Effects of craving behavioral intervention on neural substrates of cue-induced craving in Internet gaming disorder

Neuroimage Clin. 2016 Sep 9:12:591-599. doi: 10.1016/j.nicl.2016.09.004. eCollection 2016.


Internet gaming disorder (IGD) is characterized by high levels of craving for online gaming and related cues. Since addiction-related cues can evoke increased activation in brain areas involved in motivational and reward processing and may engender gaming behaviors or trigger relapse, ameliorating cue-induced craving may be a promising target for interventions for IGD. This study compared neural activation between 40 IGD and 19 healthy control (HC) subjects during an Internet-gaming cue-reactivity task and found that IGD subjects showed stronger activation in multiple brain areas, including the dorsal striatum, brainstem, substantia nigra, and anterior cingulate cortex, but lower activation in the posterior insula. Furthermore, twenty-three IGD subjects (CBI + group) participated in a craving behavioral intervention (CBI) group therapy, whereas the remaining 17 IGD subjects (CBI - group) did not receive any intervention, and all IGD subjects were scanned during similar time intervals. The CBI + group showed decreased IGD severity and cue-induced craving, enhanced activation in the anterior insula and decreased insular connectivity with the lingual gyrus and precuneus after receiving CBI. These findings suggest that CBI is effective in reducing craving and severity in IGD, and it may exert its effects by altering insula activation and its connectivity with regions involved in visual processing and attention bias.

Keywords: Craving; Cue reactivity; Internet gaming disorder; Intervention; fMRI.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Behavior, Addictive / diagnostic imaging
  • Behavior, Addictive / physiopathology*
  • Brain Stem / diagnostic imaging
  • Brain Stem / physiopathology*
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / physiopathology*
  • Craving / physiology*
  • Cues*
  • Female
  • Gyrus Cinguli / diagnostic imaging
  • Gyrus Cinguli / physiopathology
  • Humans
  • Internet*
  • Magnetic Resonance Imaging
  • Male
  • Neostriatum / diagnostic imaging
  • Neostriatum / physiopathology*
  • Substantia Nigra / diagnostic imaging
  • Substantia Nigra / physiopathology
  • Video Games / psychology*
  • Young Adult