Inhibitory control in problematic usage of the internet: An ALE meta-analysis

Problematic Usage of the Internet (PUI) is often characterized by deficits in inhibitory control. The links between such deficits and altered brain activity, though, have been fragmented and mixed. Thus, we seek here to identify communal patterns of brain activation related to inhibitory control in individuals with PUI through a comprehensive quantitative synthesis. To this end, we performed a systematic search of PubMed and Web of Science databases (March 2, 2025). It captured cross-sectional studies that (1) investigated whole-brain activation differences between PUI individuals and healthy controls during inhibitory control tasks, and (2) reported peak coordinates of significant differences. Out of 742 potentially relevant studies, 23 (comprising 548 PUI individuals and 537 healthy controls) were eligible for our analysis. They were subjected to anatomical likelihood estimation (ALE) meta-analysis using extracted coordinates. Results suggest spatial convergence in the left middle frontal gyrus and the right superior parietal lobule. These brain regions mediate executive control and top-down regulation. We conclude that the observed increased activation in the left middle frontal gyrus and right superior parietal lobule during inhibitory control tasks is a neural pattern that is often associated with PUI. Neurotransmitter enrichment analysis revealed that this brain activation pattern in PUI individuals was negatively associated with 5-HTT distribution, implicating a potential involvement of serotonergic systems in inhibitory control alterations. Further investigations are needed to elucidate the nature of brain activation differences across various PUI subtypes, establishing causality, and generalizability to other samples.