Abnormal White Matter Integrity in Adolescents with Internet Addiction Disorder: A Tract-Based Spatial Statistics Study

Background Internet addiction disorder (IAD) is currently becoming a serious mental health issue around the globe. Previous studies regarding IAD were mainly focused on associated psychological examinations. However, there are few studies on brain structure and function about IAD. In this study, we used diffusion tensor imaging (DTI) to investigate white matter integrity in adolescents with IAD. Methodology/Principal Findings Seventeen IAD subjects and sixteen healthy controls without IAD participated in this study. Whole brain voxel-wise analysis of fractional anisotropy (FA) was performed by tract-based spatial statistics (TBSS) to localize abnormal white matter regions between groups. TBSS demonstrated that IAD had significantly lower FA than controls throughout the brain, including the orbito-frontal white matter, corpus callosum, cingulum, inferior fronto-occipital fasciculus, and corona radiation, internal and external capsules, while exhibiting no areas of higher FA. Volume-of-interest (VOI) analysis was used to detect changes of diffusivity indices in the regions showing FA abnormalities. In most VOIs, FA reductions were caused by an increase in radial diffusivity while no changes in axial diffusivity. Correlation analysis was performed to assess the relationship between FA and behavioral measures within the IAD group. Significantly negative correlations were found between FA values in the left genu of the corpus callosum and the Screen for Child Anxiety Related Emotional Disorders, and between FA values in the left external capsule and the Young's Internet addiction scale. Conclusions Our findings suggest that IAD demonstrated widespread reductions of FA in major white matter pathways and such abnormal white matter structure may be linked to some behavioral impairments. In addition, white matter integrity may serve as a potential new treatment target and FA may be as a qualified biomarker to understand the underlying neural mechanisms of injury or to assess the effectiveness of specific early interventions in IAD.

[1]  R. C. Oldfield The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[2]  Lawrence M. Baldwin,et al.  THE McMASTER FAMILY ASSESSMENT DEVICE , 1983 .

[3]  E. Ross,et al.  Topography of the Human Corpus Callosum , 1985, Journal of neuropathology and experimental neurology.

[4]  P. Basser,et al.  Estimation of the effective self-diffusion tensor from the NMR spin echo. , 1994, Journal of magnetic resonance. Series B.

[5]  J. Patton,et al.  Factor structure of the Barratt impulsiveness scale. , 1995, Journal of clinical psychology.

[6]  P. Basser,et al.  Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. , 1996, Journal of magnetic resonance. Series B.

[7]  R. Goodman The Strengths and Difficulties Questionnaire: a research note. , 1997, Journal of child psychology and psychiatry, and allied disciplines.

[8]  Sandra M. Neer,et al.  The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[9]  Kimberly Young,et al.  Internet Addiction: The Emergence of a New Clinical Disorder , 1998, Cyberpsychology Behav. Soc. Netw..

[10]  K. Young Caught in the Net: How to Recognize the Signs of Internet Addiction--and a Winning Strategy for Recovery , 1998 .

[11]  J S Fowler,et al.  Addiction, a disease of compulsion and drive: involvement of the orbitofrontal cortex. , 2000, Cerebral cortex.

[12]  J. Price,et al.  The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans. , 2000, Cerebral cortex.

[13]  K O Lim,et al.  In vivo detection and functional correlates of white matter microstructural disruption in chronic alcoholism. , 2000, Alcoholism, clinical and experimental research.

[14]  Keith W. Beard,et al.  Modification in the Proposed Diagnostic Criteria for Internet Addiction , 2001, Cyberpsychology Behav. Soc. Netw..

[15]  Nunzio Pomara,et al.  Reduced frontal white matter integrity in cocaine dependence: a controlled diffusion tensor imaging study , 2002, Biological Psychiatry.

[16]  Scott E. Caplan Problematic Internet use and psychosocial well-being: development of a theory-based cognitive-behavioral measurement instrument , 2002, Comput. Hum. Behav..

[17]  John Russell,et al.  Dysmyelination Revealed through MRI as Increased Radial (but Unchanged Axial) Diffusion of Water , 2002, NeuroImage.

[18]  Rita Z. Goldstein,et al.  Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. , 2002, The American journal of psychiatry.

