Background and Aims:Internet Gaming Disorder (IGD) is a psychological condition that impairs various aspects of life, with adolescents being particularly vulnerable due to developmental factors and heightened digital exposure. This study aims to explore the interplay between behavioral and neural bases of the development of IGD, offering insights for possible prevention strategies. Methods:A large sample of young adults (n = 1,205, age (SD) = 18.80 (1.26)) was assessed for impulsivity, sensation seeking, and IGD tendency. Two year later, impulsivity and IGD tendency were evaluated again, to expose possible long-term effects. Resting-state MRI data were collected to measure the topological properties of functional networks through graph theory analysis, encompassing global efficiency, local efficiency, and degree centrality. Results:Sensation seeking was positively associated with impulsivity, which, in turn, was positively linked to IGD tendency. A cross-lagged effect between impulsivity and IGD tendency was evident over a two-year timeframe. Furthermore, whole-brain local efficiency was a positive predictor of impulsivity, with centrality and efficiency of the right thalamus, along with local efficiency of the right lingual gyrus, demonstrating positive correlations with IGD tendency. Conclusion:This study revealed that sensation seeking indirectly affects IGD tendency through impulsivity, which also directly impacts IGD. Neural correlates of impulsivity included local efficiency, and of IGD tendency, included the right thalamus and lingual gyrus. These findings offer insights into IGD mechanisms and possible prevention approaches.

With the advent of digital technologies, online sports betting is spurring a fast-growing expansion. In this study, we examined how sports betting availability modulates the brain connectivity of frequent sports bettors with [problem bettors (PB)] or without [non-problem bettors (NPB)] problematic sports betting. We conducted functional connectivity analyses centred on the ventral anterior insular cortex (vAI), a brain region playing a key role in the dynamic interplay between reward-based processes. We re-analysed a dataset on sports betting availability undertaken in PB (n = 30) and NPB (n = 35). Across all participants, we observed that sports betting availability elicited positive vAI coupling with extended clusters of brain activation (encompassing the putamen, cerebellum, occipital, temporal, precentral and central operculum regions) and negative vAI coupling with the orbitofrontal cortex. Between-group analyses showed increased positive vAI coupling in the PB group, as compared with the NPB group, in the left lateral occipital cortex, extending to the left inferior frontal gyrus, the anterior cingulate gyrus and the right frontal pole. Taken together, these results are in line with the central assumptions of triadic models of addictions, which posit that the insular cortex plays a pivotal role in promoting the drive and motivation to get a reward by 'hijacking' goal-oriented processes toward addiction-related cues. Taken together, these findings showed that vAI functional connectivity is sensitive not only to gambling availability but also to the status of problematic sport betting.

Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.

There is a growing trend to accept, understand and cater to people with heterogenous mental health levels, as captured by the term "neurodiversity." Population studies demonstrate growth in neurodiversity facets such as depression, anxiety, and attention deficit hyperactivity disorder (ADHD). Thus, samples of information systems (IS) users are likely neurodiverse. While studies started examining neurodiversity effects mostly in professional contexts, possible effects of IS users' neurodiversity in leisure settings have been largely overlooked. Here, we suggest that we need to consider such possible effects more systematically. This is important because neurodiversity facets can manifest in changes in cognitive- emotional processing, social reactions, and decision-making which can alter user responses to IS. Thus, ignoring the neurodiversity of users can affect the accuracy and generalizability of user behavior models; it can disadvantage large segments of users. To support these ideas, we first developed a theoretical model that explains how neurodiversity can affect the decision-making of IS users. Next, we conducted three studies (n1 n 1 = 400, n 2 = 381, and n 3 = 280) that first replicated common IS models in leisure settings and then theoretically and empirically integrated neurodiversity facets into these models. Results show that (1) typical IS user samples are neurodiverse, and (2) integrating neurodiversity facets into user behavior models can be informative, lead to greater inclusivity, and afford more nuanced theoretical and practical insights. Thus, we call for a more systematic inclusion of neurodiversity facets in behavioral IS research.

