Sex Differences In Internet Gaming Disorder In Neural Responses To Gaming Cues

Objective: A large number of studies have found that main patient population of Internet gaming disorder(IGD)is male,female addicts are less,and the difference has universality across ages and cultures.This sex difference is also mentioned in DSM-5.However,until now there is no reasonable explanation.Although sex differences are widespread in addiction,due to the uniqueness of IGD,traditional addiction theory does not seem to explain the sex differences in IGD.Therefore,it is very important to explore the sex differences in IGD.On the one hand,it can reveal the uniqueness of IGD.On the other hand,it has great significance to understand the mechanism of IGD.This study uses cravings(an important factor leading to addictive behavior)as an pointcut to explore gender differences,using game pictures as a craving-inducing cues and neutral pictures as a control condition.The right amount of men and women with IGD were selected for exploring the sex differences in brain responses of IGD.On this basis,combining with Granger Causal Modeling and Small World,the gender differences in brain connectivity of IGD are discussed in depth.Methods: In the first study,65 IGD(including 32 male subjects)were selected.The cue reaction task was used to present different types of pictures to male and female addicts for judging.The brain reaction was recorded using a functional magnetic resonance imaging(f MRI)scan.Data results were statistically analyzed using a two-way ANOVA.In the second study,Granger causality analysis(GCA)was used.Based on the results of the above study,the posterior cingulate gyrus was chosen as region of interest,and the effective connectivity analysis was performed to compare the neural pathway changes in the two groups under the condition of game cues.In the third study,the brain network components related to the task were found through independent component analysis(ICA),and then the topological changes of the related networks between the male and female under the game conditions were compared.Results:(1)The interaction of sex-cue is mainly manifested in the superior frontal gyrus(SFG),anterior cingulate gyrus(ACC)and posterior cingulate gyrus(PCC).The post-hoc analysis results showed that there was no significant difference in SFG,ACC and PCC between men and women when expose neutral pictures.While watching the game picture,men showed a significant negative activation than women.(2)Through GCA,we found that the significant differences were showed in the two neural pathways under the game conditions: ACC-PCC-median frontal gyrus(MFG),insula-PCC-orbitofrontal cortex(OFC).(3)All participants’ fronto-parietal network(FPN)showed brain response to the game pictures,reflecting the sex differences on network connectivity dysfunction.When the male addicts watch the game picture,the FPN’ standardization path length is lower than female.Conclusions: In summary,this thesis takes the craving as the pointcut,and uses neuroimaging technology to explore the sex differences of IGD in all aspects,from multiple angles and deep levels.The sex differences in traditional drug addiction are more explored from the perspective of material and biochemical reactions(especially the reaction of dopamine),while behavioral addiction is different from traditional addiction,it does not require related substances intake.Our results suggest that the sexr differences in IGD seem to be more manifested in the executive control functions,and the treatment of IGD need consider the sex differences in the future.