Transcranial Direct Current Stimulation for Online Gamers
November 9th, 2019
We present a protocol and a feasibility study for applying transcranial direct current stimulation (tDCS) and neuroimaging assessment in online gamers.
Our protocol uses a noninvasive brain modulation technique called transcranial direct current stimulation, or tDCS, to reduce online gaming use. tDCS is simple, safe and inexpensive to administer, compared to other brain stimulation techniques. We also use neuroimaging to assess brain changes related to stimulation.
After recruiting both online game playing and non-online game playing individuals, explain to each participant the aim of the study, the main experimental procedures, and any potential risks associated with participating in the study. After answering any questions, obtain written consent. Have each participant fill out questionnaires, such as the Internet Addiction Test and Brief Self Control Scale;and ask the participants to report the average weekly hours spent playing games.
To perform an FDG PET scan, inject each participant with 185 to 222 megabecquerels of FDG;and have the participants rest for 45 minutes, in a supine position, in a dark and quiet room, with their eyes closed, to allow FDG uptake. At the end of the uptake period, use a PET/CT scanner to acquire transaxial emission images and CT images in about 15 minutes, applying standard attenuation correction, filtering, and reconstruction techniques. Within a week after the baseline assessment, seat the participant in a chair in the exam room, and set the parameters of the tDCS device to ramp up to 2 milliamps over 30 seconds.
Remain at this current for 29 minutes before returning to zero milliamps over the last 30 seconds. Place a head cap, constructed in accordance with the International 10-20 system, on the participant's head, and mark the left dorsolateral prefrontal cortex at F3, and the right dorsolateral prefrontal cortex at F4.After removing the head cap, place two sponge electrodes in the rubber holders of the tDCS headband, and soak the electrodes with saline solution. Remove any makeup, dirt, or sweat from the scalp where the electrodes will be applied, and place the headband on the participant's head, with the anodal electrode over F3, and the cathodal electrode over F4.Then use the cable to connect the electrodes to the tDCS device.
Turn on the device and ask the participant to report any adverse effects during or after the tDCS session. At the end of the 30 minute stimulation, turn off the device and remove the electrodes from the participant. Within a week after the last session, administer the same questionnaires, and acquire a post treatment FDG-PET scan.
For preprocessing of the imaging data, use an appropriate software package to convert the DICOM files to NIfTI files, and spatially normalize all of the PET images to the standard PET template. After creating binary masks for the left and right dorsolateral prefrontal cortices, use the masks to extract the Regional Cerebral Metabolic Rate of Glucose of the left and right dorsolateral prefrontal cortices. Then calculate the Asymmetry Index of the Regional Cerebral Metabolic Rate of Glucose in the dorsolateral prefrontal cortex.
A positive index indicates a right greater than left asymmetry of glucose metabolism. In this representative analysis, a total of 15 gamers and 10 non-gamers were recruited. The tDCS sessions successfully lowered the Internet Addiction Test score and weekly hours spent playing games, and improved the Brief Self Control Scale score in gamers.
A significant negative correlation was also found between the changes in the Internet Addiction Test score and the changes observed in the Brief Self Control Scale score in gamers. PET analysis revealed that the Asymmetry Index of the Dorsolateral prefrontal cortex was significantly different between the gamer group and the non-gamer group at baseline. Notably, following the tDCS sessions, the Asymmetry Index of the Dorsolateral prefrontal cortex in the gamer group was significantly decreased.
While performing this procedure, it is important to ensure that the parameters are set correctly, and the electrodes are positioned accurately over the stimulation site. Active tDCS can be compared to Sham tDCS to validate its efficacy. Also, other neuroimaging methods, such as fMRI, can be used to assess the brain changes.
These protocols can be adapted to explore new treatment options, or other psychiatric or neurological disorders.
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Overview
This study presents a protocol for using transcranial direct current stimulation (tDCS) to reduce online gaming use, along with neuroimaging assessments. The approach is noninvasive, simple, and cost-effective compared to other brain stimulation techniques.
Key Study Components
Area of Science
- Neuroscience
- Behavioral Science
- Neuroimaging
Background
- Transcranial direct current stimulation (tDCS) is a noninvasive brain modulation technique.
- tDCS has been shown to influence cognitive and behavioral functions.
- Online gaming addiction is a growing concern in modern society.
- Neuroimaging can help assess brain changes associated with stimulation.
Purpose of Study
- To evaluate the feasibility of using tDCS to reduce online gaming use.
- To assess the brain changes related to tDCS using neuroimaging.
- To gather data on gaming habits and addiction levels among participants.
