PM300. Impaired fronto-insular activation during risky decision making in young adults with internet gaming disorder

Abstract

Abstract Objectives: Internet gaming disorder (IGD) is defined as the excessive and compulsive internet gaming behavior despite negative psychosocial consequences. We tested the hypothesis that subjects with internet gaming disorder would be less sensitive to high-risk situations and exhibit aberrant brain activation related to risk prediction processing. Methods: 24 young male adults with IGD (IGD group; mean age=24.8 ± 2.8) and 24 age-matched male healthy controls underwent functional MRI while performing a risky decision-making task (Odd-Even-Pass task). Task stimuli consisted of sets of white, solid-colored circles on a black background. The participants were asked to estimate whether the total number of coins was odd or even. The task consisted of 2 conditions: 1) a certain condition, in which the participants could easily estimate the correct answer; and 2) an uncertain condition, in which the coins were overlapped and the borders were blurred, so the participants could only make a guess. The trials with uncertainty were designed to give the feedback “correct” at a fixed rate of 16.6%, regardless of the participants’ responses, so the feedback indicated the same prediction error to every participant. Results: The IGD group, compared with the healthy control group, exhibited attenuated fronto-insular activation in response to high-risk uncertain conditions. Additionally, the healthy control group showed stronger activations within the dorsal attention network, including the dorsal prefrontal cortex and posterior parietal cortex. Conclusion: We found that fronto-insular activation was impaired under uncertain, high-risk conditions in young adults with internet gaming disorder. This impairment might lead to impaired sensitivity to the negative adverse consequences of excessive internet gaming and a more generalized inability to adopt new behavioral strategies, even when realizing the risk is higher than predicted.