| Objective: Craving is one of the primary behavioral components of addiction, and cue-elicited craving is an especially powerful form of this construct. The cue-reactivity has been suggested to be the most reliable and ecologically valid paradigm to evaluate craving and it has been utilized to evaluate craving for substance, gambling and food, however, cue-elicited craving of gaming urge and its underlying neurobiological mechanisms have not been studied very well. The aim of this study was to find the brain areas associated with the cue-induced gaming urge, and indentify the neural substrates of online addiction.Methods: All participants were recruited via advertising post on the internet. The invited participants were interviewed by a psychiatrist to confirm the diagnosis of online gaming addiction according CIAS. Ten subjects whose CIAS score is more than 63 were considered as case group.Ten age- and gender-matched healthy individuals with CIAS score is less than 50 were considered as control group. All recruited participants were screened to be Chinese speaking, male, right-handed, never had illegal substance use, psychosis history, head injury, and contraindications of functional magnetic resonance imaging (fMRI) scanning.All participants were presented with gaming pictures and the paired neutral pictures while undergoing functional magnetic resonance imaging (fMRI) scanning. The contrast in blood-oxygen-level dependent (BOLD) signals when viewing gaming pictures and viewing neutral pictures was calculated. The images were presented throughout an experimental run using a block design. The 288-s run of fMRI consisted of six sections of 24 s of mosaic modification for gaming picture followed by 24 s of gaming pictures. Pictures were not repeated during the six 24-s segments. A fixation on screen for 12 s and introduction for 6 s was shown before the 288-s run and 18 s of fixation on screen followed. During a 24-s trial, eight pictures were shown with each lasting 2.5 s intersected with 0.5 s of black background.The image preprocessing and statistical analysis was performed using SPM5 package. After converted the image format, spatial pre-processing, design matrix and estimate, we got the T-test for maps of activations for the contrast (Gaming-Neutral) for each participant. The activations for the"Gaming-Neutral"contrast were demonstrated for each group by one sample t-test. We used the individual contrast images of all participants in each group to determine group differences by two sample t-test. The correlations between the regional activation of ROI (% signal change) and the level of self-reported gaming urge and the level of recalling the gaming experience were examined with Spearman correlation analysis.Results:â‘ The activated brain regions response to gaming cue observed in the Gaming- Neutral contrast among the online gaming addiction group included bilateral dorsolateral prefrontal cortex (DLPFC) (middle frontal cortex and adjacent superior frontal cortex), temporal cortex, cerebellum, right inferior parietal lobe, right cuneus, left hippocampus, parahippo- campal gyrus and left caudate.â‘¡no supra-threshold activation of the Gaming-Neutral contrast was noted in the control group.â‘¢The result of two sample t-test indicated that the addiction group, compared to the control group, had significantly higher activation in the following regions: bilateral dorsolateral prefrontal cortex (DLPFC) (middle frontal cortex and adjacent superior frontal cortex), anterior cingulated, inferior parietal lobe, superior temporal cortex, cerebellum, right insula, and right angular gyrus.â‘£The results of ROI analysis revealed that the gaming urge and the level of recalling WOW experience provoked by the WOW picture were both correlated with the ROI of bilateral dorsolateral prefrontal cortex (DLPFC) (middle frontal cortex and adjacent superior frontal cortex), cingulated, and right inferior parietal lobe among all participants.Conclusion:1.The cue-reactivity has been successfully evaluated online gaming craving in online gaming addiction.2.The neuroanatomy structures mediated to cue-elicited online gaming craving were mostly located in prefrontal lobe and cingulated, and inferior parietal lobe. Craving state involved in multiple and different psychological processing, including both cognitive and emotion process. 3.The cue-induced brain activation pattern in online gaming addiction corresponds closely to that in craving of substance addiction. However, the role of dorsal visual processing stream is more important. |
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