Approach bias modification training reduces gaming severity and improves brain network topology in internet gaming...

Patients with internet gaming disorder (IGD) suffer from an imbalance of over-integrated and weakly dissociated functional brain networks. Approach bias modification training (ApBMt) has been used to correct patients' automatic approach biases to addictive stimuli; however, research exploring changes in brain network topology is limited.

Seventy subjects were randomly assigned to the approach-avoidance task (AAT) group or the sham-AAT group, and 57 subjects (AAT, 30; sham-AAT, 27) completed the entire procedure, which included pretests, AAT/sham-AAT interventions, and posttests. Behavioral and resting-state fMRI data were collected before and after the tests. This study aimed to investigate the effects of ApBMt on topological changes in resting functional brain networks in patients with IGD and explore the relationship between these network changes and behavioral indicators of addiction severity.

Repeated-measures ANOVA of the behavioral data showed that the AAT group had significant score reductions after ApBMt. Imaging data revealed significant decreases in brain network over-integration and increases in segregation of the fronto-parietal network (FPN) and the cingulo-opercular network (CON). Additionally, a positive correlation was found between the post-pre difference in DSM-5 scores and the post-pre difference in nodal efficiency (Ne) in the anterior prefrontal cortex (aPFC).

The findings of this study demonstrate that ApBMt effectively reduces the severity of IGD, along with associated changes in brain network topology, such as enhanced segregation and decreased over-integration. However, it is important to highlight that the neurobiological changes observed are correlated with the reduction in IGD severity, but causality cannot be established. Further research is necessary to better understand the clinical potential of ApBMt in treating IGD, either as a stand-alone intervention or in combination with other therapeutic approaches.