Neural responses to kills/deaths in real MOBA games are associated with addiction-related psychological traits and subjective pleasant/unpleasant experiences.

Background and aims: Players of Multiplayer Online Battle Arena (MOBA) games are at a heightened risk of developing Internet Gaming Disorder (IGD). We aimed to investigate the neural responses triggered by kills and deaths during real MOBA gameplay and explore their association with addiction-related psychological traits and subjective pleasant or unpleasant experiences. Methods: We developed an experimental protocol to capture moments of kills and deaths during real MOBA gameplay. Game players who frequently play "Honor of Kings" or "League of Legends" on mobile phones for at least 12 months were recruited. All participants completed the IGD-20 assessment and played six matches while concurrently recording electroencephalography with a 64-channel setting. Results: Among males, the amplitude of P300 induced by kills and deaths showed a significant negative correlation with IGD-20 scores. Additionally, the post-death beta-band event-related synchronization (ERS) and theta-band event-related desynchronization (ERD) were significantly positively correlated with IGD-20 scores in males, while no significant correlation was found among females. The amplitude of P300 following deaths was significantly negatively correlated with subjective unpleasant experiences in males, yet positively correlated in females. Regardless of gender, the amplitude of post-kill P300 and beta-ERS were negatively correlated with pleasant experiences. Discussion and Conclusions: This study establishes an ecologically-embedded paradigm that successfully captures real-time neural signatures of valenced in-game events in MOBA games. We offer a novel methodological framework and theoretical perspective for investigating IGD and will inspire further research into the neural mechanisms underlying IGD in naturalistic gaming environments.