Transformative Effects of Mindfulness Meditation Training on the Dynamic Reconfiguration of Executive and Default Mode Networks in Internet Gaming Disorder

Abstract

Background: Internet gaming disorder (IGD) is a pervasive global mental health issue, and finding effective treatments for the disorder has been challenging. Mindfulness meditation (MM), recognized for its holistic approach that involves integrating mental and physical facets, holds promise for addressing the multifaceted nature of addiction. Nevertheless, the effect of MM on IGD and its associated neural networks, particularly in terms of their dynamic characteristics, remains elusive.

Methods: A total of 61 eligible participants with IGD (30 in the MM group, 31 in the progressive muscle relaxation [PMR] group) completed the experimental protocol, which involved pretest, an 8-session MM/PMR training regimen, and posttests. The 142 brain regions of interest were categorized into 5 brain networks using dynamic network reconfiguration analysis based on Shen's functional template. A comparative analysis of network dynamic features, including recruitment and integration coefficients, was performed across different groups and tests using resting-state functional magnetic resonance imaging data.

Results: While clinically nonspecific effects were observed in the PMR group, the MM group exhibited a significant reduction in addiction severity and cravings. In the dynamic brain network, MM training increased the recruitment coefficient within the frontoparietal network (FPN) and basal ganglia network (BGN) but decreased it within the default mode network (DMN). Furthermore, MM training increased the integration coefficient in the FPN-DMN and DMN-limbic network (LN).

Conclusions: MM has demonstrated pronounced efficacy in treating IGD. MM may enhance top-down control functions, cognitive and emotional functions, and reward-system processing, potentially through the reconfiguration of the FPN-DMN pathway, DMN-LN pathway, and BGN.

Keywords: Integration; Internet gaming disorder; Mindfulness meditation; Progressive muscle relaxation; Recruitment.

Figure 1

Eight-session mindfulness meditation (MM) training and progressive muscle relaxation (PMR) exercise. Foundational practices (lesson 1): introduction to foundational exercises such as raisin practice, mindfulness exploration, and body scan. Breath and cravings (lesson 2): focus on awareness of breathing, urge surfing meditation, and group discussions on managing cravings and addiction. Mindful engagement (lesson 3): incorporation of practices such as mindful street walking, self-care, sober engagement, and connection with small mindful objects. Challenging situations (lesson 4): MM practices emphasizing nourishing and depleting elements and techniques for maintaining sobriety in challenging situations. Social practices (lesson 5): MM practice, paired sober exercises, and training in wise responding to various situations. Cognitive awareness (lesson 6): exploration of thoughts, application of the ABCDEF model, classroom practice, and group discussions on the relapse cycle. Loving-kindness focus (lesson 7): introduction to loving-kindness mindfulness practice, pebble meditation, and discussions on life trees. Closure and continuation (lesson 8): final lessons include body scan practice, stone meditation, and discussions on resources and support networks for ongoing mindfulness practice. The control group underwent 8 sessions of PMR exercises.

Figure 2

Overview of the experimental process and dynamic network analysis. (A) Comparative analysis of resting-state functional magnetic resonance imaging (rsfMRI) datasets in the mindfulness meditation (MM) and progressive muscle relaxation (PMR) groups. (B) The pretest phase included an rsfMRI scan and completion of the DSM-5 and gaming craving questionnaire. (C) Participants underwent 8 training sessions of either MM or PMR. (D) The posttest phase included an rsfMRI scan and the completion of the DSM-5 and gaming craving questionnaire and (E) preprocessing of rsfMRI datasets. (F) Shen’s region of interest (ROI) atlas was used to construct the brain network. (G) Time-series data were extracted from 142 ROIs using rsfMRI, using a sliding window strategy (length/step = 15/1 TR, 222 windows in total). (H) Estimation of functional connections within each layer was performed using Pearson’s correlations. (I) Dynamic community structure was identified using the generalized Louvain community detection algorithm. (J) Module allegiance matrix. (K) Calculation of the recruitment coefficient. (L) Calculation of the integration coefficient. BOLD, blood oxygen level–dependent.

Figure 3

Differences in behavioral results after training between the mindfulness meditation (MM) and progressive muscle relaxation (PMR) groups. (A) Changes in DSM-5 questionnaire scores. (B) Changes in gaming craving scores. Asterisks indicate significant group differences: ∗p < .05, ∗∗∗p < .001.

Figure 4

Differences in altered dynamic network features after training between the mindfulness meditation (MM) and progressive muscle relaxation (PMR) groups. (A) Module allegiance in the MM group before training. (B) Module allegiance in the PMR group before training. (C) Module allegiance in the MM group after training. (D) Module allegiance in the PMR group after training. (E) Recruitment within 5 brain networks in the MM group. (F) Recruitment within 5 brain networks in the PMR group. (G) Integration between the default mode network (DMN) and other brain networks in the MM group. (H) Integration between the DMN and other brain networks in the PMR group. (I) Regression equation with DSM-5 questionnaire scores (change) and recruitment within the frontoparietal network (FPN) before MM training. (J) Regression equation with Five Facet Mindfulness Questionnaire (FFMQ) scores (change) and recruitment within the basal ganglia network (BGN) before MM training. Asterisks indicate significant group differences: ∗p < .05, ∗∗p < .01, ∗∗∗p < .001. MFN, medial frontal network; LN, limbic network.