Decision-making under uncertainty (risky and ambiguous) is important for everyday life (Knight, 1921). The Iowa Gambling Task [[1]Bechara A. Damasio A.R. Damasio H. Anderson S.W. Insensitivity to future consequences following damage to human prefrontal cortex.Cognition. 1994; 50: 7-15https://doi.org/10.1016/0010-0277(94)90018-3Crossref PubMed Scopus (4220) Google Scholar] is a widely-used tool to measure decision making under uncertainty [[2]He Q.H. Xue G. Chen C.S. Lu Z.L. Dong Q. Lei X.M. Bechara A. Serotonin transporter gene-linked polymorphic region (5-HTTLPR) influences decision making under ambiguity and risk in a large Chinese sample.Neuropharmacology. 2010; 59: 518-526https://doi.org/10.1016/j.neuropharm.2010.07.008Crossref PubMed Scopus (74) Google Scholar,[3]Koritzky G. He Q.H. Xue G. Wong S. Xiao L. Bechara A. Processing of time within the prefrontal cortex: recent time engages posterior areas whereas distant time engages anterior areas.Neuroimage. 2013; 72: 280-286https://doi.org/10.1016/j.neuroimage.2013.01.056Crossref PubMed Scopus (16) Google Scholar]. Previous research has suggested that the left prefrontal cortex, particularly the orbitofrontal cortex (OFC) and the dorsolateral prefrontal cortex (DLPFC), plays an important role in decision making under uncertainty (Duncan and Owen, 2000). However, the causal relationship between these regions and decision making is yet to be fully understood [[4]Soutschek A. Burke C.J. Raja Beharelle A. Schreiber R. Weber S.C. Karipidis I.I. Kalenscher T. The dopaminergic reward system underpins gender differences in social preferences.Nat Human Behav. 2017; 1: 819-827Crossref PubMed Scopus (56) Google Scholar]. The aim of this study was to investigate the effects of high-definition transcranial direct current stimulation HD-tDCS, administered either over the OFC or the DLPFC, on decision making under uncertainty, with a design that was balanced in terms of sex. A total of 187 college students (96 females, with an average age of 20.37 ± 1.78 years) were recruited in this study. We employed a single-blind, between-subject design with two factors: sex (male vs. female) and stimulation (left OFC, left DLPFC, vs. Sham). The anodal electrode for stimulation over the left OFC was placed over Fp1 in accordance with the international 10–20 EEG System [[5]Homan R.W. Herman J. Purdy P. Cerebral location of international 10–20 system electrode placement.Electroencephalogr Clin Neurophysiol. 1987; 66: 376-382https://doi.org/10.1016/0013-4694(87)90206-9Abstract Full Text PDF PubMed Scopus (951) Google Scholar], with the four return (cathodal) electrodes positioned at Fpz, AF3, AF7, and above the left eyebrow (Fig. 1A). For stimulation over the left DLPFC, the anodal electrode was placed over F3 and the four return electrodes were set at F5, AF3, FC3, and F1 (Fig. 1B). For Sham stimulations, one of the above protocols was randomly chosen, with stimulation ramped up for 30 seconds and then turned off. The protocol of this experiment was approved by the local Institutional Review Board. The IGT performance was evaluated using two types of indexes: the IGT score and parameters generated by the Prospect Valence Learning (PVL) model. The IGT score was calculated by subtracting the total number of disadvantageous deck selections from the total number of advantageous deck selections (i.e., C + D - A - B) [[1]Bechara A. Damasio A.R. Damasio H. Anderson S.W. Insensitivity to future consequences following damage to human prefrontal cortex.Cognition. 1994; 50: 7-15https://doi.org/10.1016/0010-0277(94)90018-3Crossref PubMed Scopus (4220) Google Scholar]. The IGT scores of the first 40 trials and the last 60 trials were used to evaluate decision making under ambiguity and decision making under risk, respectively [[2]He Q.H. Xue G. Chen C.S. Lu Z.L. Dong Q. Lei X.M. Bechara A. Serotonin transporter gene-linked polymorphic region (5-HTTLPR) influences decision making under ambiguity and risk in a large Chinese sample.Neuropharmacology. 