Diminished Frontal Theta Activity During Gaming in Young Adults With Internet Gaming Disorder

Cognitive control is essential for flexible, top-down, goal-directed behavior. Individuals with Internet gaming disorder (IGD) are characterized by impaired prefrontal cortex function and cognitive control. This results in an increase in stimulus-driven habitual behavior, particularly related to pathological gaming. In the present study, we investigated the electroencephalographic (EEG) activity in individuals with IGD. Twenty-four individuals with IGD and 35 healthy control (HC) subjects were recruited. We analyzed their EEG activity while the subjects played their favorite game (30-40 min duration). We compared the band power between the two groups. During gaming, the left frontal theta, alpha, and beta band activities were lower in subjects with IGD than in HCs. Moreover, the left frontal theta power negatively correlated with IGD severity. These results indicate that left frontal theta power could be used as a neurophysiological biomarker for the detection of diminished cognitive control patterns in individuals with IGD.ope

Dopamine Transporter Density of the Basal Ganglia Assessed with [123I]IPT SPECT before and after Methylphenidate Treatment in Children with Attention Deficit Hyperactivity Disorder

Objectives : ADHD has been known as psychiatric disorder in childhood associated with dopamine dysregulation. The symptoms of ADHD can be treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). In present study, we investigated DAT density using I-123N-(3-iodopropen-2-yl)-2β-carbomethoxy-3beta-(4-chlorophenyl) tropane ([123I]IPT SPECT) in children with ADHD before and after treatment with methylphenidate. Methods : Seven drug-naive children with ADHD and eight normal children were included in the study and performed SPECT 2 hours after an intravenous administration of[123I]IPT. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate (0.7 mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. Results : Children with ADHD had a significantly greater increase of specific/nonspecific DAT binding ratio of right basal ganglia than normal children (Right : z=2.085, p=0.037 ; Left : z=1.506, p=0.132). Under treatment with methylphenidate in all children with ADHD, specific/nonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right : t=3.239, p=0.018 ; Left t=3.133, p=0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. Conclusions : The data of this study using methylphenidate in children with ADHD support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.ope

Emotional Instability and Harm Avoidance for Childhood Obesity are Related to the Motivation for Weight Loss: A Pilot Study in Korea

Objective: The aim of this study was to evaluate the relationship between such psychosocial variables as the emotional and characteristic factors, and the motivation for weight loss in children with obesity. Methods: Thirty-seven children (mean age: 9.4±1.2 years) between the ages of 7 and 12 who had entered a summer camp for childhood obesity and their parents participated in this study. A questionnaire on the eating habits and life style of the child, the Child Behavioral Checklist (CBCL), and the Child Character Inventory (CCI) were completed by the parents of the subjects. The obese children completed the Child Depression Inventory (CDI) and the Parental Bonding Instrument (PBI) by themselves. We evaluated the motivation of the obese children to lose weight by having them take the Weight Loss Readiness Test (WLRT). Then, we analyzed the correlation between the psychological variables and the WLRT items. Results: The emotional instability scale on the CBCL was correlated with the WLRT item of emotional eating (r=0.336, p=0.042). The harm avoidance scale of the CCI was negatively correlated with the WLRT item on exercise patterns and attitudes (r=-0.047, p=0.014). However, no significant correlation was found between each of the severity scores of the CDI depressive symptoms and the other psychological variables and each of the six WLRT items. Conclusion: Our findings suggest that emotional instability and harm avoidance, as measured by the CCI, are related to the motivation for weight loss in obese children.ope

The Effects of Fluoxetine on the Energy Level in Major Depressive Disorder : Multi-center Naturalistic Observational Study

Objective: A multi-center, open-labeled, prospective, observational study was conducted to evaluate the efficacy of fluoxetine on energy level over 8 weeks in a group of Korean patients with major depressive disorder. Methods: Of 635 (Ed- to avoid having to say "Six hundred?''') patients with major depressive disorder in 24 centers who were recruited to 8 weeks treatment with fluoxetine, 136 were terminated at initial session, leaving 499 patients to be included in the final analysis. They were predominantly female (59.5%), with a mean age of 45.7±15.9 years. At Three visits to the clinic (weeks 0, 4 and 8), a record was made of Retardation Factor score of Hamilton Rating Scale for Depression (HD-RF), Lack of Energy score of Symptom Check List-90R (SCLE), Energy score (QOL-E) and Fatigue score (QOL-F) of Quality of Life, and Visual Analogue Scale for Energy Level (VAS-E). Results : The average dose of fluoxetine was 18.5±6.8mg/day for the first 4 weeks and 25.3± 10.6 mg/day for the second 4 weeks. Of the patients, 85.4% in the first 4-week period and 86.8% in the second 4-week period took more than 85% of the prescribed medication. At least one of the concomitant anxiolytic drugs with fluoxetine was prescribed to 79.8% of the patients (alprazolam 47.9%, lorazepam 21.4%). The energy symptoms were significantly improved by fluoxetine over time, according to the analysis controlling the improvement of global depressive symptoms using repeated measures ANCOVA with the change of total HAM-D score as a covariate. Even comparing with the patients who took concomitant anti-anxiety medication, those who did not take concomitant anti-anxiety medication showed greater improvement of energy symptoms irrespective of the severity of baseline anxiety symptoms. Conclusion : These findings demonstrate that fluoxetine is effective in restoring the energy of patients with major depressive disorder. They also suggest that physicians should be careful in prescribing sedating antidepressants or concomitant anti-anxiety medication with fluoxetine for patients with major depressive disorder.ope

