Human Behavior and Emerging Technologies - 2024 - Anbumalar - Brain and Smartphone Addiction A Systematic Review

Prévia do material em texto

Review Article
Brain and Smartphone Addiction: A Systematic Review
C. Anbumalar and D. Binu Sahayam
School of Social Sciences and Languages, Vellore Institute of Technology, Chennai, India
Correspondence should be addressed to D. Binu Sahayam; binusahayam.d@vit.ac.in
Received 21 July 2023; Revised 28 November 2023; Accepted 8 December 2023; Published 6 January 2024
Academic Editor: Pinaki Chakraborty
Copyright © 2024 C. Anbumalar and D. Binu Sahayam. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
In recent years, the smartphone has become ubiquitous in everyone’s lives. The smartphone has both positive and negative
impacts on the users. Although addiction has been extensively studied, not much has been done to examine the association
between neurofunctional regional activation and problematic smartphone use. This review, therefore, is systematically aimed at
understanding the different neurofunctional regional activation differences related to smartphone addiction. The systematic
review was done in four stages as follows: (1) identifying the techniques/instruments used in the literature (database search),
(2) identifying relevant literature, (3) identifying criteria for inclusion and exclusion, and (4) acquiring full-text papers. The
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct the
systematic review. The literature was searched using the following databases: PubMed, Science Direct, Taylor & Francis, and
Springer Link. The inclusion requirements were met by 7 articles out of 28896. The study on smartphone addiction with a
focus on neurofunctional regional activation is limited. This review sheds light on neurofunctional regional activation
associated with problematic smartphone usage. This will open the door to focused interventions and well-informed approaches
to digital well-being in our technologically advanced society.
1. Introduction
In the contemporary digital landscape, the increased use of
smartphones has spread around the world and permeated
every aspect of everyday life. The ubiquity of smartphones
has transformed the way individuals interact with informa-
tion, socialize, and navigate daily routines.
According to Derevensky et al. [1], problematic mobile
phone use (PMPU) is also known as smartphone addiction,
mobile phone dependence, and mobile phone addiction.
Therefore, problematic mobile phone use and smartphone
addiction were used interchangeably in this review.
The extensive use of smartphones has raised concerns
about potential behavioral addictions, with smartphone
addiction emerging as a recognized and growing issue. Over-
use of smartphones has been linked to a few health issues,
including mental and medical conditions. According to
Wacks and Weinstein [2], medical issues include poor eating
habits, pain, headaches, decreased physical fitness, and diffi-
culty sleeping. Addiction to smartphones has been linked to
anxiety and depression [3]. Additionally, studies have linked
it to increased impulsivity, indications of alcohol use disor-
der, and psychological discomfort mediated by emotional
dysregulation [4, 5].
Understanding the cognitive effects of our digitally
linked lifestyles has grown increasingly dependent on
research into the neurofunctional regional activation varia-
tions associated with smartphone usage and the growing
issue of smartphone addiction. Neurofunctional regional
activation refers to the observable and measurable patterns
of activity within specific regions of the brain during various
cognitive tasks, stimuli, or conditions [6]. The neurofunc-
tional regional activation framework provides a means to
explore how the brain responds to the stimuli of smartphone
use, shedding light on the potential neural correlates of
addictive behaviors.
The advances in neuroimaging methods have made it
possible for scientists to investigate the neurofunctional
regional activation patterns linked to cognitive tasks and
stimuli. Examples of these methods include electroencepha-
lography (EEG) and functional magnetic resonance imaging
(fMRI) [7, 8].
Hindawi
Human Behavior and Emerging Technologies
Volume 2024, Article ID 5592994, 6 pages
https://doi.org/10.1155/2024/5592994
https://orcid.org/0000-0001-8434-2240
https://orcid.org/0000-0002-4233-6296
https://creativecommons.org/licenses/by/4.0/
https://creativecommons.org/licenses/by/4.0/
https://creativecommons.org/licenses/by/4.0/
https://creativecommons.org/licenses/by/4.0/
https://doi.org/10.1155/2024/5592994
http://crossmark.crossref.org/dialog/?doi=10.1155%2F2024%2F5592994&domain=pdf&date_stamp=2024-01-06
With the use of these techniques, researchers observe
and measure patterns of neural activity associated with spe-
cific tasks, behaviors, or cognitive processes. Understanding
functional changes is important for investigating the impact
of experiences, learning, and environmental influences on
the brain, as well as for comprehending the underlying pro-
cesses of many neurological and psychiatric diseases. They
contribute to a thorough understanding of neurobiology by
shedding light on how the brain interprets information, con-
trols behavior, and adjusts to various situations.
Neuroimaging studies in this realm identify specific
brain regions involved in reward processing, executive func-
tions, and cognitive control, elucidating the impact of pro-
longed smartphone engagement on these crucial cognitive
processes. This comprehensive review is aimed at compiling
scientific information about neurofunctional regional activa-
tion associated with problematic smartphone use.
