Abstract
Background and aimsNumerous studies on behavioral addictions (BAs) have reported gray matter (GM) alterations in multiple brain regions by using voxel-based morphometry (VBM). However, findings are poorly replicated and it remains elusive whether distinct addictive behaviors are underpinned by shared abnormalities. In this meta-analysis, we integrated VBM studies on different BAs to investigate common GM abnormalities in individuals with BAs.MethodsWe performed a systematic search up to January 2019 in several databases for VBM studies investigating GM differences between individuals with BAs and healthy controls. The reference lists of included studies and high-quality reviews were investigated manually. Anisotropic effect-size signed differential mapping was applied in this meta-analysis.ResultsTwenty studies including 505 individuals with BAs and 564 healthy controls met the inclusion criteria. Compared with healthy controls, individuals with BAs showed GM atrophy in the left anterior cingulate (extending to the left medial superior frontal gyrus and bilateral orbitofrontal gyrus), right putamen and right supplementary motor area. Subgroup analysis found heterogeneity in gender and subtypes of BAs. Meta-regression revealed that GM decreases in the left anterior cingulate and right supplementary motor area were positively correlated with addictive severity. Higher impulsivity was associated with smaller volume of the left anterior cingulate.Discussion and conclusionsOur findings on BAs were mainly derived from internet gaming disorder (IGD) and pathological gambling (PG) studies, preliminarily suggesting that GM atrophy in the prefrontal and striatal areas might be a common structural biomarker of BAs.
Highlights
Behavioral addictions (BAs), known as non-substance addictions, are a constellation of recognizable and clinically significant syndromes characterized by distress or interference with personal functions that develop as a result of repetitive rewarding behaviors other than the use of dependence-producing substances (World Health Organization, 2018)
Studies were eligible if they met the following criteria: (1) diagnoses of behavioral addictions (BAs) in each study were based on Diagnostic and Statistical Manual of Mental Disorders (DSM), quantitative assessment tools or both; (2) voxel-based morphometry (VBM) results were derived from comparison between individuals with BAs and healthy controls (HCs); (3) whole-brain analysis was conducted with peak coordinates in Talairach or Montreal Neurological Institute (MNI) space
The search in various databases identified 211 potential studies, of which 20 studies were eligible for meta-analysis comprising 505 individuals with BAs (451 males) and 564 HCs (514 males) (Fig. 1)
Summary
Behavioral addictions (BAs), known as non-substance addictions, are a constellation of recognizable and clinically significant syndromes characterized by distress or interference with personal functions that develop as a result of repetitive rewarding behaviors other than the use of dependence-producing substances (World Health Organization, 2018). Findings are poorly replicated and it remains elusive whether distinct addictive behaviors are underpinned by shared abnormalities In this meta-analysis, we integrated VBM studies on different BAs to investigate common GM abnormalities in individuals with BAs. Methods: We performed a systematic search up to January 2019 in several databases for VBM studies investigating GM differences between individuals with BAs and healthy controls. Discussion and conclusions: Our findings on BAs were mainly derived from internet gaming disorder (IGD) and pathological gambling (PG) studies, preliminarily suggesting that GM atrophy in the prefrontal and striatal areas might be a common structural biomarker of BAs
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