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Volitional reduction of anterior cingulate cortex activity produces decreased cue craving in smoking cessation: a preliminary real-time fMRI study.

Abstract
Numerous research groups are now using analysis of blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) results and relaying back information about regional activity in their brains to participants in the scanner in 'real time'. In this study, we explored the feasibility of self-regulation of frontal cortical activation using real-time fMRI (rtfMRI) neurofeedback in nicotine-dependent cigarette smokers during exposure to smoking cues. Ten cigarette smokers were shown smoking-related visual cues in a 3 Tesla MRI scanner to induce their nicotine craving. Participants were instructed to modify their craving using rtfMRI feedback with two different approaches. In a 'reduce craving' paradigm, participants were instructed to 'reduce' their craving, and decrease the anterior cingulate cortex (ACC) activity. In a separate 'increase resistance' paradigm, participants were asked to increase their resistance to craving and to increase middle prefrontal cortex (mPFC) activity. We found that participants were able to significantly reduce the BOLD signal in the ACC during the 'reduce craving' task (P=0.028). There was a significant correlation between decreased ACC activation and reduced craving ratings during the 'reduce craving' session (P=0.011). In contrast, there was no modulation of the BOLD signal in mPFC during the 'increase resistance' session. These preliminary results suggest that some smokers may be able to use neurofeedback via rtfMRI to voluntarily regulate ACC activation and temporarily reduce smoking cue-induced craving. Further research is needed to determine the optimal parameters of neurofeedback rtfMRI, and whether it might eventually become a therapeutic tool for nicotine dependence.
AuthorsXingbao Li, Karen J Hartwell, Jeffery Borckardt, James J Prisciandaro, Michael E Saladin, Paul S Morgan, Kevin A Johnson, Todd Lematty, Kathleen T Brady, Mark S George
JournalAddiction biology (Addict Biol) Vol. 18 Issue 4 Pg. 739-48 (Jul 2013) ISSN: 1369-1600 [Electronic] United States
PMID22458676 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2012 The Authors, Addiction Biology © 2012 Society for the Study of Addiction.
Chemical References
  • Oxygen
Topics
  • Adult
  • Analysis of Variance
  • Cues
  • Female
  • Functional Neuroimaging (methods)
  • Gyrus Cinguli (metabolism, physiopathology)
  • Humans
  • Linear Models
  • Magnetic Resonance Imaging (methods)
  • Male
  • Middle Aged
  • Neurofeedback (methods)
  • Oxygen (metabolism)
  • Photic Stimulation
  • Pilot Projects
  • Prefrontal Cortex (metabolism, physiopathology)
  • Smoking (psychology)
  • Smoking Cessation
  • Smoking Prevention
  • Substance Withdrawal Syndrome (physiopathology, psychology)
  • Tobacco Use Disorder (physiopathology, psychology)
  • Volition
  • Young Adult

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