2. Methods and Search Strategy
This review followed the PRISMA guidelines [9]. The litera-
ture was retrieved by the researcher using well-known data-
base sources such as PubMed, Science Direct, Taylor &
Francis, and Springer link citations and references, from Jan-
uary 2012 to March 2023. The study contained bibliograph-
ical lists of all brain studies connected to smartphone use,
with the search process limited to articles published in the
English language.
The search for pertinent literature started on April 1,
2023. Each database was searched by title or abstract. The fol-
lowing combination of terms and keywords were used in the
search: “Smartphone addiction” or “Mobile Phone Addiction
or “Mobile Phone Addiction Tendency” or “Smartphone
Overuse or “Problematic Smartphone Use” or “Excessive
Mobile Phone” or “Brain” or “Brain Structure” or “Brain
Function”.
2.1. Eligibility Criteria. In this review, the PRISMA statement
was closely followed to establish the standards to obtain,
include, screen, and exclude the documents. The following
qualifications were to be eligible for the studies that were being
evaluated. The following components must be included in the
research: (1) smartphone addiction/problematic smartphone
use, (2) smartphone addiction and different neurofunctional
regional activations, and (3) English only. The following
exclusion criteria were considered: (1) documents that have
been previously published, (2) meta-analyses and reviews of
the literature, (3) articles that contain an abstract but no full
text, and (4) publications with incomplete or erroneous
outcome data.
2.2. Data Extraction. The researcher conducted a literature
search and gathered pertinent information. After screening,
data extraction, cross-checking, and analysis, the final
decision on the articles was made by the researcher. The
following general information was gathered: (1) author, title,
and year of publication and (2) papers discussing various
neurofunctional regional activations linked to problematic
smartphone use.
3. Results
Figure 1 shows the search results. There were a total of
28896 records found. Following the elimination of duplicates
and applying the inclusion and exclusion criteria, 228
articles weresought for retrieval, with 45 full-text articles
obtained and examined. To find eligible research, the refer-
ences, citations, and quality of the included papers were
examined, yielding 39 more papers. The review included 7
papers that satisfied the requirements (Table 1).
The advancements in neuroimaging techniques have led
to a growing body of research on the changes in brain struc-
ture and function associated with addictive behaviors. Con-
sidering a few previous studies, Li et al.’s [11] functional
near-infrared spectroscopy study demonstrated that smart-
phone addiction influences creative cognition (i.e., the ability
to transcend semantic restrictions). The study revealed that
the prefrontal brain and temporal areas of smartphone
addiction tendency participants were less active during the
Alternate Uses Task (AUT) than the healthy control group.
Wu et al. [12] conducted a longitudinal study that employed
intrinsic functional connectivity (iFC) analysis (based on the
observation that activity levels in distant brain regions often
exhibit strong connections by [13]). The results revealed that
the group with problematic mobile phone use had higher
levels of left inferior frontal gyrus (IFG), left occipital gyrus
(OcG), right orbital gyrus (OrG), left OcG and left parahip-
pocampal gyrus (PhG), and right middle temporal gyrus
(MTG). The left PhG and right MTG are crucial in the link
between problematic smartphone use and depression. These
brain regions are of particular interest due to their known
involvement in memory, emotional processing, and other
cognitive functions. By investigating the moderating role of
specific brain connectivity patterns, the study provides a
nuanced understanding of the complex interplay between
PMPU and depressive symptoms. Problematic smartphone
use (PSU) has a negative correlation with grey matter vol-
ume (GMV) of the right fusiform gyrus and anterior cingu-
late gyrus inversely correlated with fractional anisotropy
(FA) in the body of the corpus callosum. This study delves
into the neurobiological mechanisms involved, aimed at
understanding how the anterior cingulate gyrus, with its role
in emotional and cognitive processes, might contribute to or
mitigate the development of depressive symptoms in the
context of problematic mobile phone use [14]. FA is a
method used to emphasize and evaluate white matter fiber
tracts. Among the problematic smartphone users, there
was a considerable reduction in the superior cerebellar
peduncle (SCP) volume. The reduced volume in this
brainstem substructure may have implications for neural
function, potentially impacting physiological processes regu-
lated by the brainstem, such as autonomic functions, sensory
processing, and motor control [15]. By detecting structural
alterations in a particular brainstem substructure, this work
adds to our understanding of the impacts of problematic
smartphone usage and illuminates the possible neurobiolog-
ical causes of PSU in adolescents. The right lateral orbito-
frontal cortex (OFC), a part of the brain linked to
decision-making, emotional processing, and social behavior,
2 Human Behavior and Emerging Technologies
 hbet, 2024, 1, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1155/2024/5592994 by C
A
PE
S, W
iley O
nline L
ibrary on [01/08/2024]. See the T
erm
s and C
onditions (https://onlinelibrary.w
iley.com
/term
s-and-conditions) on W
iley O
nline L
ibrary for rules of use; O
A
 articles are governed by the applicable C
reative C
om
m
ons L
icense
showed reduced GMV in problematic smartphone users.