[19]  Shu-Wei Sun,et al.  Diffusion tensor imaging detects and differentiates axon and myelin degeneration in mouse optic nerve after retinal ischemia , 2003, NeuroImage.

[20]  Denis Le Bihan,et al.  Looking into the functional architecture of the brain with diffusion MRI , 2003, Nature Reviews Neuroscience.

[21]  Osamu Abe,et al.  Topography of the Human Corpus Callosum Using Diffusion Tensor Tractography , 2004, Journal of computer assisted tomography.

[22]  S. Wakana,et al.  Fiber tract-based atlas of human white matter anatomy. , 2004, Radiology.

[23]  Khader M Hasan,et al.  Reduced Anterior Corpus Callosum White Matter Integrity is Related to Increased Impulsivity and Reduced Discriminability in Cocaine-Dependent Subjects: Diffusion Tensor Imaging , 2005, Neuropsychopharmacology.

[24]  Karl J. Friston,et al.  Voxel-based morphometry of the human brain: Methods and applications , 2005 .

[25]  Chien Chou,et al.  A Review of the Research on Internet Addiction , 2005 .

[26]  S. Wakana,et al.  MRI Atlas of Human White Matter , 2005 .

[27]  P. Szeszko,et al.  MRI atlas of human white matter , 2006 .

[28]  Edith V. Sullivan,et al.  Dysmorphology and microstructural degradation of the corpus callosum: Interaction of age and alcoholism , 2006, Neurobiology of Aging.

[29]  M. Roesch,et al.  Orbitofrontal cortex, decision-making and drug addiction , 2006, Trends in Neurosciences.

[30]  Thomas R. Barrick,et al.  Diffusion Tensor Imaging of the Corpus Callosum in Addiction , 2007, Neuropsychobiology.

[31]  Daniel Rueckert,et al.  Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data , 2006, NeuroImage.

[32]  Khader M Hasan,et al.  Diffusion Tensor Imaging in MDMA Users and Controls: Association with Decision Making , 2007, The American journal of drug and alcohol abuse.

[33]  F. Cao,et al.  Internet addiction among Chinese adolescents: prevalence and psychological features. , 2007, Child: Care, Health and Development.

[34]  Larry A. Kramer,et al.  Diffusion tensor imaging eigenvalues: Preliminary evidence for altered myelin in cocaine dependence , 2007, Psychiatry Research: Neuroimaging.

[35]  Baoci Shan,et al.  Disrupted White Matter Integrity in Heroin Dependence: A Controlled Study Utilizing Diffusion Tensor Imaging , 2008, The American journal of drug and alcohol abuse.

[36]  Bryon A Mueller,et al.  Brain macrostructural and microstructural abnormalities in cocaine dependence. , 2008, Drug and alcohol dependence.

[37]  J. MacFall,et al.  Diffusion tensor measures of the corpus callosum in adolescents with adolescent onset alcohol use disorders. , 2008, Alcoholism, clinical and experimental research.

[38]  Mikhail J. Atallah,et al.  Internet addiction: Meta-synthesis of qualitative research for the decade 1996-2006 , 2008, Comput. Hum. Behav..

[39]  Nikos Makris,et al.  Frontal white matter and cingulum diffusion tensor imaging deficits in alcoholism. , 2008, Alcoholism, clinical and experimental research.

[40]  F. Vocci Cognitive remediation in the treatment of stimulant abuse disorders: a research agenda. , 2008, Experimental and clinical psychopharmacology.

[41]  Stefan Gazdzinski,et al.  Tract-based spatial statistics (TBSS) of diffusion tensor imaging data in alcohol dependence: Abnormalities of the motivational neurocircuitry , 2009, Psychiatry Research: Neuroimaging.

[42]  G. Schlaug,et al.  Evidence for Plasticity in White‐Matter Tracts of Patients with Chronic Broca's Aphasia Undergoing Intense Intonation‐based Speech Therapy , 2009, Annals of the New York Academy of Sciences.

[43]  Michael H. Buonocore,et al.  Cognitive Control and White Matter Callosal Microstructure in Methamphetamine-Dependent Subjects: A Diffusion Tensor Imaging Study , 2009, Biological Psychiatry.