2010; 59: 518-526https://doi.org/10.1016/j.neuropharm.2010.07.008Crossref PubMed Scopus (74) Google Scholar]. The PVL model [[6]Ahn W.-Y. Busemeyer J.R. Wagenmakers E.-J. Stout J.C. Comparison of decision learning models using the generalization criterion method.Cognit Sci. 2008; 32 (Article Pii 906363840): 1376-1402https://doi.org/10.1080/03640210802352992Crossref PubMed Scopus (164) Google Scholar] was employed to analyze the IGT, taking into account the shape parameter α (0 < α < 1, where lower values signify greater subjective utility meaning gains and losses are subjectively equal); the loss aversion parameter λ (0 < λ < 5, where higher values indicate greater loss aversion, meaning losses are weighted more heavily than gains); the recency parameter A (0 < A < 1, where higher values denote greater reliance on recent feedbacks); and the consistency parameter c (0 < c < 1, where higher values denote greater decision consistency). A two-way ANOVA on the total IGT scores revealed a significant main effect of stimulation (F (2, 181) = 3.12, p = 0.047, ηp2 = 0.03), as well as a significant interaction between stimulation and sex (F (2, 181) = 3.15, p = 0.045, ηp2 = 0.03). However, there was no main effect of sex (F (1, 181) = 0.01, p = 0.910). Anodal stimulation over the left DLPFC was found to increase the IGT scores (Fig. 1C) compared to both the stimulation over the OFC (p = 0.039) and the Sham stimulation (p = 0.024). In males (Fig. 1D), there was no significant main effect of stimulation (F (2, 88) = 2.27, p = 0.109), while in female, there was a significant main effect (F (2, 93) = 4.07, p = 0.020, ηp2 = 0.08). Subsequent analysis revealed that the DLPFC group showed significantly higher IGT score than participants in the OFC group (p = 0.005) with Sham group in the middle (Fig. 1E). Analysis of the IGT score in the first 40 trials revealed no significant main effects or interactions (all Fs < 0.84, ps > 0.134). However, when examining the IGT score in the last 60 trials (i.e., decision making under risk), a significant main effect of stimulation (F (2,181) = 3.85, p = 0.023, ηp2 = 0.04) and a significant interaction between stimulation and sex (F (2,181) = 2.55, p = 0.610, ηp2 = 0.001) were observed, though there was no main effect of sex (F (1,181) = 0.26, p = 0.610). Post-hoc multiple comparisons indicated that the DLPFC group performed significantly better than the OFC group (p = 0.028) and the Sham-stimulation group (p = 0.012) when making decisions under risk. Moreover, males in the DLPFC group had higher IGT scores than those in the Sham group (p = 0.034) while females in the DLPFC group had significantly higher IGT scores than those in the OFC group (p = 0.006). These results showed that sex played an important role in the effectiveness of tDCS on the IGT, particularly in the risky decision phase. The Kruskal-Wallis one-way ANOVA and Mann-Whitney U test were employed to conduct nonparametric tests on the parameters yielded by the PVL model, given that they did not follow a normal distribution. Results showed that there were no significant differences on all parameters (ps > 0.244) but the shape parameter α (Fig. 1F) (p = 0.045): the OFC group scored higher than the DLPFC (p = 0.021) and Sham groups (p = 0.050). Similar conclusion was reached when the data was separately analyzed for males (Fig. 1G) and females (Fig. 1H). Results showed that anodal HD-tDCS applied over the left DLPFC resulted in higher IGT scores for all participants, and particularly for females. Anodal HD-tDCS applied over the left OFC appears to increase sensitivity to gain or loss. This implies that the left OFC and DLPFC have distinct functions in decision making, and that sex modulates this process. The questionnaire followed this single-blind design revealed that participants experienced comparable side effects of tDCS regardless of the DLPFC, OFC and sham conditions; however, future experiments should incorporate a double-blind design.

