Associations between levels of Internet Gaming Disorder symptoms and striatal morphology-replication and associations with social anxiety.

Background: Brain structural alterations of the striatum have been frequently observed in internet gaming disorder (IGD); however, the replicability of the results and the associations with social-affective dysregulations such as social anxiety remain to be determined. Methods: The present study combined a dimensional neuroimaging approach with both voxel-wise and data-driven multivariate approaches to (i) replicate our previous results on a negative association between IGD symptom load (assessed by the Internet Gaming Disorder Scale-Short Form) and striatal volume, (ii) extend these findings to female individuals, and (iii) employ multivariate and mediation models to determine common brain structural representations of IGD and social anxiety (assessed by the Liebowitz Social Anxiety Scale). Results: In line with the original study, the voxel-wise analyses revealed a negative association between IGD and volumes of the bilateral caudate. Going beyond the earlier study investigating only male participants, the present study demonstrates that the association in the right caudate was comparable in both the male and the female subsamples. Further examination using the multivariate approach revealed regionally different associations between IGD and social anxiety with striatal density representations in the dorsal striatum (caudate) and ventral striatum (nucleus accumbens). Higher levels of IGD were associated with higher social anxiety and the association was critically mediated by the multivariate neurostructural density variations of the striatum. Conclusions: Altered striatal volumes may represent a replicable and generalizable marker of IGD symptoms. However, exploratory multivariate analyses revealed more complex and regional specific associations between striatal density and IGD as well as social anxiety symptoms. Variations in both tendencies may share common structural brain representations, which mediate the association between increased IGD and social anxiety.