Page 20 - ITPS-7-4

INNOSC Theranostics and
Pharmacological Sciences Neurobiology of gaming disorder

negativity (ERN) following errors. The GD group showed modulation) and inferior parietal lobule (insensitivity
lower ERN amplitudes observed in response to incorrect regarding uncertainty) during risk perception for potential
trials compared to correct trials during a Go/No-go task. losses. This reduced activation was correlated with the
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The ERN is a negative peak that occurs after incorrect severity of GD, as indicated by higher YIAT scores.
behavioral responses, reflecting rapid and automatic initial During the process of outcomes, the GD group showed
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error detection. It is assumed to originate in the ACC. In enhanced responses to experienced reward in the ventral
another ERP study during a Go/No-go task, the NoGo-N2 striatum, OFC, and vmPFC for potential gains, indicating
latency at the central electrode site was delayed in the hypersensitivity to reward outcomes. In the GD group,
GD group compared to the healthy control. It was also there was a positive association between the severity of GD
positively correlated with impulsivity and YIAT scores. and increased reward-related activity in the OFC. These
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65
The N2 ERP component in a Go/No-go task reflects an findings support a previous study that showed individuals
early stage of response inhibition and conflict monitoring. with GD exhibit increased activation in the OFC during
The latency of the N2 reflects the effort required to inhibit gain trials and decreased activation in the ACC during
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a response. This suggests a reduced ability to handle loss trials in a reality-simulated guessing task compared
performance errors in individuals with GD, similar to what to normal controls. These results suggest decision-
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is observed in patients with SUD. making deficits in individuals with GD and indicate an
imbalance between the bottom-up system associated
4.2. Impairment of decision-making ability
with hypersensitivity to reward and the top-down system
Decision-making is the cognitive process of selecting the associated with self-regulation.
best choice among several options, taking into consideration
goals, certainty, and risk. The process of decision-making 5. Increased incentive salience and cravings
involves both risk evaluation and outcome processing. from gaming stimuli
Cognitive tests, such as the Iowa Gambling Task, the Cups
Task, and the Probability Discounting Task, are used to Cravings in patients with SUD can intensify upon
exposure to stimuli associated with the substance, even
evaluate the decision-making ability of individuals by without its administration. This increased sensitivity to
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assessing their choices between high-gain but risky options
and low-gain but safe options. 58 conditioned stimuli associated with substance use is linked
to the expectation of obtaining the substance, memories
Individuals with SUD have been found to make more of its positive reinforcing effects from the past, and
disadvantageous choices under both risk and ambiguity 59,60 anticipation of its rewarding effect. Cravings involve not
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and to exhibit greater sensitivity to reward. Previous only the fronto-striatal pathway but also the hippocampus
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behavioral studies have shown that individuals with GD and amygdala, which are associated with memory
tend to select risky options more frequently and make and learning, as well as the OFC and insula, which are
decisions more quickly than healthy participants or associated with incentive salience. Incentive salience refers
RGU. 62,63 In addition, GD subjects tend to make more to the motivational and desirable aspects of a stimulus,
disadvantageous risky choices in the loss domain compared such as a drug or addictive behavior, that make it attractive
to healthy controls, but not in the gain domain, due to and desirable to an individual. It enhances the perceived
insensitivity to losses and levels of uncertainty. 64 value or “wanting” of the addictive stimulus, contributing
Several brain regions are associated with decision- to the triggering of intense cravings. The DLPFC is also
making processes. The vmPFC, OFC, and ventral striatum involved in anticipating the reward response. This
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are brain regions engaged in reward anticipation and attractiveness is initially rooted in the “liking” condition.
outcome processing during decision-making. 65,66 The As addiction progresses, the transition from “liking” to
DLPFC is associated with self-control during risky “wanting” occurs, accompanied by obsessive-compulsive
decision-making, and the inferior parietal lobule plays a aspects regarding the addictive substance or behavior.
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role in decision-making under uncertainty. 68 This transition is characterized by cravings that dominate
thoughts and behaviors, manifesting as intrusive, persistent
Functional changes were also observed in those brain
regions during the Cups Task in subjects with GD. The thoughts that compel individuals to seek out the addictive
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72,73
Cups Task evaluates risk decision-making in both gain substance or engage in the addictive behavior.
and loss domains through elements of uncertainty and In individuals with GD, exposure to game-related
reward/punishment outcomes associated with different stimuli resulted in greater cravings compared to healthy
choices. In comparison to the healthy controls, the GD controls or even the RGU. 32,74,75 Furthermore, individuals
group exhibited less activation in the DLPFC (weaker with GD exhibited increased activity in several brain

Volume 7 Issue 4 (2024) 6 doi: 10.36922/itps.3326