Abstract

Depression is one of the most common comorbid conditions in Internet Gaming Disorder (IGD). Although there have been many studies on the pathophysiology of IGD, the neurobiological basis underlying the close association between depression and IGD has not been fully clarified. Previous neuroimaging studies have demonstrated functional and structural abnormalities in the anterior cingulate cortex (ACC) in IGD patients. In this study, we explored functional connectivity (FC) abnormalities involving subregions of the ACC in IGD subjects with comorbid depression. We performed a resting state seed-based FC analysis of 21 male young adults with IGD with comorbid depression (IGDdep+ group, 23.6 ± 2.4 years), 22 male young adults without IGD with comorbid depression (IGDdep− group, 24.0 ± 1.6 years), and 20 male age-matched healthy controls (24.0 ± 2.2 years). ACC-seeded FC was evaluated using the CONN-fMRI FC toolbox. The dorsal ACC (dACC), the pregenual ACC (pgACC), and the subgenual ACC (sgACC) were selected as seed regions. Both IGD groups had stronger pgACC FC with the right precuneus, the posterior cingulate cortex, and the left inferior frontal gyrus/insula than the control group. The IGDdep+ group had stronger dACC FC with the left precuneus and the right cerebellar lobule IX than the control and IGDdep- groups. The IGDdep+ group also had weaker pgACC FC with the right dorsomedial prefrontal cortex and the right supplementary motor area and had weaker sgACC FC with the left precuneus, the left lingual gyrus, and the left postcentral gyrus than the other groups. The strength of the connectivity between the sgACC and the left precuneus correlated positively with a higher omission error rate in the continuous performance test in the IGDdep+ group. In addition, the IGDdep– group had stronger sgACC FC with the left dorsolateral prefrontal cortex than the other groups. Our findings suggest that young males with IGD comorbid with depression have FC alterations of the default mode network and diminished FC with the prefrontal cortex. This altered FC pattern may be involved in the close association of IGD and depression.

Highlights

  • During the past decade, much research has been conducted on Internet Gaming Disorder (IGD), which is characterized by a difficulty in controlling Internet game use despite psychosocial disturbance [1]

  • IGD subjects with comorbid depression had weaker pregenual ACC (pgACC) functional connectivity (FC) with the right dorsomedial prefrontal cortex (dmPFC) and the right supplementary motor area (SMA) and weaker subgenual ACC (sgACC) FC with the left precuneus, the left lingual gyrus, and the left postcentral gyrus than the other subjects. These FC alterations, which differ partially based on the presence or absence of comorbid depression, are consistent with our hypothesis that IGD patients with comorbid depression may have a characteristic neurobiological basis that contributes to their distinctive clinical features

  • In comparison with other groups, IGD subjects with comorbid depression showed stronger dorsal ACC (dACC) FC with the precuneus and the right cerebellar lobule IX, which have been associated with the default mode network (DMN) [46, 47]

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Summary

Introduction

Much research has been conducted on Internet Gaming Disorder (IGD), which is characterized by a difficulty in controlling Internet game use despite psychosocial disturbance [1]. A maladaptive emotional regulation strategy that suppresses rather than uses cognitive reappraisal of emotion has been presented as a contributing factor to the comorbidity of IGD and depression [4] Several neurobiological factors, such as decreased inter-hemispheric connectivity of the frontal regions and structural alterations in the dorsolateral prefrontal cortex, have been suggested to mediate the relationship between IGD and depressed mood [5, 6]. These previous studies have improved our understanding of the associations between IGD and depression, research on the relationship between IGD and depression remains scarce despite its high clinical significance. A recent study reported that bupropion was more effective than escitalopram as a treatment for IGD patients with comorbid depression [8]

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