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Sciences du comportement

在线玩家的颅内直接电流刺激

Published: November 09, 2019
doi:
10.3791/60007
, , , , , , , ,
1Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine,The Catholic University of Korea, 2Department of Radiology, Incheon St. Mary’s Hospital, College of Medicine,The Catholic University of Korea, 3Department of Brain and Cognitive Sciences,Ewha Womans University, 4Department of Biomedical Engineering,The City College of New York, 5Department of Neurology, Incheon St. Mary’s Hospital, College of Medicine,The Catholic University of Korea

Summary

我们提出了在网络游戏玩家中应用颅内直流刺激（tDCS）和神经成像评估的协议和可行性研究。

Abstract

颅内直流刺激（tDCS）是一种非侵入性脑刺激技术，将弱电流施加到头皮上调节神经元膜电位。与其他大脑刺激方法相比，tDCS 相对安全、简单且管理成本低廉。

由于过度的在线游戏会对心理健康和日常功能产生负面影响，因此有必要为游戏玩家开发治疗方案。虽然在侧侧前额叶皮质 （DLPFC） 的 tDCS 已经显示出各种成瘾的有希望的结果， 它还没有在游戏玩家测试.本文介绍了在DLPFC和神经成像上应用重复tDCS来检查游戏玩家中潜在的神经相关性的协议和可行性研究。

在基线，玩网络游戏的个人报告平均每周花在游戏上的时间，完成关于成瘾症状和自我控制的完整问卷，并接受大脑18个F-氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）。tDCS 协议包括 12 个会话通过 DLPFC 持续 4 周（阳极 F3/阴极 F4，每个会话 2 mA，每次 30 分钟）。然后，使用与基线相同的协议进行后续操作。不玩网络游戏的个人只收到基线FDG-PET扫描没有tDCS。在玩家中检查DLPFC中葡萄糖（rCMRglu）区域脑代谢率的临床特征变化和不对称性。此外，在基线上比较了玩家和非玩家之间的rCMRglu的不对称性。

在我们的实验中，15 名玩家接受了 tDCS 会话并完成了基线和后续扫描。十名非玩家在基线处接受了FDG-PET扫描。tDCS 减少了成瘾症状，花费在游戏上的时间，并增强了自我控制力。此外，在tDCS之后，DLPFC在基线的rCMRglu异常不对称得到了缓解。

目前的协议可能有用的评估治疗效果的tDCS及其潜在的大脑变化在游戏玩家。进一步的随机虚假控制研究是有必要的。此外，该协议可应用于其他神经和精神疾病。

Introduction

近年来，人们越来越关注网络游戏过度使用，因为有报道称网络游戏对心理健康和日常功能有负面影响，并带有网络游戏障碍（IGD）。虽然几种治疗策略，包括药物治疗和认知行为疗法已经评估，其有效性的证据是有限的4。

先前的研究表明，IGD可能与其他行为成瘾和物质使用障碍5、6具有临床和神经生物学的相似性。据报道，侧侧前额叶皮质（DLPFC）与物质和行为成瘾的病理生理学密切相关，如渴望7、冲动控制8、决策9和认知灵活性10。一些关于IGD的神经成像研究已经报告DLPFC6的结构和功能损伤。特别是，结构神经成像研究表明，DLPFC11、12的灰质密度降低，功能磁共振成像（fMRI）研究发现IGD13患者的DLPFC中一种改变的Cued诱导活性。此外，大脑的功能不对称可能导致冲动和渴望成瘾，包括IGD。例如，提示引起的对在线游戏的渴望可能与右前场激活14有关。然而，与其他大脑缺陷15相比，与过度使用在线游戏或IGD相关的区域脑代谢率（rCMRglu）的变化仍有待进一步调查。

颅内直流刺激（tDCS）是一种非侵入性脑刺激技术，通过连接到头皮的电极施加弱电流（1-2 mA）来调节神经元膜电位。一般来说，在阳极电极下，皮质兴奋度增加，阴极电极16下降低。tDCS 已成为一种流行方法，因为它与其他脑刺激技术（如颅内磁刺激 （TMS））相比，简单、廉价且安全，使用磁脉冲在线圈下的大脑组织中产生电流。根据最近的审查，使用传统的tDCS协议没有产生任何严重的副作用或不可逆转的伤害，只与轻度和暂时瘙痒或刺痛的感觉在刺激区域17。

