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Yang X, Song Y, Liu W, Huang Y, Jia T, Liu J, Lu L, Sun Y, Shi J. Efficacy and mechanisms of repeated closed-loop auditory exposure during slow-wave sleep for internet gaming disorder. Mol Psychiatry 2025:10.1038/s41380-025-02995-1. [PMID: 40425853 DOI: 10.1038/s41380-025-02995-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 02/25/2025] [Accepted: 03/26/2025] [Indexed: 05/29/2025]
Abstract
Internet Gaming Disorder (IGD) is marked by impaired psychological and social functioning but remains without effective treatments. Cue exposure therapy (CET) is typically administered during wakefulness to help extinguish addictive memories. However, recent studies suggest that sleep may be an optimal state for memory modulation. This study aimed to assess the efficacy of repeated closed-loop exposure to game sounds during UP-state of slow-wave sleep (SWS) on IGD. 84 participants meeting DSM-5 criteria for IGD were randomly assigned to sleep intervention/control groups (SIG/SCG) or awake intervention/control groups (AIG/ACG) with two consecutive days of intervention. During SWS of two intervention nights, around 300 sounds were exposed at slow-wave UP-state. While the awake groups received similar auditory cue exposure during the awake state for two consecutive days. Cravings, playtime, and P300 amplitude in the cue reactivity task were recorded at baseline, post-intervention, and follow-up intervals (1, 2, 3, weeks, and 1 month). Results showed that the SIG significantly reduced cravings (p < 0.001), and playtime (p = 0.009) at post-intervention and follow-up, whereas awake CET showed no effect. The SIG exhibited higher low-frequency and early spindle power, along with lower late spindle power after sound exposure. Notably, the linear increase in sound-elicited late spindle power across the 20 intervention blocks over two experiment nights was positively correlated with reduced cravings post-intervention (r = 0.54, p = 0.015), especially among participants achieving a craving reduction greater than 30% after one month. Our findings suggest that closed-loop auditory exposure during SWS presents a promising, non-invasive intervention strategy for treating IGD, potentially exerting its effects by modulating late spindle power.
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Affiliation(s)
- Xiaoqin Yang
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China
| | - Yixuan Song
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China
| | - Wangyue Liu
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China
| | - Yuchen Huang
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China
| | - Tianye Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Jianfeng Liu
- College of Life Sciences and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Key of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking-Tsinghua Center for Life Sciences and International Data Group/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yan Sun
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China.
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China.
| | - Jie Shi
- Department of Neurobiology, School of Basic Medical Sciences, National Institute on Drug Dependence, Peking University, Beijing, China.
- Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing, China.
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Johnson MK. Reflecting on the Origins of Subjective Experience. Annu Rev Psychol 2025; 76:1-28. [PMID: 39348520 DOI: 10.1146/annurev-psych-062424-112106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
The capacity to change with experience infuses our perceptions, thoughts, and actions in and about the past, present, and future. The cognitive system supporting this capacity for change can be exquisitely responsive to external events and yet can influence how those external events affect us. This interplay between the external and internal has been a major theme of my lab group's research. We proposed that the fundamental ambiguity of subjective experience requires ongoing reality monitoring processes for evaluating its veridicality and proposed a source monitoring framework for exploring the encoding, activation, and evaluation of information. We further proposed a functional architecture, a multiple-entry modular memory system, that characterizes component subprocesses of cognition that give rise to remembering and other subjective phenomena (e.g., knowledge, beliefs, emotion, consciousness, self). I first discuss these approaches and some issues they address and then describe some educational and professional experiences that provided opportunities to investigate this fascinating epistemological puzzle.
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Affiliation(s)
- Marcia K Johnson
- Department of Psychology, Yale University, New Haven, Connecticut, USA;
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Cairney SA, Horner AJ. Forgetting unwanted memories in sleep. Trends Cogn Sci 2024; 28:881-883. [PMID: 39168759 DOI: 10.1016/j.tics.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024]
Abstract
Memories are sometimes best forgotten, but how do our brains weaken unwanted details of the past? We propose a theoretical framework in which memory reactivation during sleep supports adaptive forgetting. This mnemonic rebalancing underpins the affective benefits of sleep by ensuring that our memories remain aligned with our emotional goals.
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Affiliation(s)
- Scott A Cairney
- Department of Psychology, University of York, York YO10 5DD, UK; York Biomedical Research Institute, University of York, York YO10 5DD, UK.
| | - Aidan J Horner
- Department of Psychology, University of York, York YO10 5DD, UK; York Biomedical Research Institute, University of York, York YO10 5DD, UK
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Paller KA. Recurring memory reactivation: The offline component of learning. Neuropsychologia 2024; 196:108840. [PMID: 38417546 PMCID: PMC10981210 DOI: 10.1016/j.neuropsychologia.2024.108840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/19/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
One can be aware of the effort needed to memorize a new fact or to recall the name of a new acquaintance. Because of experiences like this, learning can seem to have only two components, encoding information and, after some delay, retrieving information. To the contrary, learning entails additional, intervening steps that sometimes are hidden from the learner. For firmly acquiring fact and event knowledge in particular, learners are generally not cognizant of the necessity of offline consolidation. The memories that persist to be available reliably at a later time, according to the present conceptualization, are the ones we repeatedly rehearse and integrate with other knowledge, whether we do this intentionally or unknowingly, awake or asleep. This article examines the notion that learning is not a function of waking brain activity alone. What happens in the brain while we sleep also impacts memory storage, and consequently is a critical component of learning. The idea that memories can change over time and become enduring has long been present in memory research and is foundational for the concept of memory consolidation. Nevertheless, the notion that memory consolidation happens during sleep faced much resistance before eventually being firmly established. Research is still needed to elucidate the operation and repercussions of repeated reactivation during sleep. Comprehensively understanding how offline memory reactivation contributes to learning is vital for both theoretical and practical considerations.
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Affiliation(s)
- Ken A Paller
- Northwestern University, Department of Psychology, Evanston, IL, 60208, USA.
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