This suggests that problematic smartphone use may be
caused by a loss of regulatory control over previously rein-
forced behaviors [16]. The grey matter abnormalities in the
lateral orbitofrontal cortex among individuals with problem-
atic smartphone use suggest potential structural alterations
in a brain region associated with decision-making and emo-
tional processing. A resting-state fMRI study using region of
interest (ROI) to ROI analysis revealed that adolescents who
used their smartphones excessively had lower functional
connectivity between the nucleus accumbens and OFC, as
well as between the middle cingulate cortex and OFC [17].
This suggests that the neural communication between the
frontal cortex and striatum may be affected in individuals
exhibiting problematic smartphone use. Focusing on fron-
tostriatal connectivity, it provides valuable information
about the brain’s role in the development and maintenance
of problematic smartphone use. In the dorsolateral prefron-
tal cortex (DLPFC) and dorsal anterior cingulate cortex
(dACC), excessive smartphone users had more neuronal
inactivation than the control group after displaying an angry
face and emotional change. The use of smartphones exces-
sively is likely to result in decreased cognitive control while
processing emotions, which may change the emotional pro-
cessing associated with social interaction [18]. This suggests
that the neural mechanisms involved in interpreting facial
emotions may be affected in those who engage in problem-
atic smartphone use.
4. Discussion
The purpose of this systematic review was to focus on
different neurofunctional regional activations associated with
smartphone addiction.
4.1. Decreased Cortical Activations and Functional Connectivity.
Reductions in cortical activations and functional connections
are observed in the prefrontal and temporal cortices in smart-
phone addicts. These regions are critical for complex cognitive
processes and adaptive behavior. This reduction may contrib-
ute to challenges in establishing novel associations and gener-
ating creative ideas [11].
4.2. Language, Emotional, Auditory, and Visual Processing.
Problematic smartphone users show difficulties in language
processing, emotional processing, auditory processing, and
visual information processing. These challenges extend to
poor self-control, moral reasoning ability, memory issues,
and difficulty in regulating impulses [12]. In particular, the
anterior cingulate gyrus, the right fusiform gyrus, and the
fractional anisotropy in the corpus callosum body were neg-
atively correlated between PSU and brain anatomy [14].
4.3. Correlation with Corpus Callosum and SCP Volume.
Problematic smartphone use is negatively correlated with
FA values in the corpus callosum body, indicating potential
disruptions in white matter connectivity between hemi-
spheres. Reduction in SCP volume is associated with poor
motor functions, balance, and cognitive processes [15].
4.4. Impact on the Right Lateral Orbitofrontal Cortex (OFC).
The right lateral OFC, responsible for emotional processing,
decision-making, and social behavior, shows low GMV in
problematic smartphone users. This decrease has been con-
nected to several mental health conditions, such as addic-
tion, anxiety disorders, and depression [16].
4.5. Reward System and Functional Connectivity. Excessive
smartphone use is associated with lower functional connec-
tivity between brain regions involved in the reward system,
such as the OFC, nucleus accumbens, and middle cingulate
cortex. These areas are crucial for processing rewarding
stimuli, and disruptions in their activity may contribute to
addictive behaviors [17].
4.6. Neuronal Deactivation in DLPFC and dACC. More neu-
ronal deactivation is seen in the dorsolateral prefrontal cor-
tex (DLPFC) and dorsal anterior cingulate cortex (dACC) in
those who use smartphones excessively. This suggests poten-
tial neural adaptations and disruptions in the brain’s reward
circuitry, affecting attentional control and decision-making
processes [18].
Records identifed through
database searching
(n = 28896): PubMed
(n = 935), Taylor & Francis
(n = 3197), Springer
(n = 15654), Science Direct
(n = 9110)
Records removed before the
screening:
Non-English and Chinese
(n = 1458)
Full-text free access
(n = 19825)
Records removed for
other reasons (n = 1993)
Records screened
(n = 5620)
Records excluded
(n =5392)
Reports sought for retrieval
(n = 228)
Reports not retrieved
(n = 183)
Reports assessed for
eligibility (n = 45)
Reports excluded:
No relation with
smartphone addiction
(n = 32)
No quality article (n = 6)
Studies included in the
review (n = 7)
Identifcation of studies via databases and registers
Id
en
tif
ca
tio
n
Sc
re
en
in
g
In
cl
ud
ed
Figure 1: PRISMA flow diagram. Note. From [10].
3Human Behavior and Emerging Technologies
 hbet, 2024, 1, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1155/2024/5592994 by C
A
PE
S, W
iley O
nline L
ibrary on [01/08/2024]. See the T
erm
s and C
onditions (https://onlinelibrary.w
iley.com
/term
s-and-conditions) on W
iley O
nline L
ibrary for rules of use; O
A
 articles are governed by the applicable C
reative C
om
m
ons L
icense
T
a
bl
e
1:
D
et
ai
ls
of
th
e
re
vi
ew
ed
pa
pe
rs
.
S.
N
o.
A
ut
ho
r
Y
ea
r
T
oo
ls
/t
ec
hn
iq
ue
s
Sa
m
pl
e
si
ze
R
es
ul
t
In
si
gh
t
C
on
tr
ib
ut
io
n
1
Li
et
al
.
