Selecting an optimal real-time fMRI neurofeedback method for alcohol craving control training

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Real-time fMRI neurofeedback (rt-fMRI-NF) offers potential for neuromodulation in clinical applications.
• Optimal parameter identification is crucial for enhancing the clinical utility of rt-fMRI-NF.

Purpose of the Study:

• To identify optimal parameters for rt-fMRI-NF-aided craving regulation training in adults with alcohol use disorder (AUD).

Main Methods:

• Thirty adults with AUD underwent a single session of rt-fMRI-NF, involving four runs of craving-related brain activity downregulation.
• Three neurofeedback types were tested: multi-region of interest (ROI), continuous support vector machine (cSVM), and intermittent support vector machine (iSVM).
• Performance metrics included success rate, neural downregulation changes, and self-reported craving reduction.

Main Results:

• Participants showed improved trial success and downregulation of the insula, anterior cingulate, and dorsolateral prefrontal cortex (dlPFC) from run 1 to run 4.
• Greater downregulation in the anterior cingulate and dlPFC correlated with reduced craving.
• Intermittent SVM (iSVM) performed significantly worse than ROI and cSVM.
• ROI neurofeedback, unlike cSVM, enabled striatal and dlPFC downregulation correlated with greater craving reduction.

Conclusions:

• rt-fMRI-NF training demonstrates potential for downregulating alcohol craving in individuals with AUD.
• Preliminary findings suggest multi-ROI neurofeedback may be advantageous over SVM and intermittent feedback approaches.
• Further large-scale randomized controlled trials are needed to establish clinical meaningfulness.