improved our understanding of the neurobiological mechanism underlying internet addiction (IA), the results based on traditional group-level comparisons are insufficient in guiding individual clinical practice directly. Specific neuroimaging biomarkers are urgently needed for IA diagnosis and the evaluation of therapy efficacy. Therefore, this study aimed to develop support vector machine (SVM) models to identify IA and assess the efficacy of cognitive behavior therapy (CBT) based on unbiased functional connectivity density (FCD). Resting-state fMRI data were acquired from 27 individuals with IA before and after 8-week CBT sessions and 30 demographically matched healthy controls (HCs). The discriminative FCDs were computed as the features of the support vector classification (SVC) model to identify individuals with IA from HCs, and the changes in these discriminative FCDs after treatment were further used as features of the support vector regression (SVR) model to evaluate the efficacy of CBT. Based on the informative FCDs, our SVC model successfully differentiated individuals with IA from HCs with an accuracy of 82.5% and an area under the curve (AUC) of 0.91. Our SVR model successfully evaluated the efficacy of CBT using the FCD change ratio with a correlation efficient of 0.59. The brain regions contributing to IA classification and CBT efficacy assessment were the left inferior frontal cortex (IFC), middle frontal cortex (MFC) and angular gyrus (AG), the right premotor cortex (PMC) and middle cingulate cortex (MCC), and the bilateral cerebellum, orbitofrontal cortex (OFC) and superior frontal cortex (SFC). These findings confirmed the FCDs of hyperactive impulsive habit system, hypoactive reflecting system and sensitive interoceptive reward awareness system as potential neuroimaging biomarkers for IA, which might provide objective indexes for the diagnosis and efficacy evaluation of IA.

Highlights

In the last two decades, with the development of digital information technology, the internet has brought great convenience and benefit to people’s lives, but the popularity of the internet has brought new public health issues, such as internet addiction (IA)
Using global FCD (gFCD), local FCD (lFCD) and longrange FCD (lrFCD), the binary support vector classification (SVC) successfully discriminated individuals with IA from healthy control (HC) with a mean accuracy of 82.5% (Figure 4A), which was ensured by a permutation test (P < 0.05)
The brain regions contributing to IA classification and the evaluation of cognitive behavior therapy (CBT) efficacy were the left inferior frontal cortex (IFC), middle frontal cortex (MFC) and angular gyrus (AG), the right premotor cortex (PMC) and middle cingulate cortex (MCC), and the bilateral superior frontal cortex (SFC), orbitofrontal cortex (OFC) and cerebellum, which were compatible with the tripartite neurocognitive model of IA (Wei et al, 2017)

Summary

Introduction

In the last two decades, with the development of digital information technology, the internet has brought great convenience and benefit to people’s lives, but the popularity of the internet has brought new public health issues, such as internet addiction (IA). The pooled incidence rate of IA is as high as 30.1% (Zhang et al, 2018). With the popularity of mobile internet, the risk of IA in children has become an increasing concern (Mihajlov and Vejmelka, 2017). Surveys show that almost one-quarter of early teenagers spend 40 h online per week (Ayar et al, 2017), and more than 30% of children under 2 years old have used mobile internet devices (Young, 2017), reflecting the younger age trend of IA. Epidemiological features, including worldwide prevalence, high incidence, rapidly increasing incidence and younger age trend, make IA a public health threat as serious as substance addiction

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