Abstract
Internet gaming disorder (IGD) is a newly identified potential addiction disorder associated with compulsive internet-game playing behavior and attentional bias toward online gaming- related cues. Attentional bias toward addiction-related cues is the core feature of addiction that is associated with craving, but the pathophysiology of attentional bias in IGD is not well-understood, such as its relationship to compulsivity. In this study, we used the electrophysiological marker of late positive potential (LPP) to compare attentional bias in IGD and obsessive compulsive disorder (OCD). Twenty patients with IGD, 20 patients with OCD, and 23 healthy control (HC) subjects viewed a series of game-related, OCD-related, and neutral pictures while their event-related potentials (ERPs) were recorded. The game-related cues included in-game screen captures of popular internet games. The OCD-related cues included pictures which provokes obsessive and compulsive symptoms of contamination/washing or checking. LPPs were calculated as the mean value of amplitudes between 350 and 750 ms at the centro-parietal (CP1, CPz, CP2) and parietal (P1, Pz, P2) electrode sites. Higher LPP amplitudes were found for game-related cues in the IGD group than in the HCs, and higher LPP amplitudes were observed in the OCD group for OCD-related cues. The IGD group did not exhibit LPP changes in response to OCD-related cues. Subjective scales demonstrated increased arousal to game-related cues and OCD-related cues in both the IGD and OCD groups compared with the HC group. Increased LPPs in response to disorder-specific cues (game-related and OCD-related) were found in both IGD and OCD groups respectively, although the groups showed overlapping arousal on subjective scales. Our results indicate that LPP is a candidate neurophysiological marker for cue-related craving in IGD.
Highlights
Internet gaming disorder (IGD) was newly included as a putative addiction disorder in section Results, or “a condition for further study” of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) [1]
The participants with IGD had the highest scores on the Internet Addiction Test (IAT), the patients with obsessive compulsive disorder (OCD) had intermediate scores, and the healthy control (HC) had the lowest scores on the IAT (IGD vs. HC, P < 0.001; IGD vs. OCD, P < 0.001; OCD vs. HC, P = 0.425)
Higher late positive potential (LPP) were observed in the IGD group, irrespective of specific game differences (i.e., League of Legends, FIFA, Sudden Attack)
Summary
Internet gaming disorder (IGD) was newly included as a putative addiction disorder in section Results, or “a condition for further study” of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) [1]. The symptoms of IGD are similar to those of addiction-related phenomenon, including “continued excessive use of internet games despite adverse consequences,” “loss of control (compulsive playing),” and “craving” [2, 3]. Many researchers proposed that IGD be regarded as one of behavioral addictions. There are concerns of other researchers that current operationalization of IGD criteria needs more specificity, because the problematic behaviors of pathologic gaming may be different from those of substance use disorders [4]. Integrative understanding of neurobiological substrate and clinical phenomenon of IGD is important to clarify the condition from other disorders with similar clinical features
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