BACKGROUND Internet gaming disorder (IGD) is commonly comorbid with attention-deficit/hyperactivity disorder (ADHD). Although the addiction is more severe when comorbid with ADHD, little is known about the neural correlates of the association. This study aimed to identify whether an ADHD-related structural brain network exists in IGD patients with comorbid ADHD (IGDADHD+) by comparing them with those without comorbid ADHD (IGDADHD-) and elucidating how the sub-network is associated with addiction severity. METHODS Brain structural networks were constructed based on streamline tractography with diffusion tensor imaging in a cohort of 46 male IGDADHD+ patients, 48 male IGDADHD- patients, and 34 healthy controls (HC). We used network-based statistics (NBS) to identify the sub-network differences between the two IGD groups. Furthermore, the edges in the sub-network that significantly contributed to explaining the Young Internet Addiction Scale (YIAS) score were delineated using partial least square (PLS) regression analyses in IGD patients. RESULTS The YIAS score was higher in the IGDADHD+ group than in the IGDADHD- group and was correlated with the Korean Dupaul's ADHD scale score (r = 0.42, p <0.01). The NBS detected a sub-network with stronger connectivity in the IGDADHD+ group than in the IGDADHD-group. The PLS regression model showed that the sub-network is associated with the YIAS score in the IGDADHD+ group (q2 = 0.019). Edges connecting the left pre- and postcentral gyri, bilateral superior frontal gyri, medial orbital parts, and left fusiform to the inferior temporal gyrus were most important predictors in the regression model. CONCLUSION Our results suggest that an aberrant increase in some structural connections within circuits related to inhibitory function or sensory integration can indicate how comorbid ADHD is associated with addiction severity in IGD.

中文翻译：

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并发注意缺陷/多动障碍的异常结构网络与网络游戏障碍的成瘾严重程度有关。

背景技术互联网游戏障碍（IGD）通常与注意力缺乏/多动症（ADHD）并存。尽管与多动症并存时成瘾更为严重，但对该关联的神经相关性知之甚少。这项研究旨在通过将IGD合并ADHD合并症（IGDADHD +）与没有ADHD合并症（IGDADHD-）的患者进行比较，并阐明该子网络与成瘾严重程度的关系，从而确定与ADHD相关的结构性大脑网络是否存在。方法在46例男性IGDADHD +患者，48例男性IGDADHD-患者和34例健康对照（HC）队列中，基于流线束摄影术和扩散张量成像构建脑结构网络。我们使用基于网络的统计信息（NBS）来识别两个IGD组之间的子网差异。此外，在IGD患者中，使用偏最小二乘（PLS）回归分析来描绘子网中显着有助于解释年轻互联网成瘾量表（YIAS）得分的边缘。结果IGDADHD +组的YIAS评分高于IGDADHD-组，并且与韩国Dupaul的ADHD量表评分相关（r = 0.42，p <0.01）。NBS在IGDADHD +组中检测到的子网比在IGDADHD-组中具有更强的连接性。PLS回归模型显示，该子网与IGDADHD +组中的YIAS得分相关（q2 = 0.019）。在回归模型中，连接左前中央和后中央回，双侧上额叶回，内侧眼眶部分以及左梭形与颞下回的边缘是最重要的预测指标。