20
22
Sm
ar
tp
ho
ne
A
dd
ic
ti
on
Sc
al
e,
St
at
e-
T
ra
it
A
nx
ie
ty
In
ve
nt
or
y
-S
ta
te
Sc
al
e,
R
av
en
’s
St
an
da
rd
P
ro
gr
es
si
ve
M
at
ri
ce
s,
an
d
B
ec
k’
s
D
ep
re
ss
io
n
Sc
al
e-
II
50
3
st
ud
en
ts
T
he
pr
ef
ro
nt
al
co
rt
ex
(P
FC
)
an
d
te
m
po
ra
la
re
as
sh
ow
al
te
re
d
br
ai
n
ac
ti
vi
ty
an
d
fu
nc
ti
on
al
co
nn
ec
ti
vi
ty
pa
tt
er
ns
in
th
e
co
nt
ex
t
of
an
ad
di
ct
io
n
to
sm
ar
tp
ho
ne
s,
w
hi
ch
si
gn
ifi
ca
nt
ly
im
pa
ct
s
on
e’
s
ab
ili
ty
to
th
in
k
cr
ea
ti
ve
ly
.
T
he
de
tr
im
en
ta
le
ff
ec
ts
of
sm
ar
tp
ho
ne
ad
di
ct
io
n
on
cr
ea
ti
ve
co
gn
it
io
n
w
er
e
se
en
in
th
e
P
FC
an
d
te
m
po
ra
l
re
gi
on
s’
br
ai
n
ac
ti
vi
ty
an
d
fu
nc
ti
on
al
co
nn
ec
ti
on
pa
tt
er
ns
.
T
hi
s
di
sc
ov
er
y
ha
s
pr
om
is
in
g
ra
m
ifi
ca
ti
on
s
fo
r
ex
po
si
ng
th
e
ha
rm
fu
l
im
pa
ct
s
of
sm
ar
tp
ho
ne
ad
di
ct
io
n
on
pe
op
le
’s
hi
gh
er
-
or
de
r
co
gn
it
iv
e
pr
oc
es
se
s.
2
Z
ou
et
al
.
20
22
Se
lf-
ra
ti
ng
qu
es
ti
on
na
ir
e
fo
r
ad
ol
es
ce
nt
s,
P
M
P
U
,D
ep
re
ss
io
n
A
nx
ie
ty
St
re
ss
Sc
al
e-
21
,M
R
I,
an
d
fM
R
I
T
he
ba
se
lin
e
M
R
I
sc
an
w
as
co
m
pl
et
ed
by
26
8
st
ud
en
ts
,a
nd
th
e
cr
it
er
io
n
of
im
ag
e
pr
ep
ro
ce
ss
in
g
in
cl
ud
ed
23
8
co
lle
ge
st
ud
en
ts
T
he
in
tr
in
si
c
fu
nc
ti
on
al
co
nn
ec
ti
vi
ty
(i
FC
)
an
al
ys
is
of
th
e
le
ft
in
fe
ri
or
fr
on
ta
lg
yr
us
(I
FG
),
le
ft
oc
ci
pi
ta
l
gy
ru
s
(O
cG
),
ri
gh
t
or
bi
ta
lg
yr
us
(O
rG
),
le
ft
O
cG
an
d
le
ft
pa
ra
hi
pp
oc
am
pa
l
gy
ru
s
(P
hG
),
an
d
ri
gh
tm
id
dl
e
te
m
po
ra
lg
yr
us
(M
T
G
)
w
as
hi
gh
er
in
th
e
gr
ou
p
of
co
lle
ge
st
ud
en
ts
w
it
h
pr
ob
le
m
at
ic
m
ob
ile
ph
on
e
us
e
th
an
in
th
e
gr
ou
p
w
it
ho
ut
pr
ob
le
m
at
ic
m
ob
ile
ph
on
e
us
e.
T
hi
s
st
ud
y
sh
ed
s
lig
ht
on
th
e
ne
ur
ol
og
ic
al
pr
oc
es
se
s
th
at
un
de
rl
ie
th
e
as
so
ci
at
io
n
be
tw
ee
n
de
pr
es
se
d
sy
m
pt
om
s
an
d
ex
ce
ss
iv
e
m
ob
ile
ph
on
e
us
e.
T
he
ar
ti
cl
e
ad
ds
to
th
e
ex
pa
nd
in
g
co
rp
us
of
re
se
ar
ch
on
th
e
co
nn
ec
ti
on
be
tw
ee
n
m
en
ta
l
he
al
th
,b
ra
in
fu
nc
ti
on
,
an
d
te
ch
no
lo
gy
us
e.
3
Z
ou
et
al
.
20
21
M
R
I,
P
M
P
U
,a
nd
P
at
ie
nt
H
ea
lth
Q
ue
st
io
nn
ai
re
-9
26
6
st
ud
en
ts
T
he
an
te
ri
or
ci
ng
ul
at
e
gy
ru
s
an
d
ri
gh
t
fu
si
fo
rm
gy
ru
s
bo
th
ha
d
lo
w
er
gr
ey
m
at
te
r
vo
lu
m
e
(G
M
V
)
as
a
re
su
lt
of
sm
ar
tp
ho
ne
us
e.
