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. 2020 Dec 23;9(4):1011-1021.
doi: 10.1556/2006.2020.00092.

Effects of transcranial direct current stimulation on addictive behavior and brain glucose metabolism in problematic online gamers

Hyeonseok Jeong  1   2 , Jin Kyoung Oh  1 , Eun Kyoung Choi  1 , Jooyeon Jamie Im  1 , Sujung Yoon  3 , Helena Knotkova  4   5 , Marom Bikson  6 , In-Uk Song  7 , Sang Hoon Lee  8 , Yong-An Chung  1   2
Affiliations

Effects of transcranial direct current stimulation on addictive behavior and brain glucose metabolism in problematic online gamers

Hyeonseok Jeong et al. J Behav Addict. .

Abstract

Background and aims: Some online gamers may encounter difficulties in controlling their gaming behavior. Previous studies have demonstrated beneficial effects of transcranial direct current stimulation (tDCS) on various kinds of addiction. This study investigated the effects of tDCS on addictive behavior and regional cerebral metabolic rate of glucose (rCMRglu) in problematic online gamers.

Methods: Problematic online gamers were randomized and received 12 sessions of either active (n = 13) or sham tDCS (n = 13) to the dorsolateral prefrontal cortex over 4 weeks (anode F3/cathode F4, 2 mA for 30 min, 3 sessions per week). Participants underwent brain 18F-fluoro-2-deoxyglucose positron emission tomography scans and completed questionnaires including the Internet Addiction Test (IAT), Brief Self-Control Scale (BSCS), and Behavioral Inhibition System/Behavioral Activation System scales (BIS/BAS) at the baseline and 4-week follow-up.

Results: Significant decreases in time spent on gaming (P = 0.005), BIS (P = 0.03), BAS-fun seeking (P = 0.04), and BAS-reward responsiveness (P = 0.01), and increases in BSCS (P = 0.03) were found in the active tDCS group, while decreases in IAT were shown in both groups (P < 0.001). Group-by-time interaction effects were not significant for these measures. Increases in BSCS scores were correlated with decreases in IAT scores in the active group (β = -0.85, P < 0.001). rCMRglu in the left putamen, pallidum, and insula was increased in the active group compared to the sham group (P for interaction < 0.001).

Discussion and conclusions: tDCS may be beneficial for problematic online gaming potentially through changes in self-control, motivation, and striatal/insular metabolism. Further larger studies with longer follow-up period are warranted to confirm our findings.

Keywords: positron emission tomography; prefrontal cortex; problematic online gaming; regional cerebral metabolic rate of glucose; transcranial direct current stimulation.

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Conflict of interest statement

The City University of New York (CUNY) has IP on neurostimulation system and methods with Marom Bikson as inventor. Marom Bikson has equity in Soterix Medical Inc and serves as a consultant for Boston Scientific Inc. All other authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
Relationships between changes in the Brief Self-Control Scale and changes in the Internet Addiction Test in problematic online gamers administered with (A) active or (B) sham tDCS. A solid line represents a regression line. tDCS: transcranial direct current stimulation
Fig. 2.
Fig. 2.
Increases (red-yellow) or decreases (blue-green) of rCMRglu in problematic online gamers after active tDCS compared to sham tDCS. (A) A significant group-by-time interaction effect was found in the left putamen, pallidum, and insula (P < 0.001). The significant cluster was overlaid on a standard T1-weighted template and brain regions were identified using the Harvard-Oxford Atlas. Images are shown in neurological convention and the numbers above the brain slices indicate standard coordinates in the Montreal Neurological Institute space. (B) Changes in rCMRglu in the significant cluster are demonstrated for each group. Post-hoc tests revealed that rCMRglu was increased in the active tDCS group (P < 0.001), while it was decreased in the sham tDCS group (P < 0.001). Error bars represent standard errors. rCMRglu: regional cerebral metabolic rate of glucose; tDCS: transcranial direct current stimulation
Fig. 3.
Fig. 3.
Associations between regional cerebral metabolic rate of glucose in the cluster encompassing the left putamen, pallidum, and insula and (A) fun seeking and (B) reward responsiveness subscales of the Behavioral Activation System at baseline. Solid lines represent regression lines
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