Methods Used
- Recruitment of online and non-online gamers.
- Informed consent process including explanation of study aims and risks.
- Administration of questionnaires like the Internet Addiction Test.
- Neuroimaging assessments to evaluate brain changes.
Main Results
- Participants reported their average weekly gaming hours.
- Data collected on gaming addiction levels through questionnaires.
- Neuroimaging results indicated changes in brain activity post-stimulation.
- Feasibility of tDCS application in this context was demonstrated.
Conclusions
- tDCS is a viable method for reducing online gaming use.
- Neuroimaging can effectively assess the impact of tDCS on the brain.
- The study provides a foundation for further research in this area.
Frequently Asked Questions
Executive Industry Relevance
This protocol demonstrates a noninvasive neuromodulation approach with neuroimaging readouts to assess target engagement and behavioral outcomes in a digital addiction model. The integration of tDCS with FDG-PET enables quantitative measurement of regional cerebral metabolic changes, supporting mechanistic de-risking in early-stage target validation for neuropsychiatric indications. The feasibility data provide a foundation for evaluating tDCS as a tool to modulate prefrontal cortical circuits implicated in impulse control and reward processing.
Strategic Applications in Biopharma R&D
Early Discovery & Target Validation
- Scientific Value: Interrogates the causal role of dorsolateral prefrontal cortex asymmetry in gaming-related behavioral phenotypes through targeted neuromodulation.
- Operational Value: Enables longitudinal tracking of neurochemical and clinical changes using standardized FDG-PET asymmetry indices.
- Predictive Value: Supports hypothesis testing of prefrontal cortical targets for modulating compulsive behaviors and self-control deficits.
Screening & Assay Development
- Assay Readiness: Establishes a reproducible workflow for quantifying regional cerebral metabolic rate of glucose asymmetry as a pharmacodynamic biomarker.
- Scalability: Uses standardized electrode placement (F3/F4) and FDG-PET protocols amenable to multi-site adaptation.
- Quantitative Output: Generates continuous asymmetry index measurements enabling statistical comparison between pre- and post-intervention states.
Translational & Preclinical Research
- Disease Relevance: Models a behavioral addiction phenotype with clinical parallels to impulse control disorders, supporting target validation in neuropsychiatric indications.
- Translational Continuity: Links neuromodulation effects to measurable brain metabolism changes, facilitating extrapolation to clinical dosing and target engagement studies.
- Risk-Adjusted Advancement: Provides feasibility data to inform go/no-go decisions for further sham-controlled trials in addiction-related indications.
Pipeline & Workflow Integration
The method fits within the early discovery continuum by enabling target hypothesis testing through neuromodulation and neuroimaging, supporting progression from target identification to lead optimization in neuropsychiatric drug development.
- Discovery Biology: Supports interrogation of dorsolateral prefrontal cortex function in regulating gaming behavior and self-control via asymmetric metabolic modulation.
- Screening: Delivers standardized, quantifiable neuroimaging readouts (FDG-PET asymmetry index) suitable for assessing target engagement across intervention conditions.
- Analytics: Generates asymmetry index calculations that enable statistical comparison of regional cerebral metabolic changes between groups and over time.
- Translational Research: Connects prefrontal cortical neuromodulation to behavioral outcomes, supporting biomarker qualification for neuropsychiatric indications.
- Enterprise Reuse: Establishes a reusable neuromodulation-neuroimaging platform applicable to other impulse control or compulsive behavior models.
Operational & Enterprise Impact
- Scientific Value: Provides mechanistic insight into prefrontal cortical dysregulation in behavioral addiction, reducing ambiguity in target validation.
- Operational Value: Employs safe, low-cost tDCS and widely available FDG-PET for reproducible, scalable neuromodulation studies.
- Strategic Value: Enables data-driven target prioritization by linking neuromodulation to quantifiable brain and behavioral changes.
- Portfolio Impact: Supports risk-adjusted investment in prefrontal cortical targets by demonstrating feasibility of target engagement and behavioral modulation.
Implementation Considerations
- Requires expertise in neuromodulation device operation, electrode placement per 10-20 system, and FDG-PET imaging protocols.
- Depends on access to PET/CT scanners, radiotracer production (FDG), and standardized image analysis software for asymmetry index calculation.
- Necessitates cross-team standardization between neuroscience, imaging, and behavioral assessment teams for consistent protocol execution.
- Involves adaptation considerations for different target populations, stimulation parameters, and neuroimaging endpoints beyond FDG-PET.
- Limited by the open-label feasibility design; sham-controlled studies are required to establish efficacy and rule out placebo effects.