In
th
e
co
rp
us
ca
llo
su
m
bo
dy
,f
ra
ct
io
na
l
an
is
ot
ro
py
(F
A
)
an
d
P
M
P
U
ha
ve
an
in
ve
rs
e
re
la
ti
on
sh
ip
.
T
he
re
se
ar
ch
sh
ed
s
lig
ht
on
ne
ur
ob
io
lo
gi
ca
lm
ec
ha
ni
sm
s
at
pl
ay
to
co
m
pr
eh
en
d
ho
w
th
e
an
te
ri
or
ci
ng
ul
at
e
gy
ru
s,
w
hi
ch
is
en
ga
ge
d
in
em
ot
io
na
la
nd
co
gn
it
iv
e
fu
nc
ti
on
s,
m
ay
ei
th
er
ex
ac
er
ba
te
or
le
ss
en
th
e
on
se
t
of
de
pr
es
si
on
sy
m
pt
om
s
w
he
n
us
ed
in
co
nj
un
ct
io
n
w
it
h
pr
ob
le
m
at
ic
m
ob
ile
ph
on
e
us
e.
T
he
st
ud
y
ad
ds
to
th
e
bo
dy
of
re
se
ar
ch
on
th
e
co
nn
ec
ti
on
be
tw
ee
n
te
ch
no
lo
gy
us
ag
e,
br
ai
n
fu
nc
ti
on
,a
nd
m
en
ta
l
he
al
th
by
fo
cu
si
ng
on
th
e
an
te
ri
or
ci
ng
ul
at
e
gy
ru
s,
a
cr
uc
ia
l
br
ai
n
ar
ea
,a
nd
it
s
m
od
er
at
in
g
ro
le
.
4
C
ho
et
al
.
20
21
Sm
ar
tp
ho
ne
A
dd
ic
ti
on
P
ro
ne
ne
ss
Sc
al
e,
B
ec
k’
s
D
ep
re
ss
io
n
In
ve
nt
or
y
(B
D
I)
,
B
ri
ef
Se
lf-
C
on
tr
ol
Sc
al
e,
K
or
ea
n-
W
ec
hs
le
r
A
du
lts
In
te
lli
ge
nc
e
Sc
al
e,
an
d
St
ru
ct
ur
al
M
R
I
A
cq
ui
si
ti
on
87
ad
ol
es
ce
nt
s
U
nl
ik
e
ot
he
r
br
ai
ns
te
m
su
bs
tr
uc
tu
re
s,
th
e
vo
lu
m
e
of
th
e
su
pe
ri
or
ce
re
be
lla
r
pe
du
nc
le
(S
C
P
)
w
as
dr
as
ti
ca
lly
re
du
ce
d.
Fu
rt
he
rm
or
e,
th
e
de
gr
ee
of
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e
(P
SU
)
is
re
la
te
d
to
a
de
cr
ea
se
in
SC
P
vo
lu
m
e.
T
he
st
ud
y
es
ta
bl
is
he
s
a
lin
k
be
tw
ee
n
th
e
ob
se
rv
ed
st
ru
ct
ur
al
ch
an
ge
s
an
d
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e,
su
gg
es
ti
ng
th
at
ex
ce
ss
iv
e
us
e
of
sm
ar
tp
ho
ne
s
m
ay
co
nt
ri
bu
te
to
al
te
ra
ti
on
s
in
th
e
an
at
om
y
of
th
is
br
ai
ns
te
m
su
bs
tr
uc
tu
re
.
T
he
st
ud
y
sh
ed
s
lig
ht
on
th
e
po
ss
ib
le
ne
ur
ob
io
lo
gi
ca
l
ca
us
es
of
P
SU
in
ad
ol
es
ce
nt
s
by
de
te
ct
in
g
st
ru
ct
ur
al
al
te
ra
ti
on
s
in
a
pa
rt
ic
ul
ar
br
ai
ns
te
m
su
bs
tr
uc
tu
re
,w
hi
ch
ad
va
nc
es
ou
r
kn
ow
le
dg
e
of
th
e
co
ns
eq
ue
nc
es
of
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
ag
e.
4 Human Behavior and Emerging Technologies
 hbet, 2024, 1, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1155/2024/5592994 by C
A
PE
S, W
iley O
nline L
ibrary on [01/08/2024]. See the T
erm
s and C
onditions (https://onlinelibrary.w
iley.com
/term
s-and-conditions) on W
iley O
nline L
ibrary for rules of use; O
A
 articles are governed by the applicable C
reative C
om
m
ons L
icense
T
a
bl
e
1:
C
on
ti
nu
ed
.
S.
N
o.
A
ut
ho
r
Y
ea
r
T
oo
ls
/t
ec
hn
iq
ue
s
Sa
m
pl
e
si
ze
R
es
ul
t
In
si
gh
t
C
on
tr
ib
ut
io
n
5
Le
e
et
al
.
