Neurophysiological and Behavioral Responses to Gambling Cues in Individuals with Internet Gambling Disorder: A VR-EEG-GSR Study

Background: Internet Gambling Disorder (IGD) has become an important public health concern, yet relatively little is known about the combined neural, autonomic, and behavioral mechanisms underlying cue reactivity in immersive gambling environments. This study investigated whether individuals with IGD demonstrate altered neurophysiological and psychophysiological responses during a virtual reality (VR) gambling task. Methods: Fifty-seven adults, including 28 participants meeting diagnostic criteria for IGD and 29 healthy controls, completed a standardized VR casino paradigm incorporating predetermined win, loss, and near-miss events. Electroencephalography (EEG), galvanic skin response (GSR), behavioral performance, and post-task craving were assessed simultaneously. Results: Compared with healthy controls, the IGD group demonstrated significantly greater P300 amplitudes during win trials and enhanced late positive potential (LPP) responses following near-miss outcomes, indicating increased attentional allocation and sustained emotional processing of gambling-related cues. Skin conductance responses were also significantly higher in response to near-miss events, whereas overall skin conductance level and reaction time did not differ significantly between groups. Participants with IGD additionally exhibited greater engagement during the VR task and reported substantially higher craving following exposure to the gambling environment. Conclusion: These findings indicate that immersive VR combined with EEG and autonomic recordings provides a sensitive framework for detecting cue-reactivity associated with IGD. Although the findings should be interpreted in light of the relatively modest sample size and the use of a predominantly male sample, they suggest that immersive VR combined with EEG and autonomic recordings provides a sensitive framework for investigating cue reactivity associated with Internet Gambling Disorder. Integrating behavioral, physiological, and neural measures may improve understanding of the mechanisms underlying problematic gambling and inform future research on objective assessment strategies and intervention development.