Acamprosate in Korean alcohol-dependent patients: a multi-centre, randomized, double-blind, placebo-controlled study

AIMS: A multi-centre, randomized, double-blind, placebo-controlled trial was conducted to evaluate the efficacy and the safety of acamprosate over 8 weeks in Korean alcohol-dependent patients. METHODS: One hundred and forty-two alcohol-dependent patients in 12 centres were randomized to 8 weeks treatment with either acamprosate (n = 72) or a placebo (n = 70) in combination with out-patient psychosocial intervention. They were predominantly male (95.8%), with a mean age of 44.3 +/- 8.3 years; 76.1% were married; 59.9% were employed; 58.5% had received previous alcoholism treatment (previous mean number of admissions in alcoholism in-patient programmes 4.6 +/- 6.9). At visits to the clinic (weekly for 4 weeks, then biweekly for 4 weeks), a record was made of alcohol use (Time-Line Follow-Back), alcohol craving using a Korean version of the Obsessive Compulsive Drinking Scale and a visual analogue scale, and adverse events. Serum aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase (GGT), blood urea nitrogen and creatinine levels were measured on weeks 0, 2, 4 and 8. RESULTS: In the acamprosate group (A), 71.4% had had alcohol within the 2 days prior to starting medication, against 65.2% of patients in the placebo group (P); (P > 0.05). One hundred and one subjects (71.1%) completed 8-weeks of treatment (A, 73.6%; P, 68.6%; P > 0.05). During the 8-week treatment period, 37, (A) (n = 72) and 32% (P) (n = 70) achieved continuous abstinence (P > 0.05), and 40, (A) and 39% (P) remained without relapse (P > 0.05) (defined as a day when a man consumed five or more drinks or a woman four or more drinks). The percentage of days abstinent during the 8-week treatment period was 81.2, (A) and 78.5% (P) (P > 0.05), and the percentage of days without heavy drinking 86.1 (A) and 84.9% (P) (P > 0.05). The mean amount drunk per drinking occasion was 7.2, (A) and 8.6 standard drinks (P) (P > 0.05). No statistically significant differences in changes in the serum GGT level or craving scores from baseline to the end-point of treatment were found between the two groups. Recency of drinking prior to commencing study drug predicted percentage of days abstinent in the first 2 weeks on treatment; however, when ANOVAs were conducted using treatment outcomes as a dependent variable, medication condition as an independent variable and the period of abstinence prior to treatment as a covariate, a significant effect of medication condition was still not seen. CONCLUSIONS: Acamprosate was ineffective in reducing drinking in this Korean sample. The result differs from that of most European acamprosate trials. This might be explained by our sample's relatively severe alcohol dependence, and low social support, or the fact that many patients were still drinking near to their first medication. The variability of the psychosocial support, ethnicity (which might also affect acamprosate pharmacokinetics) and the Korean drinking style, which differs from that of Europeans, might have contributed to our negative result.ope

Cerebral Functional Localization Related to Attentional Work in Patients with Attention-Deficit Hyperactivity Disorder

