Abstract
This study aims to explore alterations in cortical structure in young individuals with early Internet gaming disorder (IGD) and to provide novel insights for early detection and intervention of disease treatment. We investigated the brain structural magnetic resonance imaging data of 64 individuals with IGD and 47 healthy controls (HCs). The grey matter volume, cortical thickness, and cortical complexity of the two groups were compared separately, and the correlations between the brain regions with structural changes and clinical characteristics in IGD patients were analyzed. Compared to HCs, the IGD group showed no significant GMV differences. However, they exhibited a distinct pattern of right-hemisphere dominant cortical thickening in regions spanning the default mode, dorsal attention, and visual networks (e.g., superior frontal gyrus [SFG], posterior cingulate and lateral occipital gyrus), concurrent with reduced cortical complexity in prefrontal and occipito-parietal areas. Our study suggests that long-term game stimulation is consistent with adaptive resource reallocation. Adolescents with mild IGD demonstrate a unique thickening-complexity decoupling pattern, where cortical thickening in game-related networks coexists with reduced complexity while GMV remains stable. This pattern could reflect a compensatory neuroadaptation phase, highlighting both a critical window for early intervention and specific neural targets for future therapeutic strategies.