A trans-therapeutic signature of recovery in internet gaming disorder: From shared network reorganization to molecular underpinnings.

BACKGROUND AND AIMS: A variety of self-regulation interventions have shown efficacy in treating Internet Gaming Disorder (IGD), but their shared and unique neurobiological mechanisms remain unclear. This study aims to identify a common, trans-therapeutic neural signature of recovery and to delineate the specific connectivity fingerprints of five different self-regulation interventions for IGD.

METHODS

This secondary analysis pooled resting-state fMRI data from 269 individuals with IGD who participated in one of five randomized controlled trials of self-regulation-based interventions: Approach Bias Modification (ApBM), Retrieval-Aversive Conditioning (R-AC), Progressive Aerobic Training (PAT), face-to-face Mindfulness Meditation (MM), and a Digital (online) mindfulness intervention. Participants were diagnosed with IGD according to DSM-5. Partial Least Squares (PLS) regression was used to identify a shared connectivity pattern associated with clinical improvement and similarity network fusion to define intervention-specific connectivity fingerprints. Imaging-transcriptomic analysis was further used to explore the molecular correlates.

RESULTS

All interventions were associated with significant reductions in IGD severity. PLS analysis identified a shared connectivity pattern predictive of treatment response, characterized by a rebalancing of Subcortical Network (SCN) connectivity along the sensorimotor-association axis. This shared pattern was linked to gene expression profiles related to cellular stress and neuroplasticity. Each intervention also induced a unique connectivity fingerprint, targeting distinct neural circuits.

DISCUSSION AND

CONCLUSIONS

Diverse self-regulation interventions for IGD converge on a shared therapeutic pathway involving the large-scale reorganization of cortico-subcortical circuits. These findings identify a robust neurobiological phenotype of recovery, offering a potential biomarker for treatment response and a target for future circuit-based therapies.