Objectives：The attentional deficit is a core symptom in attention deficit hyperactivity disorder. The major brain areas related to attention are frontal and parietal lobes. Abnormalities of frontal and parietal lobes in attention deficit hyperactivity disorder have been reported in previous researches. But, most of the researches are based on comparing patients and controls while they are in resting condition. Further research on funtional changes related to performance of attentional task is needed to understand the attentional dysfuntion in attention deficit hyperactivity disorder. In this study, the localized functional changes of the brains related to attentional task in patients with attention deficit hyperactivity disorder and the differences of them between patients and normal controls were examined. Also the effect of the methylphenidate on functional changes related to attentional task in patients with attention deficit hyperactivity disorder was examined. Method：Quantitative electroencephalography(QEEG) was applied to examine the fuctional changes related to attentional task. Subjects of this study consisted of 20 patients with attention deficit hyperactivity disorder and 20 controls who were matched age, sex, handedness, intelligence. QEEG was recorded on eye open resting condition, and on performing computerized attentional task. In cases of patients, after taking of methylphenidate, QEEG was recorded on both conditions. Results： 1) In attention test, normal controls had better scores in response time and variabilities of response time than those of patients with attention deficit hyperactivity disorder without taking methylphenidate. After taking medication, scores of omission, response time and variabilities of response time were significantly improved, comparing to scores without taking medication. No differences were recognized between the controls and patients with taking medication in scores of attention test. 2) In resting condition, spectral EEG revealed baseline activity levels of patients were significantly increased comparing to those of controls. 3) Analysis of delta wave revealed that amplitudes of controls were significantly elevated in parietooccipital area during performance of attentional task. But in patients, localized activated area related to attentional task was not remarkable. 4) Theta activity of controls were significantly elevated in right frontal, right temporal, and both parieto-occipital areas during performance of attentional task. But in patients without taking medication, localized activated area related to attentional work was not remarkable. After taking medication, right frontal, right temporal, and both parieto-occipital areas were significantly activated. 5) Alpha activities of controls were significantly increased in parieto-occipital area during performance of attentional task, but those of patients without taking medication were increased in broad area. 6) Beta activities of controls were significantly increased in frontal area during attentional performance, but those of patients without taking medication were significantly increased in most of the brain areas. After taking medication, significantly increased activities related to attentional task were recognized in left frontal, and both temporal areas. Localized activated patterns similar to those of controls were recognized. Conclusion：Based on the results of this research, it is suggested that patients with attention deficit hyperactivity disorder have increased baseline brain activity. In controls, brains showed localized response to a attentional stimuli, and functional changes related to attentional stimuli were recognized in frontal, and parieto-occipital areas. But, patients failed in showing appropriate localized activated response to attentional stimuli. It is concluded that frontal and parieto-occipital areas have some deficit responsible for the attentionalope

Altered Functional Connectivity of the Default Mode Network in Low-Empathy Subjects

Empathy is the ability to identify with or make a vicariously experience of another person's feelings or thoughts based on memory and/or self-referential mental simulation. The default mode network in particular is related to self-referential empathy. In order to elucidate the possible neural mechanisms underlying empathy, we investigated the functional connectivity of the default mode network in subjects from a general population. Resting state functional magnetic resonance imaging data were acquired from 19 low-empathy subjects and 18 medium-empathy subjects. An independent component analysis was used to identify the default mode network, and differences in functional connectivity strength were compared between the two groups. The low-empathy group showed lower functional connectivity of the medial prefrontal cortex and anterior cingulate cortex (Brodmann areas 9 and 32) within the default mode network, compared to the medium-empathy group. The results of the present study suggest that empathy is related to functional connectivity of the medial prefrontal cortex/anterior cingulate cortex within the default mode network. Functional decreases in connectivity among low-empathy subjects may reflect an impairment of self-referential mental simulation.ope

Use of Naltrexone in the Treatment of Alcohol Dependence

Two double-blind placebo controlled clinical trials have demonstrated that naltrexone, a pure opioid antagonist, appears to be an effective adjunct to treatment of alcohol dependence. Naltrexone alters endogenous opioids receptor activity, and its alteration blocks a positive reinforcing effect of alcohol in dopaminergic system. As a result, naltrexone reduces craving for alcohol and alcoholic high. Clinically, naltrexone, which is more compliant than disulfiram in alcoholics, results in fewer drinking days, less drinking amount and lower rate of relapse for alcoholic patients. Especially, those patients who initiatied drinking, patients who received naltrexone and concurrent coping skill/relapse prevention therapy are the least likely to relapse. In addition, a recommendation for morning dosing and the development of a pill taking routine are likely to increase the patients compliance with naltrexone and ultimately the outcome of their treatment for alcoholic dependence. In conclusion, the combined effects of naltrexone, psychosocial therapy and our patient support system need to be explored so that an optimal approach to the treatment of alcoholism, which is suitable for our own situation, should be developed.ope

Two Alcoholisms: Abuse And Dependence: Nosology issues from the Epidemiological studies of Alcoholism in Korea

This article, (1) reviews nosological issues of the distinction between alcohol abuse and alcohol dependence; (2) discusses the Korean epidemiological trends of alcohol abuse and alcohol dependence. Psychiatric epidemiological studies of Korean population that provided clues to the validity and cross-cultural applicability of alcohol abuse and alcohol dependence were reviewed. Alcohol use disorder has been the most common mental disorder in Korea. However, during the last 20 years, the prevalence rates of the two alcohol use disorders have grown in opposite directions. The lifetime prevalence rate of alcohol abuse has fallen from 12.06% to 7.11%, conversely, the lifetime prevalence rate of alcohol dependence has slightly increased from 9.92% to 10.20%. Nosological issues, such as the vulnerability of alcohol abuse to social environments, the hierarchical structure of the DSM-IV and the prevailing Korean concepts of abuse and dependence, were reviewed as factors to be considered in explaining these findings. Alcohol dependence outranks alcohol abuse and is now the main alcohol use disorder in Korea. But, there are still nosological issues that need to be assessed and considered, such as the validity of alcohol dependence in subpopulations and the heterogeneity of the DSM-IV alcohol dependence category.ope

Factors Affecting Stigma Resistance in Patients with Bipolar Disorder

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