Lee Sang Hoon, Im Jooyeon Jamie, Oh Jin Kyoung, Choi Eun Kyoung, Yoon Sujung, Bikson Marom, Song In-Uk, Jeong Hyeonseok, Chung Yong-An
Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
J Vis Exp. 2019 Nov 9(153). doi: 10.3791/60007.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that applies a weak electric current to the scalp to modulate neuronal membrane potentials. Compared to other brain stimulation methods, tDCS is relatively safe, simple, and inexpensive to administer. Since excessive online gaming can negatively affect mental health and daily functioning, developing treatment options for gamers is necessary. Although tDCS over the dorsolateral prefrontal cortex (DLPFC) has demonstrated promising results for various addictions, it has not been tested in gamers. This paper describes a protocol and a feasibility study for applying repeated tDCS over the DLPFC and neuroimaging to examine the underlying neural correlates in gamers. At baseline, individuals who play online games report average weekly hours spent on games, complete questionnaires on addiction symptoms and self-control, and undergo brain F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET). The tDCS protocol consists of 12 sessions over the DLPFC for 4 weeks (anode F3/cathode F4, 2 mA for 30 min per session). Then, a follow-up is conducted using the same protocol as the baseline. Individuals who do not play online games receive only baseline FDG-PET scans without tDCS. Changes of clinical characteristics and asymmetry of regional cerebral metabolic rate of glucose (rCMRglu) in the DLPFC are examined in gamers. In addition, asymmetry of rCMRglu is compared between gamers and non-gamers at baseline. In our experiment, 15 gamers received tDCS sessions and completed baseline and follow-up scans. Ten non-gamers underwent FDG-PET scans at the baseline. The tDCS reduced addiction symptoms, time spent on games, and increased self-control. Moreover, abnormal asymmetry of rCMRglu in the DLPFC at baseline was alleviated after tDCS. The current protocol may be useful for assessing treatment efficacy of tDCS and its underlying brain changes in gamers. Further randomized sham-controlled studies are warranted. Moreover, the protocol can be applied to other neurological and psychiatric disorders.
经颅直流电刺激（tDCS）是一种非侵入性脑刺激技术，通过在头皮上施加微弱电流来调节神经元膜电位。与其他脑刺激方法相比，tDCS相对安全、操作简单且成本低廉。由于过度网络游戏会对心理健康和日常功能产生负面影响，因此为游戏玩家开发治疗方案很有必要。尽管对背外侧前额叶皮质（DLPFC）进行tDCS已在各种成瘾问题上显示出有前景的结果，但尚未在游戏玩家中进行测试。本文描述了一种对DLPFC应用重复tDCS并结合神经成像来检查游戏玩家潜在神经关联的方案及可行性研究。在基线时，玩网络游戏的个体报告每周平均游戏时长，完成关于成瘾症状和自我控制的问卷，并接受脑F-氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）。tDCS方案包括在DLPFC上进行12次治疗，为期4周（阳极F3/阴极F4，每次治疗2毫安，持续30分钟）。然后，使用与基线相同的方案进行随访。不玩网络游戏的个体仅接受基线FDG-PET扫描，不进行tDCS。在游戏玩家中检查临床特征的变化以及DLPFC中局部脑葡萄糖代谢率（rCMRglu）的不对称性。此外，在基线时比较游戏玩家和非游戏玩家之间rCMRglu的不对称性。在我们的实验中，15名游戏玩家接受了tDCS治疗并完成了基线和随访扫描。10名非游戏玩家在基线时接受了FDG-PET扫描。tDCS减轻了成瘾症状、游戏时长，并增强了自我控制。此外，tDCS后基线时DLPFC中rCMRglu的异常不对称性得到缓解。当前方案可能有助于评估tDCS对游戏玩家的治疗效果及其潜在的脑部变化。有必要进一步开展随机假对照研究。此外，该方案可应用于其他神经和精神疾病。
