Increased Attentional Bias Toward Visual Cues in Internet Gaming Disorder and Obsessive-Compulsive Disorder: An Event-Related Potential Study

Abstract

Internet gaming disorder (IGD) is a newly identified potential addiction disorder associated with compulsive internet-game playing behavior and attentional bias toward online gaming- related cues. Attentional bias toward addiction-related cues is the core feature of addiction that is associated with craving, but the pathophysiology of attentional bias in IGD is not well-understood, such as its relationship to compulsivity. In this study, we used the electrophysiological marker of late positive potential (LPP) to compare attentional bias in IGD and obsessive compulsive disorder (OCD). Twenty patients with IGD, 20 patients with OCD, and 23 healthy control (HC) subjects viewed a series of game-related, OCD-related, and neutral pictures while their event-related potentials (ERPs) were recorded. The game-related cues included in-game screen captures of popular internet games. The OCD-related cues included pictures which provokes obsessive and compulsive symptoms of contamination/washing or checking. LPPs were calculated as the mean value of amplitudes between 350 and 750 ms at the centro-parietal (CP1, CPz, CP2) and parietal (P1, Pz, P2) electrode sites. Higher LPP amplitudes were found for game-related cues in the IGD group than in the HCs, and higher LPP amplitudes were observed in the OCD group for OCD-related cues. The IGD group did not exhibit LPP changes in response to OCD-related cues. Subjective scales demonstrated increased arousal to game-related cues and OCD-related cues in both the IGD and OCD groups compared with the HC group. Increased LPPs in response to disorder-specific cues (game-related and OCD-related) were found in both IGD and OCD groups respectively, although the groups showed overlapping arousal on subjective scales. Our results indicate that LPP is a candidate neurophysiological marker for cue-related craving in IGD.

Functional neural changes and altered cortical–subcortical connectivity associated with recovery from Internet gaming disorder

“…In this study, decreased activations were found in the lentiform nucleus and other reward-related brain regions after recovery. The findings suggest that neural response to gaming cues decreases following recovery, which is consistent with previous studies comparing IGD with controls (Kim et al, 2018;Ko et al, 2013;Ma et al, 2019). The correlations between decreases in lentiform activation and self-reported cue-elicited craving provide support to the notion that decreased neural reactivity in the lentiform may underlie decreased cue-elicited craving responses in recovery in IGD and may relate importantly to diminished motivations to engage excessively in gaming behaviors.…”

“…Like drug cues in drug addictions, gaming cues may trigger game-seeking behaviors in IGD (Dong & Potenza, 2016). IGD participants have exhibited higher cue-induced brain features in the ventral and dorsal striatum (Liu et al, 2017), altered functional networks (Ko et al, 2013;Ma et al, 2019), higher late positive potential amplitude (Kim et al, 2018), when compared with control subjects when exposed to gaming cues. Neural responses to gaming cues may predict the emergence of IGD (Dong, Wang, Liu, et al, 2019) and operate in a gender-sensitive fashion .…”

“…Internet gaming disorder (IGD) has been associated with significant impairments in social and personal functioning, poorly controlled craving (Kim et al, 2018), excessive time spent gaming (Dong, Zhou, & Zhao, 2010), poor academic achievement (Hawi, Samaha, & Griffiths, 2018), and other negative measures of health and functioning. IGD has been considered as an addictive disorder, and preliminary diagnostic criteria have been established in part based on another behavioral addiction, i.e., gambling disorder (Dowling, 2014;Petry, Rehbein, Ko, & O'Brien, 2015).…”

Incentive sensitization in binge behaviors: A mini review on electrophysiological evidence

“…Binge Watching, Gaming, Gambling ( He et al, 2019 ) P100 90–150 PO5, PO6 Internet Gaming Disorder [playing the online game “Strike of Kings”] (15) vs. HC (15) IAT score > 79, IGAS score > 7, DSM-5 criteria of IGD as assessed by clinical interview Cartoon faces out “Strike of Kings” vs. Realistic faces IGD: Larger amplitude for cartoon vs. realistic faces in left hemisphere HC: No difference N170 150–210 IGD: Larger amplitude for cartoon faces vs. realistic faces in right hemisphere HC: Larger amplitude for cartoon faces vs. realistic faces in both hemispheres P200 210–270 IGD: Larger amplitude for cartoon faces vs. realistic faces in both hemispheres HC: No difference ( Kim et al, 2018 ) LPP 350–700 CP1, CPz, CP2, P1, Pz , P2 Internet Gaming Disorder (20) vs. HC (23) vs. Obsessive-Compulsive Disorder (20) Playing one of three games (League of Legend, FIFA, Sudden Attack) for > 4 h/day Game related (League of Legend, FIFA, Sudden Attack) vs. OCD related vs. neutral images IGD > HC for LPP to game-related cues (but not for OCD related cues). Limitation: effect was not found for all electrode sites, not controlled for multiple testing ( Lai et al, 2017 ) LPP 200–300, 300–400, 400–500.…”

Altered Eye-Movement Patterns During Text Reading in Obsessive–Compulsive Disorder and Internet Gaming Disorder

“…Both OCD and IGD are most prevalent during early adolescence, which is a critical period for learning and social development (Kessler et al, 2007 ). In addition, both OCD and IGD has repetitive thought and attentional bias to a specific object or target related with their symptom (Tata et al, 1996 ; Bradley et al, 2016 ; Kim et al, 2018 ). Because those symptoms affect attentional capacity which is a very basic unit of cognitive functioning, broad range of cognitive functioning can be affected by symptoms of OCD and IGD.…”