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Previous studies have demonstrated beneficial effects of transcranial direct current stimulation (tDCS) on various kinds of addiction. This study investigated the effects of tDCS on addictive behavior and regional cerebral metabolic rate of glucose (rCMRglu) in problematic online gamers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Problematic online gamers were randomized and received 12 sessions of either active (<jats:italic>n<\/jats:italic> = 13) or sham tDCS (<jats:italic>n<\/jats:italic> = 13) to the dorsolateral prefrontal cortex over 4 weeks (anode F3\/cathode F4, 2 mA for 30 min, 3 sessions per week). Participants underwent brain <jats:sup>18<\/jats:sup>F-fluoro-2-deoxyglucose positron emission tomography scans and completed questionnaires including the Internet Addiction Test (IAT), Brief Self-Control Scale (BSCS), and Behavioral Inhibition System\/Behavioral Activation System scales (BIS\/BAS) at the baseline and 4-week follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant decreases in time spent on gaming (<jats:italic>P<\/jats:italic> = 0.005), BIS (<jats:italic>P<\/jats:italic> = 0.03), BAS-fun seeking (<jats:italic>P<\/jats:italic> = 0.04), and BAS-reward responsiveness (<jats:italic>P<\/jats:italic> = 0.01), and increases in BSCS (<jats:italic>P<\/jats:italic> = 0.03) were found in the active tDCS group, while decreases in IAT were shown in both groups (<jats:italic>P<\/jats:italic> &lt; 0.001). Group-by-time interaction effects were not significant for these measures. Increases in BSCS scores were correlated with decreases in IAT scores in the active group (<jats:italic>\u03b2<\/jats:italic> = \u22120.85, <jats:italic>P<\/jats:italic> &lt; 0.001). rCMRglu in the left putamen, pallidum, and insula was increased in the active group compared to the sham group (<jats:italic>P<\/jats:italic> for interaction &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and conclusions<\/jats:title><jats:p>tDCS may be beneficial for problematic online gaming potentially through changes in self-control, motivation, and striatal\/insular metabolism. Further larger studies with longer follow-up period are warranted to confirm our findings.<\/jats:p><\/jats:sec>","DOI":"10.1556\/2006.2020.00092","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T18:25:36Z","timestamp":1612290336000},"page":"1011-1021","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":20,"title":["Effects of transcranial direct current stimulation on addictive behavior and brain glucose metabolism in problematic online gamers"],"prefix":"10.1556","volume":"9","author":[{"given":"Hyeonseok","family":"Jeong","sequence":"first","affiliation":[{"name":"1Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea"},{"name":"2Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Kyoung","family":"Oh","sequence":"additional","affiliation":[{"name":"1Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Kyoung","family":"Choi","sequence":"additional","affiliation":[{"name":"1Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jooyeon Jamie","family":"Im","sequence":"additional","affiliation":[{"name":"1Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujung","family":"Yoon","sequence":"additional","affiliation":[{"name":"3Department of Brain and Cognitive Sciences and Ewha Brain Institute, Ewha Womans University, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Knotkova","sequence":"additional","affiliation":[{"name":"4MJHS Institute for Innovation in Palliative Care, New York, NY, USA"},{"name":"5Department of Family and Social Medicine, Albert Einstein College of Medicine, The Bronx, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marom","family":"Bikson","sequence":"additional","affiliation":[{"name":"6Department of Biomedical Engineering, The City College of New York, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Uk","family":"Song","sequence":"additional","affiliation":[{"name":"7Department of Neurology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South 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