20
19
Sm
ar
tp
ho
ne
A
dd
ic
ti
on
P
ro
ne
ne
ss
Sc
al
e
(S
A
P
S)
te
st
,
In
te
rn
et
A
dd
ic
ti
on
T
es
t
an
d
T
he
B
ar
ra
tt
Im
pu
ls
iv
en
es
s
Sc
al
e
ve
rs
io
n
11
,B
D
I,
B
ec
k’
s
A
nx
ie
ty
In
ve
nt
or
y,
an
d
A
lc
oh
ol
U
se
D
is
or
de
r
Id
en
ti
fi
ca
ti
on
T
es
t
(A
U
D
IT
)
39
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
er
s
an
d
49
m
al
e
an
d
fe
m
al
e
us
er
s
un
de
r
no
rm
al
co
nt
ro
l
In
th
e
ri
gh
t
la
te
ra
l
or
bi
to
fr
on
ta
l
co
rt
ex
(O
FC
),
sm
ar
tp
ho
ne
us
er
s
di
sp
la
ye
d
lo
w
er
G
M
V
th
an
no
nu
se
rs
.
T
he
m
ai
n
fi
nd
in
g
of
th
e
st
ud
y
is
th
at
th
os
e
w
it
h
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e
ha
d
an
om
al
ie
s
in
th
e
la
te
ra
l
or
bi
to
fr
on
ta
l
co
rt
ex
re
la
te
d
to
gr
ey
m
at
te
r.
T
hi
s
de
m
on
st
ra
te
s
th
e
co
nn
ec
ti
on
be
tw
ee
n
st
ru
ct
ur
al
al
te
ra
ti
on
s
in
th
is
br
ai
n
re
gi
on
an
d
he
av
y
sm
ar
tp
ho
ne
us
e.
B
y
de
te
ct
in
g
ce
rt
ai
n
st
ru
ct
ur
al
ch
an
ge
s
in
th
e
la
te
ra
l
or
bi
to
fr
on
ta
lc
or
te
x,
th
e
re
se
ar
ch
ad
va
nc
es
ou
r
kn
ow
le
dg
e
of
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
ag
e.
T
hi
s
da
ta
m
ig
ht
im
pr
ov
e
ou
r
un
de
rs
ta
nd
in
g
of
th
e
ne
ur
ol
og
ic
al
pr
oc
es
se
s
th
at
un
de
rl
ie
P
SU
.
6
C
hu
n
et
al
.
20
18
K
or
ea
n
SA
P
S
fo
r
Y
ou
th
,t
he
K
-
Sc
al
e,
B
D
I,
B
ec
k’
s
A
nx
ie
ty
In
ve
nt
or
y,
W
ec
hs
le
r
In
te
lli
ge
nc
e
Sc
al
e
fo
r
C
hi
ld
re
n,
K
or
ea
n
(4
th
ed
it
io
n)
,a
nd
Fu
nc
ti
on
al
an
d
St
ru
ct
ur
al
M
R
I
38
ad
ol
es
ce
nt
s
w
ho
us
ed
th
ei
r
sm
ar
tp
ho
ne
s
ex
ce
ss
iv
el
y
an
d
42
he
al
th
y
co
nt
ro
ls
R
es
ea
rc
he
rs
di
sc
ov
er
ed
th
at
te
en
ag
er
s
w
ho
us
ed
sm
ar
tp
ho
ne
s
ex
ce
ss
iv
el
y
ha
d
re
du
ce
d
fu
nc
ti
on
al
co
nnec
ti
vi
ty
be
tw
ee
n
th
e
or
bi
to
fr
on
ta
l
co
rt
ex
,t
he
m
id
dl
e
ci
ng
ul
at
e
co
rt
ex
,a
nd
th
e
nu
cl
eu
s
ac
cu
m
be
ns
in
a
re
st
in
g-
st
at
e
fu
nc
ti
on
al
m
ag
ne
ti
c
re
so
na
nc
e
im
ag
in
g
(f
M
R
I)
st
ud
y
th
at
us
ed
R
O
I
to
R
O
I
an
al
ys
is
.
T
hi
s
st
ud
y
off
er
s
in
si
gh
t
in
to
ho
w
ne
ur
al
co
m
m
un
ic
at
io
n
be
tw
ee
n
th
e
fr
on
ta
lc
or
te
x
an
d
st
ri
at
um
m
ay
be
aff
ec
te
d
in
in
di
vi
du
al
s
ex
hi
bi
ti
ng
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e.
T
he
re
se
ar
ch
ad
ds
to
ou
r
un
de
rs
ta
nd
in
g
of
th
e
ne
ur
al
un
de
rp
in
ni
ng
s
of
sm
ar
tp
ho
ne
us
e,
pa
rt
ic
ul
ar
ly
in
th
e
ad
ol
es
ce
nt
po
pu
la
ti
on
.F
oc
us
in
g
on
fr
on
to
st
ri
at
al
co
nn
ec
ti
vi
ty
pr
ov
id
es
va
lu
ab
le
in
fo
rm
at
io
n
ab
ou
t
th
e
br
ai
n’
s
ro
le
in
th
e
de
ve
lo
pm
en
t
an
d
m
ai
nt
en
an
ce
of
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e.
