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Front Psychiatry. 2018 Sep 11;9:429. doi: 10.3389/fpsyt.2018.00429. eCollection 2018.

Altered Heart Rate Variability During Gameplay in Internet Gaming Disorder: The Impact of Situations During the Game.

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Biomedical Engineering, Hanyang University, Seoul, South Korea.
Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, South Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Psychiatry, Yonsei University College of Medicine, Seoul, South Korea.
Psychiatry, Eunpyeong Hospital, Seoul, South Korea.


Internet gaming disorder (IGD) is characterized by a loss of control over gaming and a decline in psychosocial functioning derived from excessive gameplay. We hypothesized that individuals with IGD would show different autonomic nervous system (ANS) responses to the games than those without IGD. In this study, heart rate variability (HRV) was assessed in 21 young males with IGD and 27 healthy controls while playing their favorite Internet game. The subjects could examine the game logs to identify the most and least concentrated periods of the game. The changes in HRV during specific 5-min periods of the game (first, last, and high- and low-attention) were compared between groups via a repeated measures analysis of variance. Significant predictors of HRV patterns during gameplay were determined from stepwise multiple linear regression analyses. Subjects with IGD showed a significant difference from controls in the patterns of vagally mediated HRV, such that they showed significant reductions in high-frequency HRV, particularly during the periods of high attention and the last 5 min, compared with baseline values. A regression analysis showed that the IGD symptom scale score was a significant predictor of this reduction. These results suggest that an altered HRV response to specific gaming situations is related to addictive patterns of gaming and may reflect the diminished executive control of individuals with IGD while playing Internet games.


addiction; autonomic nervous system; gameplay; heart rate variability; internet gaming disorder

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