Mindfulness meditation reduces symptoms and modulates neural circuitry in comorbid internet gaming disorder and depression

Internet gaming disorder (IGD) frequently co-occurs with depression. IGD and depression have overlapping and distinct biological and psychological substrates. Mindfulness meditation (MM) has demonstrated efficacy in treating IGD and depression separately. However, its efficacy in treating concurrent IGD and depression and the possible brain mechanisms remain largely unknown. Seventy individuals with co-occurring IGD and depression were recruited. Fifty-nine (32 receiving MM and 27 receiving progressive muscle relaxation [PMR]) completed experimental procedures including pre- and posttests (cue-craving task) and eight-session MM or PMR. Behavioral and brain measures were compared using ANOVAs. Functional connectivity (FC) was assessed among survived brain regions to explore brain coupling changes associated with MM. Relative to the PMR, MM demonstrated decreased gaming and depression severity. MM was associated with decreased bilateral brain activations in the medial frontal gyrus (MFG) and parahippocampal gyrus (PHG) and increased brain activation in the left lentiform when facing gaming cues. Increased FC between the MFG and PHG, and decreased FC between the PHG and lentiform were observed following MM. PMR was associated with similar effects less robustly. MM could be an efficacious treatment strategy for individuals with co-occurring IGD and depression. MM was associated with decreased brain responses previously implicated in executive control and gaming craving and decreased coupling between regions implicated in reward processing.