THE NEURAL BASIS OF GAMING DISORDER AND THEIR COMORBIDITIES
Authors: Tei *Shisei , Fujino Junya 
Published: February 2025

Abstract

Background
Given the growing popularity of online gaming and the rapid rise of societal and mental health crises, it is crucial to identify the neurocognitive features that delineate problematic gaming. Digital technologies are continually developing, and gaming has become much more social, immersive, and also monetized [1]. Furthermore, preoccupation with games frequently leads to behavioral addiction and aggravates physical and mental problems, similar to other psychiatric disorders. In response to this situation, the World Health Organization included gaming disorder (GD) in its latest revision of the International Classification of Diseases, 11th edition (ICD 11). However, the neuropsychological mechanisms underlying GD and addiction-related mindsets have not been sufficiently understood.

Aims & Objectives
To better understand GD, we aimed to explore the current research on GD by focusing primarily on neuropsychological features. We intended to investigate the brain imaging findings to illuminate the cognitive mechanisms underlying the symptoms of GD and its common features with other psychiatric disorders. In particular, we focused on two key features of GD: (1) EF dysfunction, and (2) altered game-related cue reactivity.

Method
In this preliminary review, we performed a literature search to identify the current state-of-the-art literature on GD, addiction, and other psychiatric comorbidities. We combined the results of recent findings to provide a more coherent explanation for the possible cognitive mechanisms of GD. We mainly searched the PubMed and Web of Science databases using relevant keywords. All retrieved studies were assessed for eligibility to reduce the selection bias.

Results
GD is frequently associated with general EF dysfunction and addiction-related reward processing [2, 3]. It may hinder controlled, planned, and conscious processing of daily behaviors while enhancing automatic processing that aggravates craving by habitual reactions to gaming cues. These abnormalities can be linked to structural changes and neuroadaptations in the brain, which may be due to persistent gaming and suppression of daily activities [2, 4]. These GD-related characteristics resemble those of other addictions. Moreover, it is possible that such shared features of addiction might also be observed in seemingly unrelated psychiatric disorders such as autism spectrum disorder (ASD), including inflexible self-control, atypical empathy, and reduced social skills [5,6].

Discussion & Conclusion
The possible similarities in cognitive features between GD and other psychiatric conditions warrant more empirical investigation, as this conclusion is based on relatively few studies. Moreover, there were substantial variations among experimental participants, necessitating new research strategies. Future studies with both GD and ASD cohorts may provide novel theoretical and clinical insights. This may provide additional clues for more practical interventions.

References
[1]King, D. L., Wö lfling, K., &Potenza, M. N. (2020). Taking gaming disorder treatment to the next level. JAMA psychiatry, 77(8), 869-870.
[2]Weinstein, A., Livny, A., &Weizman, A. (2017). New developments in brain research of internet and gaming disorder. Neuroscience &Biobehavioral Reviews, 75, pp. 314-330.
[3]Wang, M., Zheng, H., Zhou, W., Yang, B., Wang, L., Chen, S., &Dong, G. H. (2022). Disrupted dynamic network reconfiguration of the executive and reward networks in internet gaming disorder. Psychological Medicine, pp.1-10.
[4]Dong, G., Wang, L., Du, X., &Potenza, M. N. (2017). Gaming increases craving to gaming-related stimuli in individuals with Internet gaming disorder. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2(5), pp. 404-412.
[5]Murray, A., Koronczai, B., Kirá ly, O., Griffiths, M. D., Mannion, A., Leader, G., &Demetrovics, Z. (2021). Autism, problematic internet use and gaming disorder: A systematic review. Review Journal of Autism and Developmental Disorders, pp.1- 21.
[6]Fujino, J., Tei, S., Hashimoto, R. I., Itahashi, T., Ohta, H., Kanai, C.,... &Takahashi, H. (2017). Attitudes toward risk and ambiguity in patients with autism spectrum disorder. Molecular autism, 8, pp. 1-10.