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Background <p>Internet 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).</p> Methods <p>In a cross-sectional sample (<i>N</i> = 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 (<i>N</i> = 220) and an independent replication cohort (<i>N</i> = 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.</p> Results <p>Combining positively and negatively impulsivity-linked RSFC outperformed either alone in predicting current IGD severity (training <i>r</i> = 0.73, <i>p</i> &lt; 0.0001; testing <i>r</i> = 0.27, <i>p</i> = 0.009; higher than two single-pattern models, <i>p</i> = 0.028 and <i>p</i> &lt; 0.0001, respectively). Two subtypes emerged; the high-risk subtype showed greater 2-year IGD conversion (23.61% vs. 6.76%; χ<sup>2</sup> = 9.54, <i>p</i> = 0.002), replicated in an independent cohort (22.2% vs. 4.3%; χ<sup>2</sup> = 3.90, <i>p</i> = 0.048). High-risk individuals exhibited reduced orbitofrontal RSFC and increased occipital RSFC; the former was negatively and the latter positively associated with impulsivity. Baseline left orbitofrontal–left insula RSFC (c − c’ = 0.032, 95% confidence interval (CI) 0.006–0.065) and right precentral–left lateral occipital RSFC (c − c’ = 0.035, 95% CI 0.006–0.071) partially mediated the link between baseline impulsivity and IGD severity 2 years later.</p> Conclusions <p>Impulsivity-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.</p>

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Risk classification of internet gaming disorder based on neurobiological subtyping from impulsivity-linked resting-state functional connectivity: a longitudinal design study

  • 期刊论文

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  • 发表日期：

    2026年3月26日

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  • Xinwen Wen,
  • Jiahao Zhao,
  • Zhe Du,
  • Xiao Yu,
  • Dongcheng Wang,
  • Boxun Fu,
  • Mengjiao Ge,
  • Haichao Zhao,
  • Hongmei Wang,
  • Fu Li,
  • Dahua Yu,
  • Qinghua He,
  • Kai Yuan

摘要

Background

Internet 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).

Methods

In 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.

Results

Combining 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%; χ2 = 9.54, p = 0.002), replicated in an independent cohort (22.2% vs. 4.3%; χ2 = 3.90, p = 0.048). High-risk individuals exhibited reduced orbitofrontal RSFC and increased occipital RSFC; the former was negatively and the latter positively associated with impulsivity. Baseline left orbitofrontal–left insula RSFC (c − c’ = 0.032, 95% confidence interval (CI) 0.006–0.065) and right precentral–left lateral occipital RSFC (c − c’ = 0.035, 95% CI 0.006–0.071) partially mediated the link between baseline impulsivity and IGD severity 2 years later.

Conclusions

Impulsivity-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.