Lateral orbitofrontal gray matter abnormalities in subjects with problematic smartphone use
Open accessAbstract
Background and aims: Smartphone use is becoming commonplace and exerting adequate control over smartphone use has become an important mental health issue. Little is known about the neurobiology underlying problematic smartphone use. We hypothesized that structural abnormalities in the fronto-cingulate brain region could be implicated in problematic smartphone use, similar to that has been reported for Internet gaming disorder and Internet addiction. This study investigated fronto-cingulate gray matter abnormalities in problematic smartphone users, particularly those who spend time on social networking platforms. Methods: The study included 39 problematic smartphone users with excessive use of social networking platforms via smartphone and 49 normal control male and female smartphone users. We conducted voxel-based morphometric analysis with diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm. Region of interest analysis was performed on the fronto-cingulate region to identify whether gray matter volume (GMV) differed between the two groups. Results: Problematic smartphone users had significantly smaller GMV in the right lateral orbitofrontal cortex (OFC) than healthy controls, and there were significant negative correlations between GMV in the right lateral OFC and the Smartphone Addiction Proneness Scale (SAPS) score, including the SAPS tolerance subscale. Conclusions: These results suggest that lateral orbitofrontal gray matter abnormalities are implicated in problematic smartphone use, especially in social networking platform overuse. Small GMV in the lateral OFC was correlated with an increasing tendency to be immersed in smartphone use. Our results suggest that orbitofrontal gray matter abnormalities affect regulatory control over previously reinforced behaviors and may underlie problematic smartphone use.
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Excessive smartphone use is associated with changes in the brain's gray matter volume.
“Medical problems include sleep problems, reduced physical fitness, unhealthy eating habits, pain and migraines, reduced cognitive control and changes in the brain's gray matter volume.”
From Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults (2021) · cites this paper as [84]
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Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults
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Anbumalar, C., & Sahayam, D. B. (2024) · Human Behavior and Emerging Technologies · doi:10.1155/2024/5592994 · Cited by 18 · see citing works
“This suggests that problematic smartphone use may be caused by a loss of regulatory control over previously reinforced behaviors [16].”
BackgroundThe Modulation of Reward and Habit Systems by Acupuncture in Adolescents with Internet Addiction
Wang, Y., Qin, Y., Li, H., Yao, D., Sun, B., Li, Z., Li, X., Dai, Y., Wen, C., Zhang, L.-R., et al. (2020) · Journal of Neural Transplantation and Plasticity · doi:10.1155/2020/7409417 · Cited by 18 · see citing works
“As to IA, altered microstructure and function in the cerebellum, OFC, and vmPFC were also observed by previous neuroimaging studies [22, 48, 49].”
ResultUnveiling the grip of mobile phone addiction: an in-depth review
Li, J., & Yang, H. Y. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1429941 · Cited by 15 · see citing works
“People with MPA have less gray matter in this region, which may contribute to their dif fi culty in making choices (49).”
BackgroundXiang, M.-Q., Lin, L., Song, Y.-T., Hu, M., & Hou, X.-H. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1097375 · Cited by 16 · see citing works
“In addition, a smaller gray-matter volume in the orbitofrontal cortex (OFC) was found in individuals with PSPU compared to controls (17).”
Mindfulness mediates relations between anxiety with problematic smartphone use severity
Hallauer, C., Rooney, E. A., Billieux, J., Hall, B. J., & Elhai, J. (2022) · Cyberpsychology: Journal of Psychosocial Research on Cyberspace · doi:10.5817/cp2022-1-4 · Cited by 16 · see citing works
“(2021), we use the term “PSU” to capture the predominantly mobile form of PIU and to account for an uncontrolled and excessive use of the smartphone engendering tangible negative consequences, such as interpersonal and school/work impairment (Billieux, 2012; Busch & McCarthy, 2021; Elhai, Levine, et al., 2019; Lee et…”
BackgroundMethodHallauer, C., Rooney, E. A., Yang, H.-B., Meng, Q., Montag, C., & Elhai, J. (2021) · Human Behavior and Emerging Technologies · doi:10.1002/hbe2.319 · Cited by 16 · see citing works
“2021;3:788–797.wileyonlinelibrary.com/journal/hbe2 of the smartphone which leads to tangible negative consequences, such as interpersonal and school/work impairment (Billieux, 2012; Busch & McCarthy, 2020; Elhai, Levine, & Hall, 2019; Lee et al., 2019).”
BackgroundScreens and brains: multimodal neuroimaging insights into mechanisms of problematic smartphone use.
