The Comorbidity Between Internet Gaming Disorder and Depression: Interrelationship and Neural Mechanisms

Lu Liu, Yuan-Wei Yao, Chiang-Shan R Li, Jin-Tao Zhang, Cui-Cui Xia, Jing Lan, Shan-Shan Ma, Nan Zhou, Xiao-Yi Fang, Lu Liu, Yuan-Wei Yao, Chiang-Shan R Li, Jin-Tao Zhang, Cui-Cui Xia, Jing Lan, Shan-Shan Ma, Nan Zhou, Xiao-Yi Fang

Abstract

Internet gaming disorder (IGD) is characterized by cognitive and emotional deficits. Previous studies have reported the co-occurrence of IGD and depression. However, extant brain imaging research has largely focused on cognitive deficits in IGD. Few studies have addressed the comorbidity between IGD and depression symptoms and underlying neural mechanisms. Here, we systematically investigated this issue by combining a longitudinal survey study, a cross-sectional resting-state functional connectivity (rsFC) study and an intervention study. Autoregressive cross-lagged modeling on a longitudinal dataset of college students showed that IGD severity and depression are reciprocally predictive. At the neural level, individuals with IGD exhibited enhanced rsFC between the left amygdala and right dorsolateral prefrontal cortex (DLPFC), inferior frontal and precentral gyrus, compared with control participants, and the amygdala-frontoparietal connectivity at the baseline negatively predicted reduction in depression symptoms following a psychotherapy intervention. Further, following the intervention, individuals with IGD showed decreased connectivity between the left amygdala and left middle frontal and precentral gyrus, as compared with the non-intervention group. These findings together suggest that IGD may be closely associated with depression; aberrant rsFC between emotion and executive control networks may underlie depression and represent a therapeutic target in individuals with IGD. Registry name: The behavioral and brain mechanism of IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Registration number: NCT02550405.

Keywords: amygdala; depression; fMRI; internet gaming disorder; resting-state functional connectivity; subgenual anterior cingulate cortex.

Figures

Figure 1
Figure 1
The cross-lagged regression analysis. We indicate the metric invariance, configural invariance, and invariance of error covariance across time using letters on the paths. The numbers are standardized path coefficients (*P < 0.05; ***P < 0.001).
Figure 2
Figure 2
Resting-state functional connectivity in IGD and HC subjects (A) and association with depression in IGD group (B).
Figure 3
Figure 3
Results in study 3. Comparisons of the rsFC changes ([rsFC at the second scanning]–[rsFC at baseline]) between the CBI+ and CBI− groups over the left amygdala with MFG, precentral gyrus and SFG (A); Negative association between the FC of left amygdala and right DLPFC at baseline with changed score of depression in the CBI+ group (B); Scatterplot is shown of correlation between changed score of BDI and beta values for cluster surviving in baseline rsFC of amygdala-DLPFC (C).

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