Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC;
Nicotine Tob Res. 2013 Dec;15(12):2120-4. doi: 10.1093/ntr/ntt122. Epub 2013 Aug 9.
Neurofeedback delivered via real-time functional magnetic resonance imaging (rtfMRI) is a promising therapeutic technique being explored to facilitate self-regulation of craving in nicotine-dependent cigarette smokers. The current study examined the role of nicotine-dependence severity and the efficacy of multiple visits of neurofeedback from a single region of interest (ROI) in the anterior cingulate cortex (ACC) on craving reduction.
Nine nicotine-dependent cigarette smokers participated in three rtfMRI visits that examined cue-induced craving and brain activation. Severity of nicotine dependence was assessed with the Fagerström Test for Nicotine Dependence. When viewing smoking-related images with instructions to "crave," patient-tailored ROIs were generated in the vicinity of the ACC. Activity levels from the ROI were fed back while participants viewed smoking cues with the instruction to reduce craving.
Neurofeedback from a single ROI in the ACC led to consistent decreases in self-reported craving and activation in the ACC across the three visits. Dependence severity predicted response to neurofeedback at Visit 3.
This study builds upon previous rtfMRI studies on the regulation of nicotine craving in demonstrating that feedback from the ACC can reduce activation to smoking cues across three separate visits. Individuals with lower nicotine-dependence severity were more successful in reducing ACC activation over time. These data highlight the need to consider dependence severity in developing more individualized neurofeedback methods.
通过实时功能磁共振成像（rtfMRI）提供的神经反馈是一种很有前途的治疗技术，正在探索中，以促进尼古丁依赖的吸烟者对渴望的自我调节。本研究考察了在注意前皮质（ACC）的一个单一感兴趣区域（ROI）中，神经反馈的多次访问的作用，以及尼古丁依赖严重程度和神经反馈的疗效，对渴望减少的影响。
9 名尼古丁依赖的吸烟者参加了 3 次 rtfMRI 访问，以检查线索诱导的渴望和大脑激活。尼古丁依赖的严重程度用尼古丁依赖测试（Fagerström Test for Nicotine Dependence）来评估。当观看与“渴望”指令相关的吸烟图像时，在 ACC 附近生成了针对患者的 ROI。当参与者观看吸烟线索并被指示减少渴望时，从 ROI 反馈活动水平。
在三个访问中，来自 ACC 的单个 ROI 的神经反馈导致自我报告的渴望和 ACC 中的激活一致降低。在第 3 次访问时，依赖严重程度预测了对神经反馈的反应。
本研究在先前关于调节尼古丁渴望的 rtfMRI 研究的基础上，证明了来自 ACC 的反馈可以在三个单独的访问中减少对吸烟线索的激活。依赖严重程度较低的个体随着时间的推移更成功地减少了 ACC 的激活。这些数据突出表明，在开发更个体化的神经反馈方法时，需要考虑依赖严重程度。