EDITORIAL article Front. Psychol., 25 August 2023Sec. Psychopathology Volume 14 - 2023 | https://doi.org/10.3389/fpsyg.2023.1264864

Proactive inhibition is a critical ability for smokers who seek to moderate or quit smoking. It allows them to pre-emptively refrain from seeking and using nicotine products, especially when facing salient smoking cues in daily life. Nevertheless, there is limited knowledge on the impact of salient cues on behavioural and neural aspects of proactive inhibition, especially in smokers with nicotine withdrawal. Here, we seek to bridge this gap. To this end, we recruited 26 smokers to complete a stop-signal anticipant task (SSAT) in two separate sessions: once in the neutral cue condition and once in the smoking cue condition. We used graph-based modularity analysis to identify the modular structures of proactive inhibition-related network during the SSAT and further investigated how the interactions within and between these modules could be modulated by different proactive inhibition demands and salient smoking cues. Findings pointed to three stable brain modules involved in the dynamical processes of proactive inhibition: the sensorimotor network (SMN), cognitive control network (CCN) and default-mode network (DMN). With the increase in demands, functional connectivity increased within the SMN, CCN and between SMN-CCN and decreased within the DMN and between SMN-DMN and CCN-DMN. Salient smoking cues disturbed the effective dynamic interactions of brain modules. The profiles for those functional interactions successfully predicted the behavioural performance of proactive inhibition in abstinent smokers. These findings advance our understanding of the neural mechanisms of proactive inhibition from a large-scale network perspective. They can shed light on developing specific interventions for abstinent smokers.

Arguably, at its core, the fundamental goal of marketing is to create, sustain, and monetize a competitive advantage through a superior customer value proposition (CVP). This chapter highlights the evolution of the CVP across the years. It also highlights the emergent "third-wave" viewpoint of the CVP, at the core of which is brand emotion and its power in shaping a sustainable CVP. The traditional view that prevailed until the 1980s and even into the 1990s was that marketers could shape the value proposition by focusing on one or both of two routes. One route is the "branding route," where the marketer shapes the CVP through a product differentiation strategy by offering a superior value in terms of the benefits, both tangible and intangible. A second route to shaping the value proposition is "pricing route," where the marketer shapes the CVP by offering superior value in terms of lower prices, either momentarily through discounts, etc., or by adopting a price-leadership strategy.

Recent neurocognitive models propose that the insula serves as a hub of interoceptive awareness system, modulating 2 interplaying neurocognitive systems: The posterior insula (PI) receives and integrates various interoceptive signals; these signals are then transmitted to the anterior insula for processing higher-order representations into awareness, where the dorsal anterior insula (dAI) modulates the prefrontal self-control system and the ventral anterior insula (vAI) modulates the amygdala (AMG)-striatal reward-seeking circuit. We sought to test this view using a multimodal approach. We first used a resting-state functional magnetic resonance imaging (fMRI) approach with a sample of 120 undergraduate students. Then, we unpacked the neuro-cognitive association between insular connectivity and cognitive performance during an Iowa gambling fMRI task. Lastly, an independent Open Southwest University Longitudinal Imaging Multimodal dataset was used to validate the results. Findings suggested that the dAI was predominantly connected to the prefrontal regions; the vAI was primarily connected to the AMG-ventral-striatum system; and the PI was mainly connected to the visceral-sensorimotor system. Moreover, cognitive scores were positively correlated with FC between dAI and the self-control process of ventrolateral prefrontal cortex and were negatively correlated with FC between vAI and the reward-seeking process of orbitofrontal cortex and subgenual anterior cingulate cortex. The findings highlight the roles of our theorized subinsular functionality in the overall operation of the neural cognitive systems.

