Compr Psychiatry. 2011 Jan-Feb;52(1):88-95.
Department of Psychiatry, Chung Ang University, College of Medicine, Seoul 104-757, South Korea.
Recent studies have suggested that the brain circuitry mediating cue-induced desire for video games is similar to that elicited by cues related to drugs and alcohol. We hypothesized that desire for Internet video games during cue presentation would activate similar brain regions to those that have been linked with craving for drugs or pathologic gambling.
This study involved the acquisition of diagnostic magnetic resonance imaging and functional magnetic resonance imaging data from 19 healthy male adults (age, 18-23 years) following training and a standardized 10-day period of game play with a specified novel Internet video game, “War Rock” (K2 Network, Irvine, CA). Using segments of videotape consisting of 5 contiguous 90-second segments of alternating resting, matched control, and video game-related scenes, desire to play the game was assessed using a 7-point visual analogue scale before and after presentation of the videotape.
In responding to Internet video game stimuli, compared with neutral control stimuli, significantly greater activity was identified in left inferior frontal gyrus, left parahippocampal gyrus, right and left parietal lobe, right and left thalamus, and right cerebellum (false discovery rate <0.05, P < .009243). Self-reported desire was positively correlated with the β values of left inferior frontal gyrus, left parahippocampal gyrus, and right and left thalamus. Compared with the general players, subjects who played more Internet video game showed significantly greater activity in right medial frontal lobe, right and left frontal precentral gyrus, right parietal postcentral gyrus, right parahippocampal gyrus, and left parietal precuneus gyrus. Controlling for total game time, reported desire for the Internet video game in the subjects who played more Internet video game was positively correlated with activation in right medial frontal lobe and right parahippocampal gyrus.
The present findings suggest that cue-induced activation to Internet video game stimuli may be similar to that observed during cue presentation in persons with substance dependence or pathologic gambling. In particular, cues appear to commonly elicit activity in the dorsolateral prefrontal, orbitofrontal cortex, parahippocampal gyrus, and thalamus.
Video game play and fMRI scanning
Assessment of brain activity and desire for internet video game play
Brain activity was analyzed using the Brain Voyager software package (BVQX 1.9, Brain Innovation, Maastricht, The Netherlands). The fMRI time series for each subject was co-registered to the anatomical 3D data set using the multi-scale algorithm provided by BVQX. The individual structural images were spatially normalized to standard Talairach space . The same nonlinear transformation was subsequently applied to the T2*-weighted fMRI time series data. After the preprocessing steps of slice scan time correction and 3D motion correction, the functional data were spatially smoothed using Gaussian kernel with an FWHM of 6mm and temporally smoothed using Gaussian kernel of 4s using algorithms provided by BVQX
Subjects who played more internet video game (MIGP) vs general internet video game player (GP)
Dorsolateral Prefrontal Cortex
Orbitofrontal cortex and visuo-spatial working memory system
In response to internet video game cues, MIGP had increased activity of the right medial frontal gyrus (orbitofrontal cortex), precentral gyrus, parahippocampal gyrus, and occipital lingual gyrus, compared to GP. Interestingly, all the regions which activated in MIGP have been associated with visuo-spatial working memory . Cocaine users show higher levels of right medial prefrontal activity and lower levels of attentional bias in responding to cocaine stimuli, suggesting that they have difficulty with disengaging attention from drug-related stimuli . Moreover, activation in the orbitofrontal cortex and parahippocampal gyrus was associated with desire for internet video game in our study. A hyperactive OFC in drug-taking behavior  and a hyper-sensitized amygdala and hippocampus responding to cue-exposure  have been commonly reported in patients with substance dependence. In addition, a dissociation in the visual processing stream was also reported in pathological gamblers given a cue-induced type stimulus . The present findings are consistent with results reported in patients with substance dependence. Through the connection with the striatum and limbic regions such as the amygdala , the OFC is thought to select appropriate behavior in response to external stimuli and reward processing in the process of goal-directed behaviors . Activation of the OFC could explain the motivation for persisting internet video game play in the early stage.
Parahippocampal gyrus and thalamus
The current study provides information with respect brain changes that support the motivation to continue playing an internet video game in the early stages. Based on previous studies of cue-induced craving in substance abusers, the present findings also suggest the neural circuitry that mediates cue-induced desire for internet video games is similar to that observed following cue presentation to individuals with substance dependence. In particular, cues appear to commonly elicit activity in the dorsolateral prefrontal cortex, orbitofrontal cortex, parahippocampal gyrus, and thalamus..