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Meta-analyses on the functional neural alternations in Internet
gaming disorder: similarities and differences across different
paradigms
Supplement Methods
The IGD scale for each study
Table S1 Detail about the IGD scale used in each studyIGD scale BDI FIND
Study Scale
name
IGD
Mean±sd
Control
Mean±sd
IGD
Mean±sd
Control
Mean±sd
IGD
Mean±sd
Control
Mean±sd
Han et al. 2010 YIAT 71.2±9.4 27.1±5.3 6.8±3.7 8.4±3.4 NaN NaN
Han et al. 2012 YIAT 75.1±11.2 34.5±9.6 NaN NaN NaN NaN
Ko et al. 2009 CIAS 77.1±8.28 45.4±14.16 NaN NaN NaN NaN
Ko et al. 2013b CIAS 75.69±13.19 27.06±2.38 NaN NaN NaN NaN
Ko et al. 2013a CIAS 76±12.09 26±0 NaN NaN 5±2.06 0
Liu et al. 2016 YDQ NAN NAN 11.8±1 5.4±.8 NaN NaN
Liu et al. 2017b CIAS 75.59±8.82 45.65±9.8 7.49±5.84 2.91±3.12 2±1.87 0
Sun et al. 2012 CIAS 67.39±5.12 39.8±9.47 NaN NaN NaN NaN
Zhang et al. 2016a CIAS 79.88±8.67 42.11±8.27 9.13 ±5.5 2.79±4.2 3.25±.5 0
Liu et al. 2014 CIAS 75.8±9.76 40.63±12.27 NaN NaN NaN NaN
Lorenz et al. 2013 WWAI 2.2±.8 1±0 8.9±5.2 3.4±3.5 NaN NaN
Han et al. 2016 YIAT 59.1±9.8 26.2±5.7 12.1±7.0 21.7±5.5 NaN NaN
Chen et al. 2015 CIAS 76±12.09 26±0 NaN NaN NaN NaN
Ding et al. 2014 CIAS 65.82±3.25 42.88±9.68 NaN NaN NaN NaN
Ko et al. 2014 CIAS 84.96±12.94 39.68±11.92 NaN NaN NaN NaN
Luijten et al. 2015 VAT 3.34±.45 1.26±.19 NaN NaN NaN NaN
Dong et al. 2012 YIAT >80 NaN NaN NaN NaN NaN
Dong et al. 2013ca YIAT >80 NaN NaN NaN NaN NaN
Dong et al. 2014 YIAT >50 NaN NaN NaN NaN NaN
Zhang et al. 2016b YIAT >80 NaN NaN NaN NaN NaN
Na et al. 20104 NaN NaN NaN NaN NaN NaN NaN
Kim et al. 2012a YIAT 72.2±8.4 41.4±4.5 9.4±2.5 7.1±4.9 NaN NaN
Dong et al. 2011 YIAT >80 NaN NaN NaN NaN NaN
Dong et al. 2013a YIAT >80 NaN NaN NaN NaN NaN
Dong et al. 2013b YIAT >80 NaN NaN NaN NaN NaN
Dong et al. 2017 YIAT 79.5±.71 32.48±4.59 2.66±.36 1.89±.24 NaN NaN
Dong and Potenza
2016
YIAT >50 NaN NaN NaN NaN NaN
Lin et al. 2015 YIAT 64±9.78 31±11.96 NaN NaN NaN NaN
Wang et al. 2017 YIAT 65.55±10.65 31±11.93 NaN NaN NaN NaN
Kim et al. 2017 YIAT 62.78±10.3 29.75±5.9 14.17±8.8 6.45±4.9 NaN NaN
Lee et al. 2016 YIAT 50.9±12.9 27.5±13.3 8.9±4.7 6.5±5.8 NaN NaN
Liu et al. 2017ab CIAS 79.66±8.5 40.22±9.44 8.63±4.9 3.41±5.43 2±0 0
Qi et al. 2015 YIAT 70.35±10.76 33.42±7.75 NaN NaN NaN NaN
Qi et al. 2016 YIAT 70.71±10.8 33.2±7.8 NaN NaN NaN NaN
Kim et al. 2012b K-AIAS 62.76±10.19 30.29±6.1 NaN NaN NaN NaN
Leménager et al.