COPYRIGHT © 2023 Stoyanov, Telles Correia, Bechara, Turel and Noel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Editorial: Insights in: Psychopathology research

The Coronavirus disease of 2019 (COVID-19) and measures to curb it created population-level changes in male-dominant impulsive and risky behaviors such as violent crimes and gambling. One possible explanation for this is that the pandemic has been stressful, and males, more so than females, tend to respond to stress by altering their focus on immediate versus delayed rewards, as reflected in their delay discounting rates. Delay discounting rates from healthy undergraduate students were collected twice during the pandemic. Discounting rates of males (n=190) but not of females (n=493) increased during the pandemic. Using machine learning, we show that prepandemic functional connectome predict increased discounting rates in males (n=88). Moreover, considering that delay discounting is associated with multiple psychiatric disorders, we found the same neural pattern that predicted increased discounting rates in this study, in secondary datasets of patients with major depression and schizophrenia. The findings point to sex-based differences in maladaptive delay discounting under real-world stress events, and to connectome-based neuromarkers of such effects. They can explain why there was a population-level increase in several impulsive and risky behaviors during the pandemic and point to intriguing questions about the shared underlying mechanisms of stress responses, psychiatric disorders and delay discounting.

ABSTRACT Background and aims Experiencing acute stress is common in behavioral addictions such as gambling disorder. Additionally, like most substance-induced addictions, aberrant decision-making wherein a reactive habit-induced response (conceptualized as a Model-free [MF] in reinforcement learning) suppresses a flexible goal-directed response (conceptualized as a Model-based [MB]) is also common in gambling disorder. In the current study we investigated the influence of acute stress on the balance between habitual response and the goal-directed system. Methods A sample of N = 116 pathological gamblers (PG) and healthy controls (HC) performed an acute stress task – the Socially Evaluated Cold pressure task (SECPT) – or a control task. Self-reported stress and salivary cortisol were collected as measures of acute stress. Following the SECPT, participants performed the Two-Step Markov Task to account for the relative contribution of MB and MF strategies. Additionally, verbal working-memory and IQ measures were collected to account for their mediating effects on the orchestration between MB/MF and the impact of stress. Results Both groups had comparable baseline and stress-induced cortisol response to the SECPT. Non-stressed PG displayed lower MB learning than HC. MANOVA and regression analyses showed a deleterious effect of stress-induced cortisol response on the orchestration between MB and MF learning in HC but not in PG. Neither working memory nor IQ mediated these effects. Discussion and Conclusions Despite normal cortisol response to stress, we found an abnormal pattern of modulation of stress on the orchestration between MB and MF learning among PG.

BACKGROUND:There is active interest in biomarker discovery for transcutaneous auricular vagus nerve stimulation (taVNS). However, greater understanding of the neurobiological mechanisms is needed to identify candidate markers. Accumulating evidence suggests that taVNS influences activity in solitary and parabrachial nuclei, the primary brainstem relays for the transmission of visceral sensory afferents to the insula. The insula mediates interoception, which concerns the representation and regulation of homeostatic bodily states. Consequently, interoceptive pathways may be relevant to taVNS mechanisms of action.HYPOTHESES:We hypothesized that taVNS would modulate an EEG-derived marker of interoceptive processing known as the heart-evoked potential (HEP). We also hypothesized that taVNS-induced HEP effects would be localizable to the insula.METHODS:Using a within-subject, sham-controlled design, we recorded EEG and ECG concurrent to taVNS in 43 healthy adults. Using ECG and EEG data, we extracted HEPs. Estimation of the cortical sources of the taVNS-dependent HEP responses observed at the scalp were computed using the Boundary Element Method and weighted Minimum Norm Estimation. Statistics were calculated using cluster-based permutation methods.RESULTS:taVNS altered HEP amplitudes at frontocentral and centroparietal electrode sites at various latencies. The taVNS-dependent HEP effect was localized to the insula, operculum, somatosensory cortex, and orbital and ventromedial prefrontal regions.CONCLUSION:The results support the hypothesis that taVNS can access the insula as well as functionally and anatomically connected brain regions. HEPs may serve as an objective, non-invasive outcome parameter for the cortical effects of taVNS.

Consumption is a rewarding experience that results in dopamine processing in the brain. Repeated and frequent rewarding consumption experiences can sensitize some consumers to “want” more consumption. Unfortunately, some cannot resist such temptations and fail to override their impulsions, which results in maladaptive consumption. Here, we extend the neuro-marketing literature on the neural basis of normal consumption by describing a triple neural model of maladaptive consumption. The systems in this model include reward, self-control/ inhibition, and interoceptive awareness circuits. While these systems are included in common neuro-marketing circuits, they can be modulated to develop deficits that manifest in maladaptive consumption. They have also been largely examined in isolation. We propose a holistic perspective focusing on the interaction among these brain regions, according to which an imbalance between these systems drives maladaptive consumption. We illustrate these ideas and build on related findings to provide important implications for researchers, marketers, consumer rights advocates, and policy makers.

