Both online and face-to-face mindfulness meditation can change cortical structure in internet gaming disorder.

Background: Mindfulness meditation (MM) has been shown to effectively alleviate symptoms of Internet Gaming Disorder (IGD) and improve neural functioning. However, it remains unclear whether both online and face-to-face MM can enhance cortical structure, a stable and reliable neural biomarker.

Methods: This study included 100 IGD patients randomly assigned to three groups: face-to-face MM (31 participants), online MM (38 participants), or progressive muscle relaxation (PMR) (31 participants). Pre- and post-assessments were conducted after 8 training sessions. Cortical area, volume, thickness, and local gyrification index (LGI) changes were analyzed using FreeSurfer, with group comparisons and seed-based structural covariance analysis.

Results: Both online and face-to-face MM significantly reduced IGD severity. Structural analysis revealed increased cortical thickness in the superior temporal gyrus (face-to-face + online vs. PMR: t = 4.725, p = 0.014). The face-to-face group also showed significant increases in LGI in the left superior temporal gyrus (t = 6.030, p < 0.001) and right insula (t = 3.792, p = 0.009). All results were correlated with reduced IGD severity. Structural covariance further revealed that MM (face-to-face + online) reduced the covariance between the right superior temporal gyrus and both the default mode and sensory networks.

Conclusion: Both online and face-to-face MM reduce IGD severity and enhance cortical structures, such as the superior temporal and the right insula, highlighting potential neuroanatomical targets for IGD treatment.