2014
AICA 18.75±7.34 1.59±2.21 NaN NaN NaN NaN
Dieter et al. 2015 AICA 18.53±7.55 9.53±10.1 NaN NaN NaN NaN
Chun et al. 2015 K-S 37.56±5.16 24.68±4.45 12.5±11.9 5.29±4.99 NaN NaN
Lee et al. 2015 K-S NaN NaN 11.5±11.5 4.4±4.6 NaN NaN
Yip et al. 2018 CIAS 70.13±10.48 35.04±10.62 7.29±7.67 2.22±3.22 .17±.65 0
BDI=Beck's Depression Inventory, 21 items range 0-63;
FIND= Fagerstrom Test of Nicotine Dependence, 6 items range 0-10;
YIAT=Young’s Internet Addiction Test, 20 items range 20-100;
CIAS=Chen Internet Addiction Scale, 26 items range 26-104;
YDQ=Proposed modification of the diagnostic criteria for Internet addiction;
WWAI=World of Warcraft Addiction Inventory;
VAT=Video Game Addition Test, 14 items average range 1-5;
K-S=Korean Internet Addiction Proneness Scale, 15 items range 15-60;
AICA=Addiction severity assessed based on the previous 30 days, 6 criteria range
0-30;
Supplement Reuslts
Table S2. two group compare of adolescent group and adult group
Brain regions*
Maximum Cluster
MNI
coordinates x, y,
z
SDM-Z pVoxels
Number
breakdown
adult>adolescent
Bilateral anterior thalamic
projections
12,8,4 1.630 0.00089180
5
400
12,8,4 1.630 0.00089180
5
87 Right anterior
thalamic projections
45 Left anterior thalamic
projections
42 Right caudate nucleus
34 Left caudate nucleus
-8,12,10 1.627 0.00090831
5
25 Left caudate nucleus,
BA 25
-6,14,2 1.561 0.00129020
2
25 Left striatum
18,12,0 1.530 0.00150078
5
20 Right striatum
Right middle temporal gyrus,
BA 20
60,-34,-12 1.665 0.00071835
5
281
76 Right middle temporal
gyrus, BA 21
75 Right inferior
temporal gyrus, BA 20
69 Right middle temporal
gyrus, BA 20
Left precentral gyrus, BA 6 -52,2,34 1.601 0.00105178
4
238
-52,0,40 1.597 0.00106310
8
138 Left precentral gyrus,
BA 6
-48,8,36 1.465 0.00209528
2
58 Left precentral gyrus,
BA 44
Right superior frontal gyrus,
medial, BA 10
6,58,20 1.422 0.00258249
0
137
Left anterior cingulate /
paracingulate gyri
-2,14,22 1.516 0.00161325
9
26
Left cerebellum, crus I-8,-78,-22 1.366 0.00337928
5
23
adult<adolescent
Right heschl gyrus, BA 48
38,-22,14 -1.437 0.00097644
3
771
40,-18,18 -1.420 0.00105488
3
247 Right rolandic
operculum, BA 48
42,-12,14 -1.421 0.00104457
1
177 Right insula, BA 48
44,-18,8 -1.405 0.00113534
9
114 Right heschl gyrus, BA
48
84 Right superior
temporal gyrus, BA 48
Left arcuate network,
posterior segment
-48,-50,2 -1.469 0.00083297
5
53
Table S3. jackknife analysisJackknife analysis
hyper-activityhypo-
activity
Remove study Bilateral
precuneus; Bilateral median
cingulate
Left
Precentral
gyrus
Right inferior
frontal gyrus
Left frontal
orbito-polar
tract
Left inferior
network
D. H. Han et al., 2010 Y Y Y Y Y
Han et al., 2012 Y Y Y N Y
Ko et al., 2009 Y Y Y N Y
Ko et al., 2013a Y Y Y Y Y
Ko et al., 2013b Y Y Y Y Y
J. Liu et al., 2016 Y Y Y Y Y
L. Liu et al., 2017a Y Y* Y Y Y
Sun et al., 2012 Y Y Y Y Y
Zhang et al., 2016b Y Y Y Y Y
Liu et al., 2014 Y Y Y Y Y
Lorenz et al., 2013 Y Y Y Y Y
Han et al., 2016 Y Y Y Y Y
Chen et al., 2015 Y Y Y Y Y
(W. Ding et al., 2014) Y Y Y Y Y
Ko et al., 2014 Y Y Y N Y
Luijten et al., 2015 Y Y Y Y Y*
Dong et al., 2012 Y Y Y Y Y
Dong et al., 2013a Y Y Y Y Y
Dong et al., 2014 Y Y Y Y Y
Zhang et al., 2016 Y Y Y Y Y
Na et al., , 20104 Y Y Y Y Y
Kim et al., 2012a Y Y Y Y Y
Dong et al., 2011 Y Y Y Y Y
Dong et al., 2013b Y Y Y Y Y
Dong et al., 2013c Y Y Y N Y
Dong et al., 2017 Y Y Y Y Y
Dong & Potenza, 2016 Y Y Y Y Y
Lin et al., 2015 Y Y Y Y Y
Y. Wang et al., 2016 Y Y Y Y Y
Kim, & Kang, 2017 Y Y Y Y Y
D. Lee et al., 2016 Y Y Y Y Y
L. Liu et al., 2017b Y Y Y N Y
Qi et al., 2015 Y Y Y Y Y
Qi et al., 2016 Y Y Y Y Y
Kim et al., 2012b Y Y Y Y Y
Lemenager et al., 2014 Y Y Y Y Y
Dieter et al., 2015 Y Y Y Y Y
Chun et al., 2015 Y Y Y Y Y
J. Lee et al., 2015 Y Y Y Y Y
Yip et al., 20171 Y Y Y Y Y
Sum 40 40 40 35 40
Subgroup analysis Only China study(n=20) Y Y Y* N N*
Only Koera study(n=10) N Y* Y* N N*
Only Taiwan study(n=6) N Y N N N
Only adult (n=31) Y Y Y N Y*
Multiple comparisons(n=31) Y Y Y Y Y
Report YIAT(n=18) Y* N Y N Y
Report DICA(n=12) Y Y Y Y N
Only Siemens scan(n=24) Y* Y Y* N Y
Only use spm(n=35) Y Y Y N Y
FWHM=7-8mm(n=16) Y* Y* Y* N N
FWHM=5-6mm(n=21) Y* Y Y Y Y*
*numbers of voxels in this brain area are reduced;
Table S4. Egger’s test
