ArticleBMC medicine2026
Risk classification of internet gaming disorder based on neurobiological subtyping from impulsivity-linked resting-state functional connectivity: a longitudinal design study.
Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInternet gaming disorder (IGD) often emerges in youth, yet early, brain-based risk stratification for IGD is scarce. Impulsivity is a central vulnerability factor for IGD that may provide informative biomarkers. Our primary objective was to identify high-risk IGD subgroup and derive biomarkers from impulsivity-anchored resting-state functional connectivity (RSFC).
methodsIn a cross-sectional sample (N = 770: 642 controls, 128 IGD), we derived RSFC features positively and negatively correlated with trait impulsivity to predict current IGD severity from positive-only, negative-only, and combined feature sets. In a 2-year longitudinal discovery cohort (N = 220) and an independent replication cohort (N = 65), we applied improved deep embedded clustering to baseline impulsivity-linked RSFC to identify subtypes, evaluated prospective IGD conversion in each subtype, examined subtype-specific RSFC signatures, and illuminated whether baseline impulsivity was associated with future risk of IGD through specific circuits.
resultsCombining positively and negatively impulsivity-linked RSFC outperformed either alone in predicting current IGD severity (training r = 0.73, p < 0.0001; testing r = 0.27, p = 0.009; higher than two single-pattern models, p = 0.028 and p < 0.0001, respectively). Two subtypes emerged; the high-risk subtype showed greater 2-year IGD conversion (23.61% vs. 6.76%; χ
conclusionsImpulsivity-related RSFC identified a youth subtype at elevated risk for developing IGD. This high-risk subtype showed a higher future IGD conversion rate, greater subsequent increases in IGD severity, and a baseline orbitofrontal-occipital connectivity imbalance. These findings suggest that an orbitofrontal-occipital circuit imbalance may serve as a potential marker for identifying IGD risk in youth.
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