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The insula has been implicated in salience processing, craving, and interoception, all of which are critical to the clinical manifestations of drug and behavioral addiction. In this functional magnetic resonance imaging (fMRI) study, we examined resting-state functional connectivity (rsFC) of the insula and its association with Internet gaming characteristics in 74 young adults with Internet gaming disorder (IGD) and 41 age- and gender-matched healthy control subjects (HCs). In comparison with HCs, IGD subjects (IGDs) exhibited enhanced rsFC between the anterior insula and a network of regions including anterior cingulate cortex (ACC), putamen, angular gyrus, and precuneous, which are involved in salience, craving, self-monitoring, and attention. IGDs also demonstrated significantly stronger rsFC between the posterior insula and postcentral gyrus, precentral gyrus, supplemental motor area, and superior temporal gyrus (STG), which are involved in interoception, movement control, and auditory processing. Furthermore, IGD severity was positively associated with connectivity between the anterior insula and angular gyrus, and STG, and with connectivity between the posterior insula and STG. Duration of Internet gaming was positively associated with connectivity between the anterior insula and ACC. These findings highlight a key role of the insula in manifestation of the core symptoms of IGD and the importance to examine functional abnormalities of the anterior and posterior insula separately in IGDs. [ABSTRACT FROM AUTHOR]

Individuals with addictions often encounter environmental cues that may trigger repeated engagement in addictive behaviors despite adverse consequences. In substance use disorders, Pavlovian cues may influence instrumental behaviors (Pavlovian-to-instrumental transfer or PIT), and dominant habitual control that is insensitive to outcome values may serve as a foundational mechanism in addiction development. Although existing research suggests learning associations play important roles in internet gaming disorder (IGD), the contributions of PIT effects, habitual control, and connections with behavior remain largely uninvestigated. The present study sought to examine specific transfer effects of monetary cues, general transfer effects of gaming-related cues, and habitual control over instrumental behaviors as reflected in devaluation sensitivity, probing their interrelations and associations with gaming behaviors. Forty-five adults with IGD and 42 adults with recreational game use (RGU) at baseline performed a PIT task with a devaluation procedure. Participants reported gaming behavior and addiction severity at baseline and a four-month follow-up. Results demonstrated (1) a greater specific transfer effect in the IGD group compared to the RGU group; (2) positive correlations between specific and general transfer effects in both groups; (3) specific transfer effects of Go behavior in the IGD group positively correlating with habitual control, and No-Go behavior in the RGU group negatively correlating with habitual control; (4) transfer effects and habitual control relating prospectively to participants' gaming phenotypes at the four-month follow-up. These findings offer early evidence linking Pavlovian and instrumental associations to the development of IGD and suggest potential targets for prevention and intervention strategies. • Understanding cue-triggered biases and habitual control over instrumental behavior in IGD remains insufficient. • Adapted PIT task including specific PIT of monetary and general PIT of gaming cues components, and an outcome devaluation. • Compared with RGU, IGD showed a higher specific PIT effect, and similar general PIT effects and habit control. • The association between specific PIT effects and habit control was reversed between the two groups. • Transfer effects and habitual control were related to participants' gaming phenotypes at the four-month follow-up. [ABSTRACT FROM AUTHOR]