[44]  Linda Chang,et al.  Higher diffusion in striatum and lower fractional anisotropy in white matter of methamphetamine users , 2009, Psychiatry Research: Neuroimaging.

[45]  Torsten Rohlfing,et al.  Degradation of Association and Projection White Matter Systems in Alcoholism Detected with Quantitative Fiber Tracking , 2009, Biological Psychiatry.

[46]  Stephen M. Smith,et al.  Threshold-free cluster enhancement: Addressing problems of smoothing, threshold dependence and localisation in cluster inference , 2009, NeuroImage.

[47]  Susan F. Tapert,et al.  Altered white matter microstructure in adolescent substance users , 2009, Psychiatry Research: Neuroimaging.

[48]  Yongmin Chang,et al.  Reduced corpus callosum white matter microstructural integrity revealed by diffusion tensor eigenvalues in abstinent methamphetamine addicts. , 2009, Neurotoxicology.

[49]  G. Bartzokis,et al.  White-matter abnormalities in brain during early abstinence from methamphetamine abuse , 2010, Psychopharmacology.

[50]  S. Pallanti,et al.  Internet addiction: a descriptive clinical study focusing on comorbidities and dissociative symptoms. , 2009, Comprehensive psychiatry.

[51]  C. Ko,et al.  Brain activities associated with gaming urge of online gaming addiction. , 2009, Journal of psychiatric research.

[52]  Q. Lu,et al.  Impulse inhibition in people with Internet addiction disorder: Electrophysiological evidence from a Go/NoGo study , 2010, Neuroscience Letters.

[53]  R. Tao,et al.  Proposed diagnostic criteria for internet addiction. , 2010, Addiction.

[54]  Sang Soo Cho,et al.  Altered Regional Cerebral Glucose Metabolism in Internet Game Overusers: A 18F-fluorodeoxyglucose Positron Emission Tomography Study , 2010, CNS Spectrums.

[55]  Wang Jinan,et al.  Mental health, personality, and parental rearing styles of adolescents with Internet addiction disorder. , 2010 .

[56]  D. Sheehan,et al.  Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). , 2010, The Journal of clinical psychiatry.

[57]  E. Aboujaoude Problematic Internet use: an overview , 2010, World psychiatry : official journal of the World Psychiatric Association.

[58]  Huimin Zhang,et al.  Mental Health, Personality, and Parental Rearing Styles of Adolescents with Internet Addiction Disorder , 2010, Cyberpsychology Behav. Soc. Netw..

[59]  Xin Li,et al.  Increased regional homogeneity in internet addiction disorder: a resting state functional magnetic resonance imaging study. , 2010, Chinese medical journal.

[60]  A. Weinstein,et al.  Internet Addiction or Excessive Internet Use , 2010, The American journal of drug and alcohol abuse.

[61]  Samuel Asensio,et al.  Cocaine addiction: Diffusion tensor imaging study of the inferior frontal and anterior cingulate white matter , 2010, Psychiatry Research: Neuroimaging.

[62]  Wei Hao,et al.  Frontal white matter abnormalities following chronic ketamine use: a diffusion tensor imaging study. , 2010, Brain : a journal of neurology.

[63]  Ya-song Du,et al.  Longer Term Effect of Randomized, Controlled Group Cognitive Behavioural Therapy for Internet Addiction in Adolescent Students in Shanghai , 2010, The Australian and New Zealand journal of psychiatry.

[64]  Larry A. Kramer,et al.  Diffusion Tensor Imaging and Decision Making in Cocaine Dependence , 2010, PloS one.

[65]  In Kyoon Lyoo,et al.  Brain activity and desire for Internet video game play. , 2011, Comprehensive psychiatry.

[66]  Jie Tian,et al.  Microstructure Abnormalities in Adolescents with Internet Addiction Disorder , 2011, PloS one.

[67]  John J. Foxe,et al.  Assessing white matter integrity as a function of abstinence duration in former cocaine-dependent individuals. , 2010, Drug and alcohol dependence.

[68]  Yan Zhou,et al.  Gray matter abnormalities in Internet addiction: a voxel-based morphometry study. , 2011, European journal of radiology.

[69]  Alex Fornito,et al.  White matter microstructure in opiate addiction , 2012, Addiction biology.