Internet gaming disorder (IGD) is characterized by addiction to online gaming and reduced executive control, particularly when individuals are exposed to gaming-related cues. Executive control can be measured as vagally mediated heart rate variability (HRV), which corresponds to variability in the time interval between heart beats. In this study, we investigated whether individuals with IGD have altered HRV while playing online games. We hypothesized that while gaming, individuals with IGD would exhibit phasic suppression of vagally mediated HRV, which would reflect executive control dysfunction during game play. To test this, we measured the changes of HRV when young males with IGD were engaged in real-time online gaming. The changes of HRV were associated with the severity of IGD assessed by self-reports and prefrontal gray matter volume (GMV) calculated by voxel-based morphometry. We included 23 IGD subjects and 18 controls in our analyses. Changes in HRV were not statistically different between IGD subjects and controls. Within the IGD group, however, subjects showed significant decreases in high-frequency (HF) HRV during gaming. Furthermore, the degree of decrease correlated with IGD severity and prefrontal GMV. Importantly, this phasic suppression of HF-HRV in response to gaming did not occur in control subjects. In conclusion, young males with IGD showed an altered HRV response while playing an online game, reflecting their difficulties in executive control over gaming. The dynamics between executive control and reward seeking may be out of balance during game play in IGD.
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