The Internet has grown considerably in the last twenty years, and as a result, cases of excessive iinterney use have emerged. These cases, which have clinical similarities with substance addiction, involve the various activities related to the Internet (online gambling, discussion forums, online networking, e-mail, pornography, shopping, etc.). However, to date, only the pathological use of Internet gaming (PUIG) is referenced in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, section III).
In PUIG, an individual loses control when gambling online. He/she typically spends 8 to 10 hours on this activity, sometimes without eating or sleeping. Usual obligations, such as school or work, or family obligations are neglected. PUIG can cause great psychological and social suffering. Neurological complications (epilepsy) and deaths (cardiac arrest) related to PUIG have also been reported. These situations are all the more dramatic because they often affect adolescents and young adults. In Asia, PUIG has become a public health problem. To date, no treatment has been validated for this disorder.
Non-invasive brain stimulation (NIBS) techniques can modulate neural activity in the dorsolateral prefrontal cortex (DLPFC). This modulation makes it possible to reduce addictive behaviours through different mechanisms (reduction of craving, impulsivity, and decision-making disorders). These techniques could be effective for PUIG.
Patient aged ≥ 12 years old
Patient and/or parents who have given oral consent
Patient with PUIG (DSM-5 criteria)
Patient that is motivated and willing to reduce or stop internet gaming
a person who is not affiliated to or not a beneficiary of a social security scheme
Patient with severe chronic psychiatric comorbidity (schizophrenia, paranoia, chronic hallucinatory psychosis) and bipolar disorder types I and II
Patient with a gambling addiction
Patient who has had a recent change (< 1 month) in the prescription of psychotropic treatment
Parallel
Active tDCS
Deviceactive D.C. transcranial stimulation (delivers a low current (1 to 2 mA)) for 10 to 30 minutes, during 5 sessions
Placebo tDCS
Deviceinactive DC transcranial stimulation (delivering a non-significant current at the beginning and end of the stimulation, simulating active stimulation) for 10 to 30 minutes, during 5 sessions
Questionnaires
Other intervention* visual analogue scale (VAS) * impulsivity scale: Barratt Impulsiveness Scale - version 11 (BIS-11) * Decision-making scales: Iowa Gambling Task (IGT) and Balloon Analogue Risk Task (BART) * Go-No go test * HAM-D scale * SF-12 quality of life scale
Evolution of scores on the IAT scale (Internet Addiction Test)
Evolution of scores on the IAT (Internet Addiction Test) scale 4 weeks after treatment with tDCS (5 sessions) compared to the 4 weeks preceding brain stimulation
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