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Brain. 2019 Jun 1;142(6):1827-1841. doi: 10.1093/brain/awz114.

Effect of deactivation of activity patterns related to smoking cue reactivity on nicotine addiction.

Author information

1
Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China.
2
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
3
School of Humanities and Social Science, University of Science and Technology of China, Hefei, China.
4
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
5
Functional Brain Center, Tel-Aviv University, Tel-Aviv, Israel.
6
Hefei Medical Research Center on Alcohol Addiction, Anhui Mental Health Center, Hefei, China.
7
Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin, China.

Abstract

With approximately 75% of smokers resuming cigarette smoking after using the Gold Standard Programme for smoking cessation, investigation into novel therapeutic approaches is warranted. Typically, smoking cue reactivity is crucial for smoking behaviour. Here we developed a novel closed-loop, smoking cue reactivity patterns EEG-based neurofeedback protocol and evaluated its therapeutic efficacy on nicotine addiction. During an evoked smoking cue reactivity task participants' brain activity patterns corresponding to smoking cues were obtained with multivariate pattern analysis of all EEG channels data, then during neurofeedback the EEG activity patterns of smoking cue reactivity were continuously deactivated with adaptive closed-loop training. In a double-blind, placebo-controlled, randomized clinical trial, 60 nicotine-dependent participants were assigned to receive two neurofeedback training sessions (∼1 h/session) either from their own brain (n = 30, real-feedback group) or from the brain activity pattern of a matched participant (n = 30, yoked-feedback group). Cigarette craving and craving-related P300 were assessed at pre-neurofeedback and post-neurofeedback. The number of cigarettes smoked per day was assessed at baseline, 1 week, 1 month, and 4 months following the final neurofeedback visit. In the real-feedback group, participants successfully deactivated EEG activity patterns of smoking cue reactivity. The real-feedback group showed significant decrease in cigarette craving and craving-related P300 amplitudes compared with the yoked-feedback group. The rates of cigarettes smoked per day at 1 week, 1 month and 4 months follow-up decreased 30.6%, 38.2%, and 27.4% relative to baseline in the real-feedback group, compared to decreases of 14.0%, 13.7%, and 5.9% in the yoked-feedback group. The neurofeedback effects on craving change and smoking amount at the 4-month follow-up were further predicted by neural markers at pre-neurofeedback. This novel neurofeedback training approach produced significant short-term and long-term effects on cigarette craving and smoking behaviour, suggesting the neurofeedback protocol described herein is a promising brain-based tool for treating addiction.

KEYWORDS:

closed-loop; multivariate pattern analysis; neurofeedback; nicotine addiction; smoking cue reactivity

PMID:
31135053
DOI:
10.1093/brain/awz114

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