Dopaminergic Mechanisms in Video Gaming Addiction: Implications for Behavioral Addictions

By: Saida Eazizayene

Video gaming differs from many other forms of addiction because it is primarily considered a behavioral addiction rather than one involving a substance or ingestible agent. While gaming can be enjoyable and entertaining, it is an activity in which individuals may voluntarily engage for extended periods. There remains ongoing debate regarding whether excessive video gaming should be classified as an addiction. This debate highlights the importance of empirical research in determining whether problematic gaming produces behavioral and neurobiological patterns comparable to those observed in substance-related addictions (Spekman et al., 2013).

Emerging neuroscientific evidence suggests that video gaming may influence the brain in ways similar to traditional substances of abuse, with notable parallels between the psychological effects of gaming and drug use (Zastrow, 2017). At the same time, concerns persist that labeling individuals particularly adolescents as “addicted” may pathologize normative behavior and contribute to overly broad interpretations of other compulsive activities, such as those related to eating or sexuality.

Research by Spekman et al. (2013) demonstrated that problematic gaming behaviors and associated physical symptoms were positively correlated with three substance-abuse–related personality scales on the MMPI-2. These findings suggest that individuals with problematic gaming patterns may exhibit personality characteristics similar to those observed in substance addictions. Video game addiction may therefore be conceptualized as persistent and repetitive engagement in online gaming, often involving multiplayer interaction, that leads to functional impairment across multiple life domains. With technological advances increasing access to gaming across devices, the prevalence of problematic gaming behaviors has risen, positioning video game addiction as an emerging public health concern (Mohammad et al., 2023).

Ma et al. (2024) conducted a multi-method investigation examining the dissociation between wanting and liking, as well as dopaminergic functioning, in individuals with Internet Gaming Disorder (IGD). Study 1 employed a behavioral Implicit Association Test (IAT) to assess implicit motivation (“wanting”) and enjoyment (“liking”) responses to gaming cues among individuals with IGD (n = 39) and recreational gamers (n = 35). Results indicated that participants with IGD demonstrated significantly greater wanting than liking, with the magnitude of this dissociation positively correlated with IGD severity.

Study 2 utilized functional magnetic resonance imaging (fMRI) to examine connectivity within neural circuits associated with wanting and liking during cue exposure among individuals with IGD (n = 65), tobacco use disorder (TUD; n = 31), and healthy controls (n = 71). Both IGD and TUD groups exhibited stronger connectivity within wanting-related circuits compared with healthy controls, and connectivity strength was associated with disorder severity.

Study 3 employed neuromelanin-sensitive MRI (NM-MRI) to assess dopaminergic integrity in individuals with IGD (n = 16), TUD (n = 14), and healthy controls (n = 30). Higher neuromelanin signals were observed in both clinical groups, suggesting altered dopaminergic functioning. Across all studies, behavioral and neural data were analyzed using group comparisons, one-way ANOVAs, and correlational analyses, providing converging evidence that IGD shares dopaminergic and motivational features with substance-related addictions.

Ma et al. (2024) found that individuals with IGD exhibited a greater dissociation between wanting and liking compared with recreational gamers, and that this dissociation increased with disorder severity. Neuroimaging findings revealed that both IGD and TUD groups showed enhanced connectivity within wanting-related neural circuits relative to healthy controls. These results suggest that as addiction severity increases, motivational drive intensifies while hedonic enjoyment remains relatively stable, consistent with incentive-sensitization theory.

NM-MRI findings demonstrated higher neuromelanin signal intensity within the substantia nigra of individuals with IGD and TUD compared with controls, indicating altered dopaminergic function. Correlations between neuromelanin signal intensity and addiction severity were robust for TUD and trended in the same direction for IGD. Although the study primarily focused on dopamine—using neuromelanin as a proxy—the authors noted that noradrenergic systems may also contribute to these effects, though dopamine appears central to the observed mechanisms.

The findings of Ma et al. (2024) demonstrate a clear wanting–liking dissociation in individuals with Internet Gaming Disorder, characterized by heightened craving for gaming cues despite unchanged levels of enjoyment. This pattern mirrors neurobehavioral processes observed in substance-related addictions and aligns with incentive-sensitization theory, which proposes that dopamine-mediated motivational systems become sensitized over time while hedonic responses remain stable.

By integrating behavioral measures with advanced neuroimaging techniques, including NM-MRI, the study provides evidence of altered dopaminergic functioning in IGD that parallels findings in tobacco use disorder. These results suggest that behavioral addictions such as IGD share core neurobiological features with substance-related addictions, particularly within dopamine-mediated reward and motivational salience pathways. Collectively, these findings support the conceptualization of IGD as a disorder involving altered incentive processing rather than excessive pleasure alone.

correlated with IGD severity. Neuroimaging results using fMRI indicated that both IGD and tobacco use disorder (TUD) groups showed stronger connectivity in wanting-related circuits than healthy controls, with correlations suggesting that as disorder severity increased, wanting intensified while liking remained unchanged, consistent with incentive-sensitization theory. Dopaminergic measures using neuromelanin-sensitive MRI revealed higher neuromelanin signals in the substantia nigra of IGD and TUD participants relative to controls, indicating altered dopaminergic function. Correlations between signal intensity and severity were robust for TUD and trending for IGD. The study focused primarily on dopamine, using neuromelanin as a proxy for dopaminergic changes, and did not directly measure other neurotransmitters; however, the authors note that noradrenergic neurons may also be involved, though dopamine is emphasized as central to the observed effects.

The study observed a wanting–liking dissociation in individuals with Internet Gaming Disorder (IGD), showing stronger craving (wanting) for gaming cues relative to the actual enjoyment (liking) of gaming, a pattern similar to that seen in established addictions. This finding aligns with incentive-sensitization theory, which proposes that in addiction, dopamine-linked motivational systems become sensitized while hedonic responses remain unchanged, driving compulsive behavior. Using neuromelanin-sensitive MRI (NM-MRI) to assess dopaminergic neuronal integrity, the study found altered dopamine system functioning in both IGD and tobacco use disorder (TUD) compared with healthy controls. Overall, these results suggest that IGD shares core neurobiological features with substance-related addictions, particularly in dopamine-mediated reward processing and motivational salience (wanting) pathways.

References

Ma, X., Wang, M., Zhou, W.-R., Zhang, Z., NI, H., JIANG, A., Zheng, Y., Du, X., Potenza, M. N., & Dong, G.-H. (2024). Wanting-liking dissociation and altered dopaminergic functioning: Similarities between internet gaming disorder and tobacco use disorder. Journal of Behavioral Addictions, 13(2), 596–609. https://doi.org/10.1556/2006.2024.00011

Mohammad, S., Jan, R. A., & Alsaedi, S. L. (2023). Symptoms, Mechanisms, and Treatments of Video Game Addiction. Curēus (Palo Alto, CA), 15(3), e36957. https://doi.org/10.7759/cureus.36957

Spekman, M. L. C., Konijn, E. A., Roelofsma, P. H. M. P., & Griffiths, M. D. (2013). Gaming addiction, definition and measurement: A large-scale empirical study. Computers in Human Behavior, 29(6), 2150–2155. https://doi.org/10.1016/j.chb.2013.05.015 

Zastrow, M. (2017). Is video game addiction really an addiction?: Adding video gaming to the list of recognized behavioral addictions could help millions in need. It could also pathologize a normal behavior and create a new stigma. Proceedings of the National Academy of Sciences - PNAS, 114(17), 4268–4272