Pandria N, Athanasiou A, Konstantara L, Karagianni M, Bamidis P D
Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece; Northern Greece Neurofeedback Center, Thessaloniki, Greece.
Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
Neuroimage Clin. 2020;28:102397. doi: 10.1016/j.nicl.2020.102397. Epub 2020 Aug 25.
Smoking is a leading cause of morbidity and premature death constituting a global health challenge. Although, pharmacological and behavioral approaches comprise the mainstay of smoking cessation interventions, the efficacy and safety of pharmacotherapy is not demonstrated for some populations. Non-pharmacological approaches, such as biofeedback (BF) and neurofeedback (NF) could facilitate self-regulation of predisposing factors of relapse such as craving and stress. The current review aims to aggregate the existing evidence regarding the effects of BF and NF training on smokers. Relevant studies were identified through searching in Scopus, PubMed and Cochrane Library, and through hand-searching the references of screened articles. Peer-reviewed controlled and uncontrolled studies, where BF and/or NF training was administered, were included and evaluated according to PICOS framework. Narrative qualitative synthesis of ten eligible studies was performed, aggregated into three categories according to training provided. BF outcomes seem to be affected by smoking behavior prior to training; individualized EEG NF training holds promise for modulating craving-related response while minimizing the required number of sessions. Real-time fMRI NF studies concluded that nicotine-dependent individuals could modulate craving-related brain responses, while mixed results were revealed regarding smokers' ability to modulate brain responses related to resistance towards the urge to smoke. BF and NF training seem to facilitate modulation of autonomous and/or central nervous system activity while also transferring this learned self-regulation to behavioral outcomes. BF and NF training should a) address remaining issues on specificity and scientific validity, b) target diverse demographics, and c) produce robust reproducible methodologies and clinical guidelines for relevant health care providers, in order to be considered as viable complementary tools to standard smoking cessation care.
吸烟是发病和过早死亡的主要原因，构成了一项全球健康挑战。尽管药物和行为方法是戒烟干预措施的主要支柱，但药物治疗的有效性和安全性在某些人群中尚未得到证实。非药物方法，如生物反馈（BF）和神经反馈（NF），可以促进对复发的易感因素（如渴望和压力）的自我调节。本综述旨在汇总关于BF和NF训练对吸烟者影响的现有证据。通过在Scopus、PubMed和Cochrane图书馆中检索，并通过手工检索筛选文章的参考文献来识别相关研究。纳入了进行BF和/或NF训练的同行评审的对照和非对照研究，并根据PICOS框架进行评估。对十项符合条件的研究进行了叙述性定性综合，根据所提供的训练分为三类。BF的结果似乎受到训练前吸烟行为的影响；个性化脑电图NF训练有望调节与渴望相关的反应，同时尽量减少所需的训练次数。实时功能磁共振成像NF研究得出结论，尼古丁依赖个体可以调节与渴望相关的大脑反应，而关于吸烟者调节与抵抗吸烟冲动相关的大脑反应的能力则呈现出混合结果。BF和NF训练似乎有助于调节自主和/或中枢神经系统活动，同时也将这种习得的自我调节转化为行为结果。BF和NF训练应：a）解决特异性和科学有效性方面的剩余问题；b）针对不同的人口统计学特征；c）为相关医疗保健提供者制定可靠的可重复方法和临床指南，以便被视为标准戒烟护理的可行补充工具。
