Higher levels of (Internet) Gaming Disorder symptoms according to the WHO and APA frameworks associate with lower striatal volume

Abstract

Background and aims: Growing concerns about the addictive nature of Internet and computer games led to the preliminary recognition of Internet Gaming Disorder (IGD) as an emerging disorder by the American Psychiatric Association (APA) and the official recognition of Gaming Disorder (GD) as a new diagnosis by the World Health Organization (WHO). While the definition of clear diagnostic criteria for (I)GD represents an important step for diagnosis and treatment of the disorder, potential neurobiological correlates of the criteria remain to be explored.

Methods: The present study employed a dimensional Magnetic Resonance Imaging (MRI) approach to determine associations between (I)GD symptom-load according to the APA and WHO diagnostic frameworks and brain structure in a comparably large sample of n = 82 healthy subjects.

Results: Higher symptom-load on both, the APA and WHO diagnostic frameworks convergently associated with lower volumes of the striatum.

Discussion: The results from this exploratory study provide the first initial evidence for a neurobiological foundation of the proposed diagnostic criteria for (I)GD according to both diagnostic classification systems and suggest that the transition from non-disordered to disordered gaming may be accompanied by progressive neuroplastic changes in the striatum, thus resembling progressive changes in other addictive disorders.

Conclusions: The proposed (I)GD criteria in both diagnostic systems were associated with neurostructural alterations in the striatum, suggesting an association with progressive changes in the motivational systems of the brain.

Keywords: DSM-5; ICD-11; gray matter; internet gaming disorder; striatum.

Fig. 1.

Flow diagram displaying screening and exclusion of participants.

Fig. 2.

Lower striatal volume with (I)GD symptom severity. A) Associations between symptom load and brain structure displayed at pFWE <0.05 within the striatum (IGDS9-SF = red, GDT = green, and overlapping = yellow). B) Extracted gray matter from the significant regions and associations with symptom severity. C) The striatal mask, including ventral and dorsal regions as used in the present study.