Ctrl+ADHD: Navigating the Mechanisms Tethering Internet Gaming Disorder and ADHD

The tentative psychiatric disorder known as Internet Gaming Disorder (IGD) is characterized by persistent and repetitive engagement with video games, often resulting in notable disruptions in daily life, work, and/or education. The American Psychiatric Association (APA) has recognized the need for additional research in this area. The literature suggests a strong correlation between IGD and attention deficit hyperactivity disorder (ADHD), as a meta-analysis suggested an 85% correlation with symptoms of ADHD. In fact, both combined type ADHD and predominantly hyperactive/impulsive ADHD are linked to IGD. This study aims to understand the neurobiological overlap between these comorbid disorders in order to best understand which treatment modalities could best help patients with either symptoms of ADHD or IGD.

Google Scholar and PubMed were explored using search terms including "IGD," "internet gaming disorder," "ADHD," "attention deficit hyperactivity disorder," and "mechanism" in various permutations. Eighteen studies were included from 58 search results that addressed IGD's connection to ADHD and their common biological mechanisms.

Findings suggest that In individuals with Internet Gaming Disorder (IGD), there is a decrease in the functional connectivity within brain networks associated with cognitive control, executive function, motivation, and reward. Additionally, structural changes such as reduced gray-matter volume and white-matter density have been observed. Furthermore, comorbidity studies suggest that the executive control networks affected in attention deficit-hyperactivity disorder (ADHD) may increase the vulnerability to developing IGD. Another meta-analysis found that , VBM (voxel-based morphometry) analysis showed disorder-specific GMV abnormality in the putamen among IGD subjects and orbitofrontal cortex in ADHD and shared GMV in the prefrontal cortex. Functionally, fMRI analysis discovered that IGD-differentiating increased activation in the precuneus and shared abnormal activation in anterior cingulate cortex, insular, and striatum. A 119 adolescent case-control study found that after a 6-week treatment period, both groups escitalopram and bupropion demonstrated improvement across all clinical symptom scales compared to the matched control group. Moreover, the bupropion group exhibited greater enhancements in scores on the Clinical Global Impression-Severity Scale, Young Internet Addiction Scale, ADHD Rating Scale, and Behavioral Inhibition Scale compared to the escitalopram group.

The literature findings suggest that individuals with IGD exhibit reduced functional connectivity and structural changes in brain networks associated with cognitive control and reward. Comorbidity studies indicate that executive control networks affected in ADHD may contribute to the vulnerability of developing IGD. These findings are helpful in the assessment and treatment of IGD which currently does not have any official treatment recommendations.

No Funding.