Mean analysis result Bias t df p
Bilateral precuneus; Bilateral median cingulate 0.43 0.83 38 0.412
Left middle frontal gyrus 0.44 0.63 38 0.530
Right inferior frontal gyrus -0.20-
0.2638 0.796
Left frontal orbito-polar tract -0.08-
0.1238 0.906
Left inferior network 0.56 1.24 38 0.224
Table S5. Meta-regression analysis
Brain regions*
Maximum Cluster
MNI coordinates x, y,
zSDM-Z p
Voxels
Number
IGD>HC
Right middle temporal gyrus, BA 21 62, -34, -2 62, -34, -
2
62, -34, -2521
Left anterior thalamic projections -38, 44, 0 2.298 0.00026631
4
158
Left superior parietal gyrus, BA 7 -18, -70, 50 1.651 0.00368481
9
32
Left inferior frontal gyrus, triangular part, BA
48
-44, 24, 22 1.631 0.00397384
2
21
Right insula, BA 48 38, -12, 16 1.664 0.00348871
9
18
IGD<HC
Right striatum 22, 14, 2 -1.853 0.00083500
1
100
Right inferior frontal gyrus, opercular part, BA
44
50, 6, 24 -1.674 0.00190126
9
63
Left precentral gyrus, BA 6 -54, 6, 44 -1.724 0.00151729
6
30
Figure S1. Two group compare from all studies(adult-adolescent)
Figure S2. Heterogeneity and statistical map for all studies
Right heschl gyrus(BA 48, x=46, y=-18, z=12, sdm-z=1.409, voxels=516), Right inferior
frontal gyrus(opercular part, BA 44, x=50, y=10, z=26, sdm-z=2.492, voxels=273), Left
median cingulate(paracingulate gyri, BA 23, x=0, y=-26, z=34, sdm-z=1.279, voxels=474),
Right calcarine fissure(surrounding cortex, BA 30, x=12, y=-58, z=16, sdm-z=2.444,
voxels=213), Left precentral gyrus(BA 6, x=-50, y=4, z=38, sdm-z=1.605, voxels=157) and
Right precuneus(x=2, y=-58, z=44, sdm-z=1.160, voxels=202).
Figure S3. The funnel plot for mean meta-analysis
From top to bottom were bilateral precuneus and bilateral cingulate, left precentral gyrus,
right inferior frontal gyru, left frontal orbito-polar tract and left inferior network
Figure S4. Meta-regression analyses for game time
Group comparisons
Compared with the adolescent group studies (n=8), the adult group studies
(n=31) showed significant hyperactivity in the bilateral anterior thalamic
projections (caudate and striatum), right middle temporal gyrus (MTG; BA 20),
left precentral gyrus (BA 6, BA 44), right superior frontal gyrus (medial, BA 10),
left anterior cingulate / paracingulate gyri, and left cerebellum (crus I). Adult
group studies (n=31) had significant hypoactivity in right Heschl gyrus (BA 48)
and left arcuate network (posterior segment). Detail is shown in Table S2 and
Figure S1.
Sensitivity and heterogeneity analysis
The jackknife analysis removes one study and repeats the mean analysis. The
idea is that if a significant brain region remains significant in all or most of the
combinations of studies, it can be concluded that this finding is highly replicable.
The details are shown in Table S3. The MCC and right IFG were replicable in all
40 analyses; the bilateral precuneus, bilateral median cingulate, left MFG, right
IFG and left inferior network were replicable in all 40 analyses, and the left
frontal orbitopolar tract was replicable in 35 analyses.
The statistical heterogeneity analysis was examined using a random effects
model with Q statistics ( 2) transformed to z distribution (0-1). The χ
heterogeneity and statistical maps are both shown for visual inspection in Figure
S2. Egger’s test can identify publishing bias. This analysis found that there was
no significant bias in any of the mean results, and the details are shown in Table
S3. However, d showed some heterogeneity, as shown in Figure S3.
Insert Table 3 and Table 3 here
Meta-regression analysis
This study explored gaming time (hours per week) and found differences
between IGDs with maximum gaming time and IGDs with minimum gaming time.
Form the slope map, with the increase of game time, IGDs had significant hyper-
activity in right middle temporal gyrus (MTG, BA 21), left anterior thalamic
projections, left superior parietal gyrus (BA 7), left inferior frontal gyrus
(triangular part, IFG, BA 48), right insula (BA 48). And IGDs had significant hypo-
activity in the right striatum, right inferior frontal gyrus (opercular part, IFG, BA
44), left precentral gyrus (BA 6). As shown in Table S5 and Figure S4.
Insert Table S5 and Figure S4 here
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