Brain Gamma-Aminobutyric Acid Levels in Internet and Smartphone Addiction: A Comprehensive Review

Internet and smartphone addiction have emerged as important behavioural disorders characterized by compulsive digital technology use, impaired self-control, withdrawal symptoms, and significant psychosocial dysfunction. Growing evidence suggests that these conditions share neurobiological mechanisms with substance use disorders, particularly involving dysfunction of the brain's inhibitory and reward pathways. Gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the central nervous system, plays a critical role in regulating executive function, reward processing, emotional regulation, and inhibitory control. This review summarizes current evidence on GABAergic alterations in internet and smartphone addiction and their therapeutic implications. Studies consistently demonstrate significantly elevated GABA-to-creatine ratios within the anterior cingulate cortex of adolescents with internet and smartphone addiction compared with healthy controls. In contrast to several psychiatric disorders, including depression, anxiety, and attention-deficit/hyperactivity disorder, where reduced GABA levels are commonly reported, digital addiction exhibits a distinct neurochemical profile characterized by increased GABA concentrations. Elevated GABA levels are positively associated with addiction severity, anxiety, and depressive symptoms, suggesting disrupted inhibitory control and maladaptive reward processing. Although current evidence is limited by small sample sizes and methodological constraints, altered GABAergic neurotransmission appears to be a promising biomarker of digital addiction. Future longitudinal and multicentre studies incorporating advanced neuroimaging techniques are warranted to validate these findings, clarify the underlying pathophysiological mechanisms, and facilitate the development of targeted, evidence-based therapeutic interventions for internet and smartphone addiction.