Dynamic brain network changes induced by retrieval-aversive conditioning in internet gaming disorder: a coactivation pattern study.

Background

Internet gaming disorder (IGD) features uncontrollable gaming, driven by persistent gaming cue-reward memory links. Traditional interventions fail to rewrite deep neural circuits and rely on executive functions, while retrieval-aversive conditioning (R-AC) targets addictive memories but its impact on dynamic brain networks is unclear.

Methods

Fifty-two IGD subjects were randomly assigned to the R-AC group (n = 30) or control group (n = 22). The R-AC group underwent 5-day training: gaming video-induced memory retrieval, followed by aversive conditioning (pairing gaming images with aversive stimuli). The control group used neutral stimuli instead. Pre- and post-intervention assessments included the internet addiction test (IAT), DSM-5 criteria, craving scales, and fMRI. Coactivation pattern (CAP) analysis was applied to explore dynamic brain network changes (occurrence and resilience).

Results

Behavioral data showed significant reductions in IAT scores, DSM-5 scores, and craving in the R-AC group post-training, with no significant changes in the control group. CAP analysis revealed increased occurrence and resilience of a CAP involving the dorsal default mode network (DMN) and executive control network (ECN) in the R-AC group, which was not observed in the control group.

Conclusions

R-AC alleviates IGD symptoms, and this therapeutic effect is associated with an enhanced dorsal DMN-ECN coactivation pattern. These findings provide correlational neural evidence for the potential mechanism underlying R-AC in IGD; however, the absence of significant brain-behavior correlations indicates that the clinical predictive value of these neural markers remains to be established.