- A high-risk subgroup can be identified before IGD onset:
Individuals without IGD at baseline showed markedly different 2-year conversion rates (~24% vs ~7%), suggesting potential for early risk stratification. - Impulsivity alone is insufficient—brain-behavior integration matters:
Combining impulsivity measures with functional connectivity outperformed either alone in predicting IGD severity and risk. - Imbalance between control and impulsive systems is central:
High-risk individuals showed reduced orbitofrontal (top-down control) and increased occipital (impulsive/visual cue-related) connectivity, consistent with dual-process models of addiction. - Specific circuits may underlie progression to IGD:
Orbitofrontal–insula and precentral–occipital connectivity partially mediated the link between impulsivity and later IGD severity, suggesting potential neurobiological targets. - Clinical application remains preliminary:
Findings require validation; limitations include modest sample sizes, limited follow-up time points, and lack of detailed behavioral exposure data.
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