Real-time fMRI neurofeedback: application in patients with substance use disorder

One of the most prominent symptoms in substance use disorders is a strong desire to consume a particular substance or to show a certain behaviour (craving). The aim of the present project was to modify craving-related neuronal responses in patients with alcohol use disorder (AUD) using neurofeedback (real-time fMRI). Patients with AUD and healthy subjects participated in the study; neurofeedback was an add-on to other therapeutic interventions. Neutral and alcohol-associated pictures were presented during functional MRI measurements. Alcohol-associated BOLD-responses in the frontal cortex were used as a region of interest (ROI). During the neurofeedback sessions, participants were instructed to reduce their neuronal activity in the specific ROI during the presentation of alcohol-associated pictures. The results indicated decreased brain responses after real-time fMRI sessions in alcohol-associated brain areas, especially the anterior cingulate cortex, the insula, inferior temporal gyrus, medial frontal gyrus and cuneus. In addition, the neuronal activity was reduced in the individual ROIs after the neurofeedback training in patients. In future, real-time fMRI may offer a therapeutic strategy to be used in addition to other psychotherapeutic strategies for patients with psychiatric and psychosomatic disorders.

This study was supported by LMUexcellent