More stringent criteria are needed for diagnosing internet gaming disorder: Evidence from regional brain features and whole-brain functional connectivity multivariate pattern analyses

J Behav Addict. 2020 Oct 7;9(3):642-653. doi: 10.1556/2006.2020.00065. Print 2020 Oct 12.

Abstract

Background: Internet gaming disorder (IGD) is included in the DSM-5 as a provisional diagnosis. Whether IGD should be regarded as a disorder and, if so, how it should be defined and thresholded have generated considerable debate.

Methods: In the current study, machine learning was used, based on regional and interregional brain features. Resting-state data from 374 subjects (including 148 IGD subjects with DSM-5 scores ≥5 and 93 IGD subjects with DSM-5 scores ≥6) were collected, and multivariate pattern analysis (MVPA) was employed to classify IGD from recreational game use (RGU) subjects based on regional brain features (ReHo) and communication between brain regions (functional connectivity; FC). Permutation tests were used to assess classifier performance.

Results: The results demonstrated that when using DSM-5 scores ≥5 as the inclusion criteria for IGD subjects, MVPA could not differentiate IGD subjects from RGU, whether based on ReHo or FC features or by using different templates. MVPA could differentiate IGD subjects from RGU better than expected by chance when using DSM-5 scores ≥6 with both ReHo and FC features. The brain regions involved in the default mode network and executive control network and the cerebellum exhibited high discriminative power during classification.

Discussion: The current findings challenge the current IGD diagnostic criteria thresholding proposed in the DSM-5, suggesting that more stringent criteria may be needed for diagnosing IGD. The findings suggest that brain regions involved in the default mode network and executive control network relate importantly to the core criteria for IGD.

Keywords: MVPA; ReHo; diagnosing criteria; functional connectivity; internet gaming disorder.

MeSH terms

  • Adolescent
  • Adult
  • Brain / diagnostic imaging
  • Brain / physiopathology*
  • Connectome*
  • Default Mode Network / diagnostic imaging
  • Default Mode Network / physiopathology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Executive Function / physiology*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Internet Addiction Disorder / diagnosis*
  • Internet Addiction Disorder / diagnostic imaging
  • Internet Addiction Disorder / physiopathology*
  • Machine Learning*
  • Magnetic Resonance Imaging
  • Male
  • Multivariate Analysis
  • Nerve Net / diagnostic imaging
  • Nerve Net / physiopathology*
  • Pattern Recognition, Automated
  • Recreation*
  • Video Games*
  • Young Adult