Internet gaming disorder (IGD) is a concerning issue that requires further research. Here, we seek to examine its neural etiology with an emphasis on the role of the insula. To do so, we relied on the tripartite neurocognitive model of addictive behaviors as applied to IGD. We hypothesized that (a) video game cues will elicit stronger reward system activation and weaker prefrontal activation in gamers vs controls, (b) the IGD scores of gamers will be positively associated with activation of the reward system and negatively with activation of prefrontal regions, (c) deprivation from video gaming will result in increased activation of the insula, when gamers are exposed to video game cues vs to neutral cues, and (d) in deprivation conditions, there will be positive and negative coupling, respectively, between activation of the insula and the reward and prefrontal regions in gamers. We tested these hypotheses with a design with one between-subjects factor (gamers vs controls) and two within-subjects factors: stimuli (gaming vs neutral; for all participants) and session (deprivation vs satiety; only for gamers). Findings based on functional magnetic resonance imaging (fMRI; applied to all 52 subjects, 26 gamers, and 26 controls) and psychophysiological interaction (PPI; applied to the 26 gamers) engaged in a video reactivity task supported our assertions. The IGD score positively correlated with activity in the right ventral striatum and negatively with activity in the right dorsolateral prefrontal cortex (DLPFC). Left insular cortex activity was the highest when observing video gaming cues under deprivation. Lastly, there was an increased coupling between the left insula and left ventral striatum and a decreased coupling with left DLPFC when observing video gaming cues compared with when watching control videos in the deprivation condition.

Addiction behaviors are characterized by conditioned responses responsible for craving and automatic actions as well as disturbances within the supervisory network, one of the key elements of which is the inhibition of prepotent response.Interventions such as brain stimulation and cognitive training targeting this imbalanced system can potentially be a positive adjunct to treatment as usual.The relevance of several invasive and noninvasive brain stimulation techniques in the context of addiction as well as several cognitive training protocols is reviewed.By reducing cue-induced craving and modifying the pattern of action, memory associations, and attention biases, these interventions produced significant but still limited clinical effects.A new refined definition of response inhibition, including automatic inhibition of response and a more consistent approach to cue exposure capitalizing on the phase of reconsolidation of pre-activated emotional memories, all associated with brain and cognitive stimulation, opens new avenues for clinical research.

The unprecedented development and ubiquity of sports betting constitute an emerging public health concern. It is crucial to provide markers that could help to better identify people experiencing sports betting-related harms. The current study investigated whether problem gambling status, sports betting passion, and trait-self-control modulate brain reactivity to sports betting cues. Sixty-five frequent sports bettors (35 "nonproblem bettors" and 30 "problem bettors") were exposed to cues representing real upcoming sport events (with varying levels of winning confidence) that were made available or blocked for betting, during functional magnetic resonance imaging (fMRI) recording. Sports betting passion and trait-self-control were assessed using self-report scales. Sport events nonavailable for betting elicited higher insular and striatal activation in problem bettors, as compared with nonproblem bettors. Within a large cluster encompassing the ventral striatum, hippocampus, and amygdala, lower trait-self-control was associated with increased brain reactivity to sport events with high levels of winning confidence that were nonavailable for betting. No significant effect of sports betting passion was observed. These findings suggest that sports bettors' brain reactivity to gambling unavailability might be a relevant marker of sports betting-related harms, as well as of blunted trait-self-control.