7
C
hu
n
et
al
.
20
17
SA
P
S,
B
eh
av
io
ra
l
In
hi
bi
ti
on
Sc
al
e
an
d
B
eh
av
io
ra
l
A
ct
iv
at
io
n
Sc
al
e,
Fa
ci
al
E
m
ot
io
n
D
is
cr
im
in
at
io
n,
an
d
Im
ag
e
ac
qu
is
it
io
n
th
ro
ug
h
fM
R
I
an
d
St
ru
ct
ur
al
M
R
I
H
ea
vy
sm
ar
tp
ho
ne
us
er
s
(2
5)
an
d
no
rm
al
co
nt
ro
lu
se
rs
(2
7)
W
he
n
an
an
gr
y
vi
sa
ge
an
d
an
em
ot
io
na
lt
ra
ns
it
io
n
w
er
e
di
sp
la
ye
d,
th
e
do
rs
ol
at
er
al
pr
ef
ro
nt
al
co
rt
ex
(D
LP
FC
)
an
d
do
rs
al
an
te
ri
or
ci
ng
ul
at
e
co
rt
ex
(d
A
C
C
)
of
co
m
pu
ls
iv
e
sm
ar
tp
ho
ne
us
er
s
ha
d
m
or
e
ne
ur
on
al
in
ac
ti
va
ti
on
th
an
th
e
co
nt
ro
lg
ro
up
.
A
s
to
th
e
st
ud
y,
th
e
ne
ur
al
m
ec
ha
ni
sm
s
in
vo
lv
ed
in
in
te
rp
re
ti
ng
fa
ci
al
em
ot
io
ns
m
ay
be
aff
ec
te
d
in
th
os
e
w
ho
en
ga
ge
in
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e.
T
he
re
se
ar
ch
co
nt
ri
bu
te
s
to
un
de
rs
ta
nd
in
g
th
e
ne
ur
al
co
rr
el
at
es
of
ex
ce
ss
iv
e
sm
ar
tp
ho
ne
us
e,
em
ph
as
iz
in
g
th
e
ro
le
of
al
te
re
d
br
ai
n
ac
ti
vi
ty
du
ri
ng
fa
ci
al
em
ot
io
n
pr
oc
es
si
ng
.T
hi
s
in
fo
rm
at
io
n
m
ay
ai
d
in
id
en
ti
fy
in
g
po
te
nt
ia
l
fa
ct
or
s
co
nt
ri
bu
ti
ng
to
pr
ob
le
m
at
ic
sm
ar
tp
ho
ne
us
e.
5Human Behavior and Emerging Technologies
 hbet, 2024, 1, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1155/2024/5592994 by C
A
PE
S, W
iley O
nline L
ibrary on [01/08/2024]. See the T
erm
s and C
onditions (https://onlinelibrary.w
iley.com
/term
s-and-conditions) on W
iley O
nline L
ibrary for rules of use; O
A
 articles are governed by the applicable C
reative C
om
m
ons L
icense
5. Conclusion
Smartphone addiction goes beyond a societal concern; it
involves behavioral addiction linked to neurobiological
changes. The findings underscore the complex interactions
between neural alterations and smartphone addiction,
providing crucial insights into the potential behavioral and
cognitive fallout from problematic smartphone use. This
review highlights how important it is to have a multimodal
approach that takes into account the behavioral and neuro-
logical aspects of problematic smartphone use for an indi-
vidual’s overall well-being.
6. Recommendations
Further longitudinal studies are necessary to validate the
findings of current research on the brain anatomy and func-
tioning of individuals with PSU. Intervention studies target-
ing cognitive and emotional regulation, along with those
altering brain structure and function, need to be done to
reduce harmful effects and encourage healthier technological
practices. Ongoing research should explore the complex
relationships between smartphone use and neurobiology
for tailored interventions and enhanced digital well-being.
7. Limitations
All non-English-language papers were excluded; nonetheless,
smartphone addiction has attracted attention from countries
in Europe and Asia, and studies may have been published in
other languages. As a result, studies carried out in various
cultures might be disregarded, which might bias the review
findings. Most of the research that met the criteria to be
included in this review was carried out in wealthy nations,
raising concerns about the generalizability of the applicability
of the findings to underdeveloped nations. Finally, many of
the results were published with a follow-up of less than a year.
Conflicts of Interest
The authors have no conflicts of interest.
References
[1] J. L. Derevensky, V. Hayman, and L. Gilbeau, “Behavioral
addictions: excessive gambling, gaming, internet, and smart-
phone use among children and adolescents,” Pediatric Clinics,
vol. 66, no. 6, pp. 1163–1182, 2019.
[2] Y. Wacks and A. M. Weinstein, “Excessive smartphone use is
associated with health problems in adolescents and young
adults,” Frontiers in Psychiatry, vol. 12, 2021.
[3] J. Lee, J.-S. Ahn, S. Min, and M. H. Kim, “Psychological char-
acteristics and addiction propensity according to content type
of smartphone use,” International Journal of Environmental
Research and Public Health, vol. 17, no. 7, p. 2292, 2020.