多项研究已显示tDCS18、19、20和重复性TMS21、22在DLPFC治疗行为和物质成瘾方面的良好结果。然而，还需要进一步研究，以研究大脑刺激技术对网络游戏使用和大脑基本变化的影响。

本研究的目的是提出一个协议，在DLPFC和神经成像上应用tDCS的重复会话，使用18个F-氟-2-脱氧葡萄糖正电子发射断层扫描（FDG-PET）检查玩家中的基础神经相关性，并评估其可行性。具体来说，我们专注于成瘾症状的变化、花在游戏上的平均时间、自我控制以及 DLPFC 中 rCMRglu 的不对称性。

Protocol

本议定书中提出的所有实验程序均已获得机构审查委员会的批准，符合《赫尔辛基宣言》。 1. 研究参与者 招募报告他们玩网络游戏的个人（玩家组）和报告他们不玩网络游戏（非玩家组）的个人。注：在这里，我们包括有两个或两个以上IGD症状的个人根据精神障碍的诊断和统计手册-523或那些谁玩游戏平均每天至少一小时在玩家组。?…

Representative Results

共招募了15名游戏玩家（表1）和10名非游戏玩家。玩家组（21.3 ~ 1.4）的平均年龄明显低于非玩家组（28.8 ~ 7.5）（t = -3.81，p < 0.001）。玩家组有 8 名男子，非玩家组有 6 名男子（+2 = 0.11，p = 0.74）。 使用线性混合模型的行为结果表明，tDCS 会话成功地降低了 IAT 分数（z = -4.29，p < 0.001），每周玩游戏的时间（z = -2.41，p = 0.02），并提高了玩家组中的 BSCS 分数?…

Discussion

我们为在线游戏玩家提供了tDCS和神经成像协议，并评估了其可行性。结果表明，在DLPFC上反复的tDCS会话减少了网络游戏成瘾症状和花在游戏上的平均时间，并增强了自我控制力。自我控制力的增强与成瘾症状的减少有关。此外，在玩家组中的 tDCS 会话后，DLPFC 中右侧大于左侧的 rCMRglu 的异常不对称得到了改进。这些结果可能建议tDCS在减少在线游戏使用方面的可行性。然而，由于我们的实验没有?…

Divulgations

The authors have nothing to disclose.

Acknowledgements

这项研究得到了韩国国家研究基金会（NRF）的支持，由科学和ICT部资助（2015M3C7A1064832，2015M3C7A1028373，2018M3AA3058651）和国家卫生研究院（NIHNIMH 1R01MH11896，NIH-NINDS）1R01NS101362）。

Materials

Discovery STE PET/CT Imaging System GE Healthcare
MarsBaR region of interest toolbox for SPM Matthew Brett Neuroimaging analysis software; http://marsbar.sourceforge.net/
Statistical Parametric Mapping 12 Wellcome Centre for Human Neuroimaging Neuroimaging analysis software; https://www.fil.ion.ucl.ac.uk/spm/software/spm12/
Transcranial direct current stimulation device Ybrain YDS-301N
WFU_PickAtlas ANSIR Laboratory, Wake Forest University School of Medicine Neuroimaging analysis software; https://www.nitrc.org/projects/wfu_pickatlas/
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Tags

Keywords: TDCSTranscranial Direct Current StimulationOnline GamingBrain ModulationNeuroimagingFDG PET ScanDorsolateral Prefrontal CortexInternet Addiction TestBrief Self Control Scale
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Lee, S. H., Im, J. J., Oh, J. K., Choi, E. K., Yoon, S., Bikson, M., Song, I., Jeong, H., Chung, Y. Transcranial Direct Current Stimulation for Online Gamers. J. Vis. Exp. (153), e60007, doi:10.3791/60007 (2019).
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