Brain Changes in Video Gamers: Addiction or Just People Having Fun?

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A new study finds changes in brain regions associated with addiction in frequent video gaming teenagers. But the findings raise questions about whether such research is really relevant to the understanding of true addiction.

Led by psychologist Simone Kuhn of the University of Ghent in Belgium, scientists studied 154 normal 14-year-old videogamers. About half were frequent gamers who played at least 9 hours of video games a week. The others were less frequent gamers whose playing time didn’t reach that amount.

Using functional magnetic resonance imaging (fMRI), the researchers scanned the teens’ brains and found that frequent gamers had a greater volume of gray matter — indicating a higher number of brain cell bodies — on the left side of a brain region called the ventral striatum, which is known to play a role in reward and addiction.

Further, while inside a functional MRI scanner, participants performed a task that involved pushing buttons to get varying levels of points for correct responses. Teens were advised in advance of how many points the correct answer would earn on each trial and were kept informed of their scores. The task was designed to gauge brain activity as the participants’ anticipated and received (or lost) a reward. Frequent gamers showed higher levels activity in the left ventral striatum when they received feedback about losing points — activity that mirrors that seen in addicted gamblers.

Outside of the scanner, the teens were also tested on a gambling task, in which they had to bet on the color of a hidden object, under conditions of greater or lesser probability of a correct answer. Frequent gaming teens made decisions more quickly during this task.

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Hundreds, perhaps thousands, of studies have associated the striatum with reward, motivation and desire. This brain region is rich in dopamine cells and helps guide decision-making and the pursuit of desired experiences and goals.

Changes in this region have also been seen in drug addictions, sometimes showing increased volume, sometimes less. It’s hard to know exactly what that means, however, because many drugs themselves directly change dopamine activity. The precise effect of such brain changes would be clearer with more research in behavioral addictions that don’t involve brain-affecting chemicals.

The authors cite research showing that increased left striatum activity in response to loss has been seen in addicted gamblers. They also note that these brain differences in video gamers may not reflect the effects of video gaming itself, but rather the fact that people who have higher striatal responses to gaming are more likely to become skilled at video games and that this may make it more rewarding for them.

“These findings, linking ventral striatum abnormalities to compulsive computer gaming in young people, are highly relevant to clinical practice as they further close the gap between this activity and other addictions, giving us a better understanding of possible long term treatment interventions,” said Henrietta Bowden Jones, a lecturer in neuroscience at Imperial College London, in a comment released in conjunction with the study.

But I’m left wondering where in the research the authors found the teens engaging in “compulsive” behavior. Indeed, this study may actually tell us more about the healthy experience of reward than it does about addiction. None of the teens imaged for these studies were addicted gamers; in order to be cleared to participate, they had to be psychologically healthy. If they had been having problems with their parents or grades, they would have been excluded.

It’s rather unsurprising, in fact, that people who enjoy videogames more would have greater activation in the pleasure-related regions of the brain while engaged in similar activities than those who are less into them. It’s also not especially shocking that those who care more about the outcome of a game have a stronger response to losses within it. While people tend to think of dopamine as “coding for” pleasure, in fact, some dopamine neurons respond to negative experiences like stress and fear.

Consequently, I wonder what would be seen in the striatum if researchers scanned top scientists, musicians, athletes or chess champions while engaged in a test of their skills. If our theories about the actions of dopamine and this region are at all correct, it would be rather astonishing if they didn’t find similar activity with such intense engagement in the experiences that particular people find most rewarding.

Would that mean that these high-level performers are “addicted” to their talent? Their friends and family who feel neglected because of their single-minded dedication to achievement might make that case — but most people, especially those who study addiction, wouldn’t buy it in all but the most extreme cases.

According to the most widely accepted definition, the one found in psychiatry’s DSM, addiction consists of compulsive activity despite negative consequences. It’s not simply pursuing pleasure or being obsessed by a drug or activity. If the consequences of the obsession are positive or neutral, the behavior does not meet the criteria that would define the condition as addiction.

As a result, if we want to understand addiction, studies like these can offer important insight into what goes on when the disorder is not present. However, if we see these striatum changes as representing addiction or possibly early signs of it, we may completely fail to find the relevant differences between addicts and others. The differences that matter have to do with being unable to stop, not enjoying a passion.

If we continue to pathologize video game use by assuming that it is simply a negative activity that must be addictive because adults think it’s a waste of time, we will fail to understand the difference between ordinary and problem gaming.  And continue to misunderstand addiction more generally, reducing our chances of effectively helping those who suffer from it.

The study was published in Translational Psychiatry.

Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.

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