Emotional bias modification weakens game-related compulsivity and reshapes frontostriatal pathways

上瘾 心理学 腹侧纹状体 渴求 神经认知 强迫行为 行为成瘾 心理干预 线索反应性 临床心理学 神经科学 神经心理学 认知 纹状体 精神科 多巴胺
作者
Lulu Wu,Jiahua Xu,Kun-ru Song,Lei Zhu,Nan Zhou,Lin-xuan Xu,GuanQun Liu,Ziliang Wang,Rong Wang,Shaozheng Qin,Xiaoyi Fang,Jintao Zhang,Marc N. Potenza
出处
期刊:Brain [Oxford University Press]
卷期号:145 (12): 4210-4221 被引量:2
标识
DOI:10.1093/brain/awac267
摘要

Abstract Addiction is characterized by compulsive engagement despite adverse consequences. Psychobehavioural interventions targeting compulsivity in addictions are relatively rare, particularly for behavioural addictions like internet gaming disorder (IGD). Free from confounding drug-on-brain effects, IGD provides a promising model for understanding neuropsychological processes of addictions. IGD is a global concern in the setting of increasing internet use worldwide. Thus, developing interventions and understanding their mechanisms of action are important. Positive emotional association biases (EABs) towards addiction cues based on reward conditioning may underlie addiction-associated compulsivity. Here, we developed an EAB modification (EABM) protocol and examined whether modifying EABs via cognitive training would alter neurocognitive aspects of addiction-associated compulsivity in IGD. We recruited 90 IGD participants who were randomly assigned to receive EABM or sham training in a 1:1 ratio (clinicaltrials.gov identifier: NCT04068064). The EABM intervention involved six consecutive days of exposure to negative emotional terms linked to gaming stimuli and positive terms linked to non-gaming healthy-alternative stimuli. The sham training involved similar stimuli linked to neutral words. Participants underwent event-related functional MRI while performing a regulation-of-craving task and received several behavioural assessments pretraining and post-training. Primary efficacy measures were changes in gaming-related positive EABs, and compulsive gaming thoughts and behaviours. Behaviourally, EABM (versus sham) training decreased gaming-related positive EABs and compulsive gaming thoughts and behaviours. Neurally, EABM training involved decreased activation in the bilateral dorsal striatum in the regulation-of-craving task and altered left dorsal striatum-centric functional connectivity with ventral prefrontal cortical regions, which correlated with decreases in gaming-related EABs or compulsive gaming thoughts and behaviours. EABM training also implicated activation changes in the right medial frontal gyrus and posterior insula. EABM may reduce compulsive gaming thoughts and behaviours via reshaping functional organization of frontostriatal pathways and insular activity in IGD. The therapeutic potential of EABM should be examined in larger, longer-term studies, as should its application to other addictive disorders.
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