Disrupted dynamic network reconfiguration of the executive and reward networks in internet gaming disorder: Why IGD subjects cannot control their gaming cravings

Background Studies have shown that people with internet gaming disorder (IGD) show impaired executive control over their gaming cravings; however, the neural mechanisms underlying this process remain unknown. In addition, these conclusions were based on the hypothesis that brain networks were temporally stationary and neglected changes in cognitive processes. Methods Resting-state fMRI data were collected from 402 subjects (162 subjects with IGD and 240 recreational game users (RGUs)). The community structure (recruitment and integration) of the executive control network and the basal ganglia network (BGN, representing the reward network) of patients with IGD and healthy controls were analyzed and compared. Mediation effects were analyzed among the different networks. Results When compared to RGUs, subjects with IGD had a lower recruitment coefficient within the right executive control network (ECN). Further analysis showed that only male subjects had a lower recruitment coefficient. Mediation analysis showed that the integration coefficient of the right ECN mediated the relationship between the recruitment coefficients of both the right ECN and the BGN in RGUs. Conclusions Subjects with IGD had a lower recruitment coefficient than RGUs, and this feature was only observed in male subjects, making them less efficient at impulse control. The meditation results suggest a top-down control mechanism of the ECN is missing in subjects with IGD. All of these findings could explain why subjects with IGD have impaired executive control over their gaming cravings.