Maladaptive neurovisceral interactions in patients with Internet gaming disorder: A study of heart rate variability and functional neural connectivity using the graph theory approach.

Jeongbong Choi,Sun Ju Chung,Ji Yoon Lee,Bo Mi Kim,Jinsick Park,Su Mi Park,Sung Jun Hong,A Ruem Choi,Jung‐Seok Choi,Minkyung Park,In Young Kim

doi:10.1111/adb.12805

Abstract

Heart rate variability (HRV) can be used to represent the regulatory adaptive system and is a proxy for neurovisceral integration. Consistent with the view that, like other addictions, Internet gaming disorder (IGD) involves disrupted regulatory function, the present study hypothesized that IGD patients would show (a) decreased HRV, (b) ineffective functional neural connectivity, and (c) differential patterns of association between HRV and functional neural connectivity relative to healthy controls (HCs). The present study included 111 young adults (53 IGD patients and 58 age‐ and sex‐matched HCs) who underwent simultaneous recordings with an electrocardiogram and electroencephalogram during a resting state. Heart rate (HR), HRV, and functional neural connectivity were calculated using the graph theory approach. Compared with the HCs, the IGD patients exhibited elevated HR and decreased HRV based on the high frequency (HF), which reflects suppression of parasympathetic and/or vagal tone. The IGD patients also exhibited a heightened theta band characteristic path length (CPL) compared with HCs, indicating decreased efficacy of the functional network. Furthermore, IGD patients exhibited negative correlations between the standard deviation of the normal‐to‐normal interval index (SDNNi) and theta and delta CPL values, which were not observed in HCs. In conclusion, the present findings suggest that IGD patients might have maladaptive brain‐body integration features involving disruptions of the autonomic nervous system and brain function.

Highlights

Because of the development of modern information technology, the Internet has become an integral part of our lives
The present study included 55 patients (52 males and three females) diagnosed with Internet gaming disorder (IGD) based on DSM‐5 criteria who were recruited from the outpatient clinic of SMG‐SNU Boramae Medical Center; all IGD patients were medication naïve
For the EEG functional network, the theta characteristic path length (CPL) was significantly higher in the IGD group than in the healthy control (HC) group (t = 2.12, P = .037, ηp2 = 0.12; Figure 2); the other frequency band CPL values did not differ between the groups

Summary

| INTRODUCTION

Because of the development of modern information technology, the Internet has become an integral part of our lives. Ko et al[26] demonstrated that functional connectivity between the amygdala and dorsolateral prefrontal cortex (DLPFC) could indicate vulnerability to the features of IGD, such as impulsivity Taken together, these findings suggest that IGD is associated with dysfunctional brain networks, which is a notion that many studies have demonstrated. A study assessing posttraumatic stress disorder (PTSD) found that decreases in the high HF HRV of parasympathetic nerves and increases in the EEG alpha spectrum were features of PTSD28; those authors did not describe correlates of HRV‐EEG interaction. Another recent study that performed a pathway analysis.

| Participants

| RESULTS

Findings

| DISCUSSION

| CONCLUSIONS