青少年网络游戏成瘾渴求调控的神经机制和干预研究

Adolescents' Internet Gaming Disorder (IGD) is becoming a worldwide mental health problem. Previous neuroimaging studies among IGD in adolescents have consistently indicated that IGD show enhanced craving and hyperactivity on the multiple brain areas, including Ventral Striatum, OFC when exposed on the gaming related cues. However, whether the ability of regulation of craving is related to individual characteristics and what brain areas or networks underlying this process is still unclear among Internet Gaming Disorder, not to mention the development and evaluation of the intervention program based on the increase of the regulation ability of craving among this populations. Based on theories on Emotion Regulation and empirical studies on the neural mechanism of regulation of craving among substance use disorder, we combine a cross-sectional study and two intervention study designs, using cognitive task, tDCS and fMRI technique together, we explore the characteristics of impaired regulation of craving among Internet gaming disorder first, and then explore the short term and long term effect of using tDCS to activate the activity of dorsolateral prefrontal cortex and then to decrease the craving and improve the ability of regulation of craving. The key is to understand the internal mechanism of how the activation of the dorsolateral prefrontal region affect addicts behavioral performance through to enact the ventral striatum, which is the key area of reward system, and Amygdala, which is the core area of emotion system. Our research results will provide an empirical support for the development and promotion of more efficient, brain stimulation- based intervention programs among IGD. The applicant has already accumulated plentiful experience on the neuroscience study among IGD and published 17 paper in SCI or SSCI journals as the first or corresponding author.

青少年网络游戏成瘾已是世界性的心理健康问题。以往神经影像学研究对成瘾者在面对游戏线索时渴求异常进行了探讨；然而对于网络游戏成瘾者的渴求调控能力异常及其神经生理基础尚不清楚，亦缺少针对渴求调控的干预方案的开发与评估。借鉴情绪调节相关理论和物质成瘾中渴求调控的研究成果，本研究综合横断研究和干预追踪研究范式，结合认知实验、经颅直流电刺激技术（tDCS）和fMRI技术探讨青少年网络游戏成瘾者渴求调控异常的行为和脑机制；并进而探讨采用tDCS技术刺激成瘾者背外侧前额叶以降低渴求、提升渴求调控和改善成瘾行为的即时和长时效果；重点揭示背外侧前额叶通过奖赏系统关键区域―腹侧纹状体和情绪系统核心区域―杏仁核进而发挥作用的内在机制。研究成果将为开发推广更加高效、基于脑刺激的干预方案提供实证支撑。申请人在网络游戏成瘾机制研究方面有较好的工作基础，已以第一或通讯作者发表17篇SCI/SSCI文章。

综合应用行为实验、磁共振技术、tDCS技术、干预追踪设计和元分析方法，围绕着网络游戏成瘾者的渴求调控特点、异常、机制及干预进行了一系列研究。探讨了网络游戏成瘾者奖赏加工的特点及神经机制;基于神经影像数据，采用机器学习算法在识别网络游戏成瘾及预测干预效果方面取得了进展。共发表22篇SCI/SSCI论文。其中8篇发表在top期刊: Addiction(2篇), Computers in Human behavior（2篇）, Journal of Behavioral Addiction(4篇)。.1、采用渴求调节任务探讨网络游戏成瘾者在面对游戏线索和美食线索时调控相应渴求的特点；发现成瘾组在调节食物渴求和游戏渴求时均表现出一定程度的能力受损；而且两种调控高度相关(Wu, et al., PSYCHIAT RES, 2020)；磁共振研究发现这种受损可能与其在调控过程中前额叶活动不足有关。.2、采用随机双盲、交叉研究设计探讨经颅电刺激（tDCS）对网络游戏成瘾者进行渴求调控的影响。结果发现tDCS刺激可以有效地提升调控的核心能力，无论是上调还是下调，不管是面对成瘾线索诱发的渴求还是负性图片刺激诱发的消极情绪均有效果；还能有效减少游戏线索带来的干扰；改善背景性渴求。(Wu et al., EUR NEUROPSYCHOPHARM, 2020; Wu et al. J PSYCHIATR NEUROSCI, 2020) 。.3、采用金钱奖励延迟任务探讨网络游戏成瘾者在奖赏加工的特点及神经机制。结果发现成瘾者的尾状核表现出与损失大小无关的钝化现象。对损失加工的敏感性降低可能是成瘾的核心特征（Yao et al., NEUROIMAGE-CLIN, 2020）。针对网络游戏成瘾奖赏相关决策的元分析结果发现成瘾者在加工不同类型（金钱、风险等）的奖赏任务时表现出类似的决策缺陷（Yao et al., Addiction, 2022）。.4、应用脑影像机器学习方法探究网络游戏成瘾者在静息态和任务态的异常脑活动模式在识别网络游戏成瘾、及预测干预效果中的作用。静息态区域一致性、静息态功能连接以及任务诱发的脑活动三类神经活动均可有效地识别成瘾群体；并可以显著预测认知行为干预效果。这些结果为个性化干预方案的开发有积极启示（Wang et al., J BEHAV ADDICT, 2022）。

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