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  Neurofeedback training versus treatment-as-usual for alcohol dependence: results of an early-phase randomized controlled trial and neuroimaging correlates

Subramanian, L., Skottnik, L., Cox, W. M., Lührs, M., McNamara, R., Hood, K., et al. (2021). Neurofeedback training versus treatment-as-usual for alcohol dependence: results of an early-phase randomized controlled trial and neuroimaging correlates. European Addiction Research, 27(5), 381-394. doi:10.1159/000513448.

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Subramanian, Leena1, Author
Skottnik, Leon2, Author
Cox, W. Miles3, Author
Lührs, Michael4, 5, Author
McNamara, Rachel6, Author
Hood, Kerry6, Author
Watson, Gareth6, Author
Whittaker, Joseph R.7, Author
Williams, Angharad N.8, Author              
Sakhuja, Raman9, Author
Ihssen, Niklas10, Author
Goebel, Rainer4, 5, Author
Playle, Rebecca6, Author
Linden, David E.J.1, 2, Author
1MRC Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, United Kingdom, ou_persistent22              
2School for Mental Health and Neuroscience, Maastricht University, the Netherlands, ou_persistent22              
3School of Psychology, Bangor University, United Kingdom, ou_persistent22              
4Department of Cognitive Neuroscience, Maastricht University, the Netherlands, ou_persistent22              
5Brain Innovation B.V., Maastricht University, the Netherlands, ou_persistent22              
6Centre for Trials Research, School of Medicine, Cardiff University, United Kingdom, ou_persistent22              
7School of Physics and Astronomy, Cardiff University, United Kingdom, ou_persistent22              
8Max Planck Research Group Adaptive Memory, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2295691              
9Addiction Services, Cwm Taf Morgannwg University Health Board, Mountain Ash, United Kingdom, ou_persistent22              
10Department of Psychology, Durham University, United Kingdom, ou_persistent22              


Free keywords: Addiction; Alcohol dependence; Neurofeedback; Real-time functional magnetic resonance imaging; Self-regulation
 Abstract: Introduction: Alcohol dependence is one of the most common substance use disorders, and novel treatment options are urgently needed. Neurofeedback training (NFT) based on real-time functional magnetic resonance imaging (rtf-MRI) has emerged as an attractive candidate for add-on treatments in psychiatry, but its use in alcohol dependence has not been formally investigated in a clinical trial. We investigated the use of rtfMRI-based NFT to prevent relapse in alcohol dependence. Methods: Fifty-two alcohol-dependent patients from the UK who had completed a detoxification program were randomly assigned to a treatment group (receiving rtfMRI NFT in addition to standard care) or the control group (receiving standard care only). At baseline, alcohol consumption was assessed as the primary outcome measure and a variety of psychological, behavioral, and neural parameters as secondary outcome measures to determine feasibility and secondary training effects. Participants in the treatment group underwent 6 NFT sessions over 4 months and were trained to downregulate their brain activation in the salience network in the presence of alcohol stimuli and to upregulate frontal activation in response to pictures related to positive goals. Four, 8, and 12 months after baseline assessment, both groups were followed up with a battery of clinical and psychometric tests. Results: Primary outcome measures showed very low relapse rates for both groups. Analysis of neural secondary outcome measures indicated that the majority of patients modulated the salience system in the desired directions, by decreasing activity in response to alcohol stimuli and increasing activation in response to positive goals. The intervention had a good safety and acceptability profile. Conclusion: We demonstrated that rtfMRI-neurofeedback targeting hyperactivity of the salience network in response to alcohol cues is feasible in currently abstinent patients with alcohol dependence.


Language(s): eng - English
 Dates: 2020-07-072020-10-202021-03-052021
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1159/000513448
Other: epub 2021
PMID: 33677449
 Degree: -



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Project name : -
Grant ID : 602186
Funding program : 7th Framework Programme
Funding organization : European Commission

Source 1

Title: European Addiction Research
Source Genre: Journal
Publ. Info: Basel : Karger
Pages: - Volume / Issue: 27 (5) Sequence Number: - Start / End Page: 381 - 394 Identifier: ISSN: 1022-6877
CoNE: https://pure.mpg.de/cone/journals/resource/954925586301