Gray matter and white matter abnormalities in online game addiction

https://doi.org/10.1016/j.ejrad.2013.01.031Get rights and content

Abstract

Online game addiction (OGA) has attracted greater attention as a serious public mental health issue. However, there are only a few brain magnetic resonance imaging studies on brain structure about OGA. In the current study, we used voxel-based morphometry (VBM) analysis and tract-based spatial statistics (TBSS) to investigate the microstructural changes in OGA and assessed the relationship between these morphology changes and the Young's Internet Addiction Scale (YIAS) scores within the OGA group. Compared with healthy subjects, OGA individuals showed significant gray matter atrophy in the right orbitofrontal cortex, bilateral insula, and right supplementary motor area. According to TBSS analysis, OGA subjects had significantly reduced FA in the right genu of corpus callosum, bilateral frontal lobe white matter, and right external capsule. Gray matter volumes (GMV) of the right orbitofrontal cortex, bilateral insula and FA values of the right external capsule were significantly positively correlated with the YIAS scores in the OGA subjects. Our findings suggested that microstructure abnormalities of gray and white matter were present in OGA subjects. This finding may provide more insights into the understanding of the underlying neural mechanisms of OGA.

Introduction

With the rapid development of computer and network technology, online gaming has been considered as a mainstream recreational activity among internet users. Unfortunately, the online gaming also contributed to the creation of a negative habit in the form of online gaming addiction, which was characterized by an individual's inability to control his or her playing online games [1]. Data from a survey about adolescents’ online gaming addiction in China, as of 2 February 2010, showed that the incidence of internet addiction among Chinese urban youths was about 14.1%, with the total number of 24 million. It is worth noting that online gaming is the main culprit in cases of adolescents’ internet addiction (http://www.zqwx.youth.cn/). The adolescents with online game addiction suffered from a number of serious psychological and social problems, resulting in adverse effects on their social relationships and day-to-day living. A survey among 174 Taiwanese college-age online players reported that the quality of interpersonal relationships worsened and social anxiety increased as the amount of time spent on playing online games increased [2].

Current studies about OGA are primarily based on psychological self-reported questionnaires. These researches have demonstrated exactly the existence of online gamers who have psychological problems and cognitive impairments [3], [4]. It is notable that most of these empirical studies have merely focused on proposing potential reasons of OGA, such as players’ personal reasons, environmental factors, and characteristics of online games, instead of the underlying reasons of OGA. Furthermore, some researchers point out the necessity of investigating physical injuries of OGA but it is hard to include this dimension by means of a questionnaire. Few neuroimaging studies of internet addiction disorder (IAD) have demonstrated that some aspects of brain structure and function existed changes in IAD [5]. However, as one primary subtype of internet addiction, studies focused on the brain morphology changes of OGA specially have not been conducted. Voxel-based morphometry (VBM) technique and tract-based spatial statistics (TBSS) analysis were two widely used neuroimaging analysis techniques that allow investigation of focal differences in brain anatomy [6], [7]. In this study we aimed to investigate the differences in the brain morphology between OGA subjects and healthy controls without OGA and to explore the possible mechanism of OGA by virtue of VBM technique and TBSS analysis.

Section snippets

Subjects

Seventeen subjects with OGA were recruited from the Department of Psychology, Anhui Provincial Hospital (13 females and 4 males, mean age = 16.25 ± 3.02), all of whom met the modified Young's diagnostic questionnaire (YDQ) for internet addiction criteria by Beard and Wolf [8]. Seventeen age- and gender-matched healthy individuals without OGA were selected as the control group (15 females and 2 males, mean age = 15.54 ± 3.19). The YDQ criteria consisting of eight “yes” or “no” questions were translated

Demographic and behavioral performance

The two groups did not differ significantly in age, sex ratio, or education. The mean amount of time spent on the internet per week of the OGA group was 49.62 ± 7.35 h which was significantly higher than the control group (18.12 ± 2.51 h) (p < 0.001). Significantly higher YIAS (OGA: 66.53 ± 12.45, CON: 36.52 ± 10.43, p < 0.001) and BIS-11 (OGA: 68.85 ± 13.66, CON: 65.94 ± 6.65, p < 0.05) scores for the OGA group were also observed.

VBM and TBSS results

VBM and TBSS results were shown in Table 1 and Fig. 1.

Fig. 1A shows the VBM results:

Discussion

A number of recent findings suggested that the prefrontal cortex of the brain implicated in alcohol, cocaine, nicotine and some behavior addiction [5], [11], [12]. A hypothesis argued for the prefrontal cortex impairments in addiction resulted in executive dysfunction in the brain, which was considered been important to the cognitive control of behavior, contributed directly to the addiction process [13]. The executive system is a theorized cognitive system in psychology that controls and

Conclusion

We used VBM and TBSS analysis to investigate the microstructure of gray and white matter among OGA subjects. The results provided evidence indicating that OGA subjects had multiple structural changes in the gray matter and white matter. These findings suggested OGA may share the some mechanisms with substance addiction and provided more insights into the pathogenesis of OGA.

Conflicts of interest

There is no conflict of interest for each author including employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding.

Acknowledgements

This work was supported by the National Natural Science Foundation of China (30670683 and 30973084) and the Natural Science Foundation of Anhui Provincial, China (11040606M167 and 070413264X).

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