Wolf, N. D., Henemann, G. M., Schmitgen, M., Koenig, J., Bach, P., & Wolf, R. C. (2025) · Progress in Neuro-psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2025.111531 · Cited by 15 · see citing works
Reduced Volume of a Brainstem Substructure in Adolescents with Problematic Smartphone Use
Cho, I., Yoo, J., Chun, J.-W., Cho, H., Kim, J.-Y., Choi, J.-Y., & Kim, D. (2021) · Soa--ch'ongsonyon chongsin uihak = Journal of child & adolescent psychiatry · doi:10.5765/jkacap.210007 · Cited by 14 · see citing works
Zou, L.-W., Wu, X.-Y., Tao, S.-M., Yang, Y.-J., Zhang, Q., Hong, X., Xie, Y., Li, T.-T., Zheng, S.-S., & Tao, F. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2021.749194 · Cited by 10 · see citing works
The impact of childhood trauma on short video addiction: psychological and morphological correlates
Yao, Q., Gao, Y., Liu, C., Li, X., Jin, W., & Wang, Q. (2025) · Scientific Reports · doi:10.1038/s41598-025-04020-5 · Cited by 7 · see citing works
“For example, some studies have reported gray matter atrophy in the right orbitofrontal cortex (OFC), bilateral insula, and right supplementary motor area in individuals with problematic smartphone use 24 .”
Ma, P., Xia, Z.-L., Zhao, Y.-B., & Zhao, Y. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.04.018 · Cited by 7 · see citing works
Alwazzeh, M., Harfouch, M., Hasan, M., Alqatari, S. G., Alsaid, A., & Alwazzeh, M. (2024) · Clinical Practice and Epidemiology in Mental Health · doi:10.2174/0117450179295575240520064919 · Cited by 6 · see citing works
Wan, Z., Qin, X.-C., Wan, Q., Xu, B., Lin, H., Ouyang, F., & Wang, G. (2024) · Journal of Medical Internet Research · doi:10.2196/63485 · Cited by 4 · see citing works
“Furthermore, previous studies have identified abnormal brain activity in young individuals with smartphone addiction, such as a reduction in fronto-limbic resting-state functional connectivity and smaller gray matter volume in the right lateral orbitofrontal cortex [16,17].”
Kobayashi, N., Jitoku, D., Mochimatsu, R., Hamamura, T., Honjo, M., Takagi, S., Sugihara, G., & Takahashi, H. (2024) · Psychiatry and Clinical Neurosciences · doi:10.1002/pcn5.172 · Cited by 4 · see citing works
Liu, X., Liu, H., Kendrick, K. M., Montag, C., & Becker, B. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.06.13.598945 · Cited by 3 · see citing works
Ünsal, F., & Korkmaz, Z. (2025) · Psikiyatride Guncel Yaklasimlar · doi:10.18863/pgy.1644556 · Cited by 3 · see citing works
Addictive-like Dimensions of Problematic Use of Social Media
Yuste, R., Baler, R., & Volkow, N. D. (2025) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001525 · Cited by 3 · see citing works
Hu, M., Song, K. S., Choi, J.-Y., Pyeon, A., Cho, H., Choi, J.-S., Choi, I., Chun, J.-W., & Kim, D.-J. (2025) · Life · doi:10.3390/life15121899 · Cited by 2 · see citing works
Qu, B., Chen, J., Tian, Q., Niu, Q., Sun, J., Xie, M., Huang, Y.-E., Xue, B., Tong, X., & Wu, R.-P. (2026) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2025.100890 · Cited by 2 · see citing works
Ge, J.-M., & Zhang, A.-B. (2026) · Behaviour & Information Technology · doi:10.1080/0144929x.2026.2671387 · Cited by 1 · see citing works
Hubungan antara Motives dengan Problematic Smartphone Use (PSU): A Systematic Review
Ramadhan, R., Rachmasari, C., Sudrajat, Z. K., Mote, E. S., Susanto, A. V., Heng, P. H., & Idulfilastri, R. M. (2025) · RIGGS: Journal of Artificial Intelligence and Digital Business · doi:10.31004/riggs.v4i4.4072 · Cited by 1
Faro, H., Franchini, E., Albuquerque, M., Cavalcante-Silva, D., Pereira, D. C., de Lima, L. A. D., Machado, D. G. D. S., & Fortes, L. D. S. (2025) · Experimental Brain Research · doi:10.1007/s00221-025-07185-7 · Cited by 1 · see citing works
“Nonetheless, given the evidence that social media use can cause long-term brain modulation over time (Chun et al. 2017 ; Horvath et al. 2020; Lee et al. 2019), future studies should explore the neurophysiological effects of extended social media exposure.”
Anghelescu, L. A. M., Anghelescu, A., & Onose, G. (2024) · Balneo and PRM Research Journal · doi:10.12680/balneo.2024.750 · Cited by 1 · see citing works
“(69 ) The lack of objective longitudinal imagery records to investigate the neuro-plastic neuroadaptations secondary to cyber-addiction currently prevents recognition of phone addiction.”
