title: The effects of a virtual reality treatment program for online gaming addiction.
abstract: OBJECTIVE
  Neuroimaging studies have demonstrated dysfunction in the brain reward circuit in individuals with online gaming addiction (OGA). We hypothesized that virtual reality therapy (VRT) for OGA would improve the functional connectivity (FC) of the cortico-striatal-limbic circuit by stimulating the limbic system.
  
  
  METHODS
  Twenty-four adults with OGA were randomly assigned to a cognitive behavior therapy (CBT) group or VRT group. Before and after the four-week treatment period, the severity of OGA was evaluated with Young's Internet Addiction Scale (YIAS). Using functional magnetic resonance imaging, the amplitude of low-frequency fluctuation (ALFF) and FC from the posterior cingulate cortex (PCC) seed to other brain areas were evaluated. Twelve casual game users were also recruited and underwent only baseline assessment.
  
  
  RESULTS
  After treatment, both CBT and VRT groups showed reductions in YIAS scores. At baseline, the OGA group showed a smaller ALFF within the right middle frontal gyrus and reduced FC in the cortico-striatal-limbic circuit. In the VRT group, connectivity from the PCC seed to the left middle frontal and bilateral temporal lobe increased after VRT.
  
  
  CONCLUSIONS
  VRT seemed to reduce the severity of OGA, showing effects similar to CBT, and enhanced the balance of the cortico-striatal-limbic circuit.
authors: Department of Psychiatry, Chung-Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: architers@hanmail.net.
authors: Sung Yong
authors: SY
authors: Park
authors: Department of Psychiatry, Chung-Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: sunmikim706@gmail.com.
authors: Sun Mi
authors: SM
authors: Kim
authors: Department of Psychiatry, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Republic of Korea. Electronic address: swroh@hanyang.ac.kr.
authors: Sungwon
authors: S
authors: Roh
authors: Department of Mental Health Research, Seoul National Hospital, Junggok 3-dong, Gwangjin-gu, Seoul 143-711, Republic of Korea. Electronic address: soho27@gmail.com.
authors: Min-Ah
authors: MA
authors: Soh
authors: Eun Hye Hospital, Simgok-dong, Seo-gu, Incheon 404-793, Republic of Korea. Electronic address: lnh409@naver.com.
authors: Sang Hoon
authors: SH
authors: Lee
authors: Department of Psychology, Rice University, 6100 Main Street, Houston, TX 77005, USA. Electronic address: hk19@rice.edu.
authors: Hyungjin
authors: H
authors: Kim
authors: Department of Psychiatry, Chung-Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: hawkeyelys@hanmail.net.
authors: Young Sik
authors: YS
authors: Lee
authors: Department of Psychiatry, Chung-Ang University Medical Center, 102 Heukseok-ro, Dongjak-gu, Seoul 156-755, Republic of Korea. Electronic address: hduk@yahoo.com.
authors: Doug Hyun
authors: DH
authors: Han
mesh_terms: D016739:Behavior, Addictive / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D006801:Humans; D020407:Internet; D012201:Reward; D014584:User-Computer Interface; D018910:Video Games
keywords: Amplitude low-frequency fluctuation; Cortico-striatal-limbic circuit; Functional connectivity; Online gaming addiction; Virtual reality therapy