Dysregulation of autonomic cardiovascular homeostasis is an important cardiological and neurological risk factor. Cortical regions including the prefrontal and insular cortices exert tonic control over cardiovascular autonomic functions. Transcranial Magnetic Stimulation (TMS) may be a suitable approach for studying top-down control of visceromotor processes. However, there is inconsistent evidence as to whether TMS can modify cardiovascular autonomic states. One reason for the inconsistency may arise from the lack of studies accounting for the acute affective states of participants with respect to the stimulation procedures. To gain more insights into these processes, we evaluated the effects of intermittent and continuous theta-burst stimulation (TBS) to the right frontotemporal cortex on state anxiety and cardiovascular responses in a preliminary study. State anxiety significantly increased for both intermittent and continuous TBS relative to sham. Intermittent TBS also significantly increased heart-rate variability (HRV) at natural and slow-paced breathing rates. The effect of intermittent TBS on vagally-mediated HRV was attenuated after accounting for stimulation-induced anxiety, suggesting that increased HRV after stimulation may reflect a response to a transient stressor (i.e., the stimulation itself), rather than TBS effects on visceromotor networks. In contrast, continuous TBS increased pulse transit time latency across breathing rates, an effect that was enhanced after accounting for state anxiety. TMS is a promising approach to study cortical involvement in cardiovascular autonomic regulation. The findings show that TBS induces effects on visceromotor networks, and that analysis of state covariates such as anxiety can be important for increasing the precision of these estimates. Future non-invasive brain stimulation studies of top-down neurocardiac regulation should account for the potential influence of non-specific arousal or anxiety responses to stimulation.

Video gaming can be associated with inter-individual differences in brain morphology. Much of this literature has focused on non-professional/occasional gamers who barely play, on the one extreme; or Internet Gaming Disorder (IGD) cases who typically play more than 5 h/day, on the other extreme. We sought to extend this literature and focus on extensive gamers, who play about 3 h/day, which is typically more than non-professional gamers, but less than IGD cases. Findings regarding this sector of gamers can inform research on risk factors or markers for IGD development, even before addiction symptoms emerge. We predicted that extensive gamers have smaller prefrontal regions that presumably reflect weaker inhibition abilities, and larger visuomotor regions that presumably reflect stronger motor skills in response to visual stimuli. We tested these assertions with a between-subject brain morphology comparison of 26 extensive League of Legends (LOL) and matched 26 non-gamers, using voxel based morphometry, deformation based morphometry, and cortical thickness and sulcus depth analyses. Findings largely supported our predictions by pointing to morphological alterations in extensive gamers in the bilateral ventromedial prefrontal cortex and left dorsolateral prefrontal cortex, as well is in the left superior parietal lobule. These findings suggest that extensive gamers, at least of Massive-Multiplayer battle arena games, present brain alterations that are consistent with presumed loss of control (as mediated by the prefrontal cortex), but also improved attention and visoumotor skills (as mediated by superior parietal lobule). Implications for research and practice are discussed.

Brain reward processing mechanisms that underlie complex decision-making are compromised in psychosis. The goal of this research was to advance our understanding of the underlying (1) neural mechanisms and (2) discrete neuro-economic/motivational processes that may be altered in complex decision-making in euthymic patients on the psychosis spectrum (PPS). Utilizing a functional magnetic resonance neuroimaging (fmri) paradigm of a well-validated laboratory measure of complex decision-making (Iowa Gambling Task-IGT), the brain activation patterns of a target group of PPS were compared to a demographically matched healthy comparison group (HMC). These two groups were also evaluated on real-life decision outcomes on day of scan. PPS primarily activate the Dorsal Attentional Network (DAN) in real-life decision outcomes and in achieving similar levels of performance on the IGT as the HMC, in-spite of dysregulated dopamine-based brain-reward circuit and salience network fmri activation patterns. However, PPS report more significant negative outcomes of their decision-making in real-life, compared to HMC. The differential engagement of brain networks by PPS on the IGT appear to be moderated by antipsychotic, dopamine antagonist, medication lifetime/daily dose levels. These findings may also be mediated by extent of dysregulation in brain reward circuitry and salience network associated with psychosis severity in the target PPS group. This is also evident in case studies of unmedicated PPS. We conclude by suggesting that the brain may adapt to this dysregulation by co-opting the DAN network, which is implicated in the related function of problem-solving, towards complex decision-making. The extent of utilization of the DAN network in complex decision-making may be moderated by psychosis severity.