Neural Efficiency and Attentional Instability in Gaming Disorder: A Task-Based Occipital EEG and Machine Learning Study.

Gaming Disorder (GD) is becoming more widely acknowledged as a behavioral addiction characterized by impaired control and functional impairment. While resting-state impairments are well understood, the neurophysiological dynamics during active gameplay remain underexplored. This study identified task-based occipital EEG biomarkers of GD and assessed their diagnostic utility. Occipital EEG (O1/O2) data from 30 participants (15 with GD, 15 controls) collected during active mobile gaming were used in this study. Spectral, temporal, and nonlinear complexity features were extracted. Feature relevance was ranked using Random Forest, and classification performance was evaluated using Leave-One-Subject-Out (LOSO) cross-validation to ensure subject-independent generalization across five models (Random Forest, KNN, SVM, Decision Tree, ANN). The GD group exhibited paradoxical "spectral slowing" during gameplay, characterized by increased Delta/Theta power and decreased Beta activity relative to controls. Beta variability was identified as a key biomarker, reflecting altered attentional stability, while elevated Alpha power suggested potential neural habituation or sensory gating. The Decision Tree classifier emerged as the most robust model, achieving a classification accuracy of 80.0%. Results suggest distinct neurophysiological patterns in GD, where increased low-frequency power may reflect automatized processing or "Neural Efficiency" despite active task engagement. These findings highlight the potential of occipital biomarkers as accessible and objective screening metrics for Gaming Disorder.