Arató, Á., Darnai, G., Dudás, B., Szente, A., Alhour, H., Perlaki, G., Orsi, G., Nagy, S., & Janszky, J. (2026) · iScience · doi:10.1016/j.isci.2026.117913
Zeng, Y.-Y., Li, Z.-X., Li, W., Kan, Q.-Y., Xie, Y.-X., Zhao, X.-S., Li, J.-B., Zhang, M.-Z., Yang, L.-Y., Abudukadier, A., et al. (2026) · Progress in Neuro-psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2026.111956
SCROLL-BLINDED: THE ASSOCIATION BETWEEN SOCIAL MEDIA USE LEVELS, AFFECTIVE STATE AND DECISION-MAKING
Martínez-Maldonado, A., & Benito-Lázaro, M. (2026) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2026.101324
Repercusiones neurobiológicas, cognitivas y clínicas de adicción a redes sociales
Díaz-Rodríguez, M., Mestres-Vázquez, L., Pérez-Banchilleria, P., & Adan, A. (2026) · Revista de Psicología Universidad de Antioquia · doi:10.17533/udea.rp.e364626
Wang, Y.-L., Ding, K.-M., Zhu, J., Zhao, B., Zhang, D.-W., Chang, X.-L., Li, G.-H., Pan, Y., Zhu, L., Hu, Q., et al. (2026) · Scientific Reports · doi:10.1038/s41598-026-62981-7
Hyperconnected Minds: A Systematic Review of the Neurobiology of Problematic Internet Use
Molnar, R., Butiu, O., & Mihai, A. (2026) · Psychiatry International · doi:10.3390/psychiatryint7030113
Petro, N. M., Webert, L. K., McDonald, K. M., Son, J. J., Ward, T. W., Rice, D. L., Ende, G. C., Coutant, A. T., Steiner, E. L., Livermore, C. L., et al. (2026) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2026.101735
“The location of this effect is consistent with previous reports linking frontal cortical differences with excessive social media use (D. Lee et al., 2019; Loh and Kanai, 2014; Moisala et al., 2016; Montag et al., 2018) and other problematic internet-related behaviors (Brand et al., 2014; Hong, Kim,…”
Shi, Y., & Zhang, X.-W. (2025) · Psychiatry Investigation · doi:10.30773/pi.2025.0026
Wacks, Y., Koslowsky, M., Bloch, A., & Weinstein, A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1691748
“Recent brain imaging studies have shown structural alterations in the prefrontal cortex that were related to problematic smartphone use (23, 24).”
Mechanismen problematischer Smartphone-Nutzung
Wolf, N. D., Henemann, G. M., Schmitgen, M., & Wolf, R. (2025) · Nervenheilkunde · doi:10.1055/a-2625-7090
“Vergleichbare Befunde wurden auch für die INA des insu-lären Kortex berichtet, wobei insbesondere eine Assoziation zwischen insulärer/striataler und insulärer/OFC-Konnektivität und pro-longierter Smartphone-Nutzung im Bett hergestellt wurde [29].”
Smartphone addiction as a risk factor for medication non-adherence in renal transplant recipients
Helvacı, Ö., Demirezen, A., Akçay, Ö., Aksu, M., & Derici, U. (2025) · Archives of medical science : AMS · doi:10.5114/aoms/209207
Ge, J.-M., Chen, I.-J., Cao, W.-J., Shu, T.-Y., Peng, D., & Zhang, A.-B. (2025) · Behavior and Information Technology · doi:10.1080/0144929x.2025.2517209
“Additionally, Lee et al. (2019) found through an MRI (magnetic resonance imaging) study that PSUs had lower grey matter volume in the orbitofrontal cortex (OFC) of the basal ganglia compared to controls.”
Das Smartphone als ständiger Begleiter
Kohler, S., & Fauth-Bühler, M. (2024) · Sucht : Zeitschrift für Wissenschaft und Praxis · doi:10.1024/0939-5911/a000876
Lestari, D. (2022) · Journal of Health Literacy and Qualitative Research · doi:10.61194/jhlqr.v2i2.540
“As excessive gaming replaces real-world interactions, children may experience diminished social skills, leading to difficulties in establishing meaningful relationships(Lee et al., 2019).”
Zou, L.-W., Wu, X.-Y., Tao, S.-M., Yang, Y.-J., Zhang, Q., Hong, X., Xu, H., Xie, Y., Li, T.-T., Zheng, S.-S., et al. (2020) · doi:10.21203/rs.3.rs-30314/v1
“Moreover, the study report smaller GMV in right lateral orbitofrontal cortex in problematic smartphone users than controls (29).”
Background
- Authors
- Lee, D., Namkoong, K., Lee, J., Lee, B. O., & Jung, Y.-C.
- Affiliations
- Yonsei University (KR)
- Corresponding author
- Jung, Young-Chul
- Venue
- Journal of Behavioral Addictions
- Publisher
- Akademiai Kiado Zrt.
- Published
- 2019-09
- Volume
- 8
- Issue
- 3
- Pages
- 404-411
- ISSN
- 2062-5871 (ISSN-L)
- 2063-5303
- PMC
- PMC7044619
- OpenAlex
- W2976669220
- Cited by
- 64
- References
- 58
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 10 · 2023: 3 · 2022: 8 · 2021: 12 · 2020: 8 · 2018: 1
- FWCI
- 14.09
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Journal of Behavioral Addictions (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Repository of the Academy's Library (Library of the Hungarian Academy of Sciences) (acceptedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Keywords
- smartphone addiction, lateral orbitofrontal cortex, gray matter volume, addiction proneness, behavioral addiction, behavioral regulation
- MeSH terms
- Smartphone, Adolescent, Adult, Female, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Behavior, Addictive, Prefrontal Cortex, Young Adult, Social Networking
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