Altered functional connectivity in neural circuits of bipolar disorder and problematic gaming: a resting-state fMRI study

Problematic gaming (PG) represents an addictive behavior that is prevalent among young adults and has a significant impact on mental health. Patients diagnosed with bipolar disorder (BD) may be particularly susceptible to PG. Nevertheless, the neural circuits underlying PG in patients with BD remain poorly understood. A total of 73 participants were included in this study, including the group of BD patients with PG (BD-PG, n = 26), the group of BD patients without PG (BD-NPG, n = 23), and the healthy control group (HC, n = 24). All participants completed the VGD-S and underwent resting-state fMRI scanning, while BD patients additionally completed the BDI-II and YMRS within 24 h before scanning. Seed-based functional connectivity (FC) related to cognitive control, emotion, and reward was examined. ANCOVA, FDR correction, a separate BD sensitivity analysis, and partial correlation analysis were performed. After FDR correction, FC between the left thalamus and right amygdala was increased in the BD-PG group compared with both the BD-NPG and HC groups and was also increased in the BD-NPG group compared with the HC group. Partial correlation analysis further showed that FC between the left thalamus and right amygdala was positively associated with VGD-S scores after controlling for age, education years, and medication burden. Increased FC between the left thalamus and right amygdala may represent a preliminary neural correlate of problematic gaming severity among patients with BD. This finding may suggest the potential importance of the thalamus and amygdala in cognitive control and reward processing in BD patients with PG.