Neural correlates of problematic gaming in adolescents: A systematic review of structural and functional magnetic resonance imaging studies

Abstract

The addictive use of digital games (problematic gaming [PG]) is a phenomenon with rising prevalence, especially in adolescents. The period of adolescence is characterized by intense brain maturation processes and increased vulnerability for mental disorders. However, no recent systematic review on functional and structural neural correlates of PG is available exclusively for this age group. This paper aimed to close this gap by describing neuroimaging findings and derive clinical implications. A systematic literature search was performed via PubMed, PsycInfo, and PSYNDEX including magnetic resonance imaging (MRI) studies on structural and functional changes in problematic gamers under 20 years of age until December 2020. The findings suggest especially prefrontal brain areas (important for cognitive control functions) but also temporoparietal regions (associated with attention processes and self‐concepts), as well as frontolimbic and subcortical regions (connected to emotion regulation and reward processing) to be significantly altered in adolescents with PG compared with healthy controls. Reduced interhemispheric connectivity and altered network activity further support theories of neurofunctional imbalance as well as structural deficits to explain addictive behaviours. Based on these findings, interventions should specifically address executive and cognitive‐affective deficits together with adolescent‐specific developmental tasks such as personality formation. Methodological limitations including heterogeneous PG classifications need to be considered. Additional neuroimaging studies on PG based on the DSM‐5 or ICD‐11 framework for the (Internet) gaming disorder in adolescents with larger sample sizes and prospective designs are highly warranted to understand potential causality and to generate valid and reproducible results.

Current Status of Internet Gaming Disorder (IGD) in Japan: New Lifestyle-Related Disease in Children and Adolescents

“…Adolescents with IGD have similar traits to those with substance dependence, including higher impulsivity, greater propensity to make risky decisions, less capacity to defer gratification, and impaired ability to assess risk. Schettler et al [ 60 ] reported that adolescents with problematic gaming have altered brains that show deficits in executive functioning (including working memory and attention), emotion management, and reward processing, as well as cognition, which includes decision making. Adolescents with IGD seem to exhibit a stronger imbalance between cognitive control (including fronto-parietal areas) and the affective system (including subcortical and limbic structures) than non-IGDs [ 42 ].…”

Applying ICD-11 criteria of Gaming Disorder to identify problematic video streaming in adolescents: Conceptualization of a new clinical phenomenon

“…Adolescents seem to be especially vulnerable to developing StrD due to immature cognitive-control abilities ( Casey & Jones, 2010 ). Adolescent gamers with GD show a larger cognitive-affective imbalance than unaffected gamers ( Schettler, Thomasius, & Paschke, 2021 ). This might be also the case in adolescents with StrD although further studies, including neuroimaging are highly warranted.…”

Resource-Strengthening Training for Parents of Adolescents with Problematic Gaming (Res@t-P): A Clinical Pilot Study

“…The etiology of PG is multifactorial and based on biological, psychological, parental, family, peer, and society risk factors [ 4 , 15 , 16 , 17 ]. Interactional aspects between personal, parental, family, and peer factors are emphasized in the Interactional Theory of Childhood Problematic Media Use (IT-CPU) [ 18 ].…”