Altered Resting-State Functional Connectivity in Internet Gaming Disorder: Convergent Evidence and Independent Validation

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Background: Internet gaming disorder (IGD) has attracted increasing attention worldwide. However, findings from resting-state functional connectivity (RSFC) studies have remained inconsistent, making it difficult to identify robust and reproducible neural alterations. To address this issue, we performed a coordinate-based synthesis of RSFC studies involving IGD-related conditions and examined whether the principal convergent findings could be replicated in an independent IGD cohort. Methods: Convergent RSFC abnormalities across eligible studies were identified using anisotropic effect size-signed differential mapping (AES-SDM). Clusters derived from the meta-analysis in the middle frontal gyrus and midline medial frontal/cingulate-related region were defined as regions of interest for independent validation. Resting-state fMRI data were collected from 58 individuals with IGD and 38 healthy controls, followed by seed-based RSFC analyses. Group differences were examined using two-sample t-tests with Gaussian random field correction, and brain-behavior associations were evaluated using Pearson correlations. Results: Seventeen studies met the inclusion criteria for meta-analysis. Convergent RSFC abnormalities were mainly observed in the median cingulate/paracingulate region and bilateral middle frontal gyrus. In the independent sample, individuals with IGD showed significant seed-based RSFC alterations involving both the middle frontal gyrus seed and the midline medial frontal/cingulate-related seed. Connectivity strength related to the middle frontal gyrus seed was positively associated with Internet Addiction Test scores. Conclusions: These findings provide convergent evidence for abnormal resting-state connectivity in IGD, particularly in frontal and midline regions involved in executive control and self-referential processing. Independent validation further supports the reproducibility and potential clinical relevance of these regionally specific alterations.