[4] J. E. Grant, K. Lust, and S. R. Chamberlain, “Problematic
smartphone use associated with greater alcohol consumption,
mental health issues, poorer academic performance, and
impulsivity,” Journal of Behavioral Addictions, vol. 8, no. 2,
pp. 335–342, 2019.
[5] L. Squires, K. Hollett, J. Hesson, and N. Harris, “Psychological
distress, emotion dysregulation, and coping behaviour: a theo-
retical perspective of problematic smartphone use,” Interna-
tional Journal of Mental Health and Addiction, vol. 19, no. 4,
pp. 1284–1299, 2021.
[6] M. E. Raichle, “A paradigm shift in functional brain imaging,”
Journal of Neuroscience, vol. 29, no. 41, pp. 12729–12734,
2009.
[7] S. J. Luck, An Introduction to the Event-Related Potential Tech-
nique, The MIT Press, 2014.
[8] R. A. Poldrack, “Inferring mental states from neuroimaging
data: from reverse inference to large-scale decoding,” Neuron,
vol. 72, no. 5, pp. 692–697, 2011.
[9] D. Moher, A. Liberati, J. Tetzlaff, D. G. Altman, and PRISMA
Group, “Preferred reporting items for systematic reviews and
meta-analyses: the PRISMA statement,” BMJ, vol. 339, 2009.
[10] M. J. Page, J. E. McKenzie, P. M. Bossuyt et al., “The PRISMA
2020 statement: an updated guideline for reporting systematic
reviews,” BMJ, vol. 372, 2021.
[11] X. Li, Y. Li, X. Wang, and W. Hu, “Reduced brain activity and
functional connectivity during creative idea generation in
individuals with smartphone addiction,” Social Cognitive and
Affective Neuroscience, vol. 18, no. 1, 2023.
[12] L. Zou, X. Wu, S. Tao et al., “Functional connectivity between
the parahippocampal gyrus and the middle temporal gyrus
moderates the relationship between problematic mobile phone
use and depressive symptoms: evidence from a longitudinal
study,” Journal of Behavioral Addictions, vol. 11, no. 1,
pp. 40–48, 2022.
[13] K. R. Van Dijk, T. Hedden, A. Venkataraman, K. C. Evans,
S. W. Lazar, and R. L. Buckner, “Intrinsic functional connec-
tivity as a tool for human connectomics: theory, properties,
and optimization,” Journal of Neurophysiology, vol. 103,
no. 1, pp. 297–321, 2010.
[14] L. Zou, X. Wu, S. Tao et al., “Anterior cingulate gyrus acts as a
moderator of the relationship between problematic mobile
phone use and depressive symptoms in college students,”
Social Cognitive and Affective Neuroscience, vol. 16, no. 5,
pp. 484–491, 2021.
[15] I. H. Cho, J. H. Yoo, J.-W. Chun et al., “Reduced volume of a
brainstem substructure in adolescents with problematic smart-
phone use,” Journal of the Korean Academy of Child and Ado-
lescent Psychiatry, vol. 32, no. 4, pp. 137–143, 2021.
[16] D. Lee, K. Namkoong, J. Lee, B. O. Lee, and Y.-C. Jung, “Lateral
orbitofrontal gray matter abnormalities in subjects with prob-
lematic smartphone use,” Journal of Behavioral Addictions,
vol. 8, no. 3, pp. 404–411, 2019.
[17] J.-W. Chun, J. Choi, H. Cho et al., “Role of frontostriatal con-
nectivity in adolescents with excessive smartphone use,”Fron-
tiers in Psychiatry, vol. 9, 2018.
[18] J.-W. Chun, J. Choi, J.-Y. Kim et al., “Altered brain activity and
the effect of personality traits in excessive smartphone use dur-
ing facial emotion processing,” Scientific Reports, vol. 7, no. 1,
p. 12156, 2017.
6 Human Behavior and Emerging Technologies
 hbet, 2024, 1, D
ow
nloaded from
 https://onlinelibrary.w
iley.com
/doi/10.1155/2024/5592994 by C
A
PE
S, W
iley O
nline L
ibrary on [01/08/2024]. See the T
erm
s and C
onditions (https://onlinelibrary.w
iley.com
/term
s-and-conditions) on W
iley O
nline L
ibrary for rules of use; O
A
 articles are governed by the applicable C
reative C
om
m
ons L
icense
	Brain and Smartphone Addiction: A Systematic Review
	1. Introduction
	2. Methods and Search Strategy
	2.1. Eligibility Criteria
	2.2. Data Extraction
	3. Results
	4. Discussion
	4.1. Decreased Cortical Activations and Functional Connectivity
	4.2. Language, Emotional, Auditory, and Visual Processing
	4.3. Correlation with Corpus Callosum and SCP Volume
	4.4. Impact on the Right Lateral Orbitofrontal Cortex (OFC)
	4.5. Reward System and Functional Connectivity
	4.6. Neuronal Deactivation in DLPFC and dACC
	5. Conclusion
	6. Recommendations
	7. Limitations
	Conflicts of Interest