Effects of transcranial direct current stimulation on addictive behavior and brain glucose metabolism in problematic online gamers

Hyeonseok Jeong, Jin Kyoung Oh, Eun Kyoung Choi, Jooyeon Jamie Im, Sujung Yoon, Helena Knotkova, Marom Bikson, In Uk Song, Sang Hoon Lee, Yong An Chung

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7 Scopus citations


Background and aims: Some online gamers may encounter difficulties in controlling their gaming behavior. Previous studies have demonstrated beneficial effects of transcranial direct current stimulation (tDCS) on various kinds of addiction. This study investigated the effects of tDCS on addictive behavior and regional cerebral metabolic rate of glucose (rCMRglu) in problematic online gamers. Methods: Problematic online gamers were randomized and received 12 sessions of either active (n = 13) or sham tDCS (n = 13) to the dorsolateral prefrontal cortex over 4 weeks (anode F3/cathode F4, 2 mA for 30 min, 3 sessions per week). Participants underwent brain 18F-fluoro-2-deoxyglucose positron emission tomography scans and completed questionnaires including the Internet Addiction Test (IAT), Brief Self-Control Scale (BSCS), and Behavioral Inhibition System/Behavioral Activation System scales (BIS/BAS) at the baseline and 4-week follow-up. Results: Significant decreases in time spent on gaming (P = 0.005), BIS (P = 0.03), BAS-fun seeking (P = 0.04), and BAS-reward responsiveness (P = 0.01), and increases in BSCS (P = 0.03) were found in the active tDCS group, while decreases in IAT were shown in both groups (P < 0.001). Group-by-time interaction effects were not significant for these measures. Increases in BSCS scores were correlated with decreases in IAT scores in the active group (β 5 =0.85, P < 0.001). rCMRglu in the left putamen, pallidum, and insula was increased in the active group compared to the sham group (P for interaction < 0.001). Discussion and conclusions: tDCS may be beneficial for problematic online gaming potentially through changes in self-control, motivation, and striatal/insular metabolism. Further larger studies with longer follow-up period are warranted to confirm our findings.

Original languageEnglish
Pages (from-to)1011-1021
Number of pages11
JournalJournal of Behavioral Addictions
Issue number4
StatePublished - Jan 2021

Bibliographical note

Publisher Copyright:
© 2020 The Author(s).


  • Positron emission tomography
  • Prefrontal cortex
  • Problematic online gaming
  • Regional cerebral metabolic rate of glucose
  • Transcranial direct current stimulation


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