The relationship between heart rate variability and eye movement characteristics in adolescents with internet gaming disorder: the mediating role of impulsivity

Abstract

Background This study aimed to investigate alterations in heart rate variability (HRV) and exploratory eye-movement characteristics in adolescents with Internet Gaming Disorder (IGD), examine the associations among HRV, impulsivity, and exploratory eye-movement characteristics, and further conduct an exploratory mediation analysis based on the observed correlation pattern. Methods A cross-sectional case-control study was conducted involving 75 adolescents who met the diagnostic criteria for IGD and 75 age-, sex-, and education-matched healthy controls (HCs). All participants completed psychological assessments, including the 20-item Internet Gaming Disorder Test, the Chinese Revised Version of the Barratt Impulsiveness Scale-11 (BIS-11), the Hamilton Anxiety Scale, and the Hamilton Depression Scale. HRV parameters, including heart rate (HR), standard deviation of NN intervals (SDNN), and root mean square of successive differences (RMSSD), were collected. Eye movement parameters included the number of eye fixations (NEF), responsive search scores (RSS), total eye scanning length (TESL), mean eye scanning length (MESL), and discriminant analysis score. Statistical analyses were performed using SPSS version 25.0. Pearson correlation analyses were conducted to examine associations among variables, with Benjamini–Hochberg false discovery rate (FDR) correction applied for multiple comparisons. Mediation analyses were performed using the PROCESS macro in SPSS with the bootstrap method to test the significance of indirect effects. Results (1) Compared with the HC group, the IGD group exhibited reduced HRV, characterized by significantly decreased RMSSD and SDNN values and increased HR (all p < 0.001). (2) Compared with the HC group, the IGD group showed significant alterations in eye movement performance, including decreased NEF and RSS, as well as reduced TESL and MESL (all p < 0.001). (3) Pearson correlation analyses within the IGD group revealed that RMSSD was negatively correlated with BIS-11 total scores, BIS-11 total scores were negatively correlated with RSS, and RMSSD was positively correlated with RSS. (4) The exploratory mediation analysis showed a significant indirect association between RMSSD and RSS through BIS-11 total scores (unstandardized indirect effect = 0.0375, 95% bootstrap CI [0.0061, 0.0903]), accounting for approximately 33.0% of the total association. Conclusion This study examined the interrelationships among physiological, cognitive, and behavioral characteristics of IGD. Adolescents with IGD exhibited reduced HRV, increased impulsivity, and altered exploratory eye-movement characteristics. Impulsivity statistically accounted for part of the association between RMSSD and RSS.