Individualized real-time fMRI neurofeedback to attenuate craving in nicotine-dependent smokers

Background: cue-induced craving plays an important role in relapse,and the neural correlates of cue-induced craving have been elucidated using fmri. this study examined the utility of real-time fmri (rtfmri) neurofeedback to strengthen self-regulation of craving-related neural activation and cue-reactivity in cigarette smokers. methods: nicotine-dependent smokers were randomized to rtfmri neurofeedback or to a no-feedback control group. participants completed 3 neuroimaging visits. within each visit,an initial run during which smoking-related cues were used to provoke craving,an individualized craving-related region of interest (roi) in the prefrontal cortex or anterior cingulate cortex was identified. in the rtfmri group,activity from the roi was fed back via a visual display during 3 subsequent runs while participants were instructed to reduce craving during cue exposure. the control group had an identical experience with no feedback provided. results: forty-four nicotine-dependent smokers were recruited to participate in our study; data from the 33 participants who completed a 1-week follow-up visit were included in the analysis. subjective craving ratings and cue-induced brain activation were lower in the rtfmri group than in the control group. limitations: as participants were not seeking treatment,clinical outcomes are lacking. conclusion: nicotine-dependent smokers receiving rtfmri feedback from an individualized roi attenuated smoking cueelicited neural activation and craving,relative to a control group. further studies are needed in treatment-seeking smokers to determine if this intervention can translate into a clinically meaningful treatment modality. © 2016 8872147 canada inc.