Neural correlates of appetitive learning and extinction in individuals with risky gaming use and gaming disorder

It is hypothesized that internet gaming disorder (IGD) shares psychological and neurobiological mechanisms with substance use disorders and behavioral addictions. However, the mechanisms of appetitive conditioning, extinction, and extinction recall in gaming disorder remain underexplored. A total of 83 male participants were enrolled in the study. The sample included 25 individuals with IGD, 23 gaming-risky (GR), and 35 non-problematic individuals. They underwent a classical conditioning, extinction, and extinction recall paradigm, with gaming-related, pornographic, and monetary stimuli used as unconditioned stimuli. Skin conductance responses (SCR), subjective ratings, and BOLD responses were recorded across all phases. No effects of group assignment were found in SCR and ratings data. We found significantly increased activation in the caudate and vmPFC in the non-problematic relative to the IGD group during acquisition learning and anticipation of pornographic rewards, and relative to the GR group, significantly increased activation in the caudate and vACC. These results suggest that individuals with problematic gaming may be less sensitive to non-addiction-related rewards. During extinction, the GR group showed significantly increased activation in the dACC, and during extinction recall marginally significantly in the amygdala, both during anticipation of gaming stimuli and compared to non-problematic users. Moreover, we found significantly greater amygdala activation in the IGD group than in the GR group during extinction training and anticipation of gaming stimuli. No differences were found between the IGD and non-problematic groups during extinction and extinction recall. The results provide preliminary evidence of altered appetitive extinction processes in individuals with problematic gaming use.