Real-time fMRI-based neurofeedback to restore brain function in substance use disorders: A systematic review of the literature

Ethan Murphy; Govinda Poudel; Saampras Ganesan; Chao Suo; Victoria Manning; Emillie Beyer; Adam Clemente; Bradford A Moffat; Andrew Zalesky; Valentina Lorenzetti

doi:10.1016/j.neubiorev.2024.105865

Real-time fMRI-based neurofeedback to restore brain function in substance use disorders: A systematic review of the literature

Neurosci Biobehav Rev. 2024 Oct:165:105865. doi: 10.1016/j.neubiorev.2024.105865. Epub 2024 Aug 27.

Authors

Affiliations

¹ Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia.
² Mary MacKillop Institute for Health Research, Australian Catholic University, Australia.
³ Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; Department of Biomedical Engineering, The University of Melbourne, Australia; Contemplative Studies Centre, Melbourne School of Psychological Sciences, The University of Melbourne, Australia.
⁴ Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia; BrainPark, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.
⁵ Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia; Turning Point, Eastern Health, Melbourne, Victoria, Australia.
⁶ Melbourne Brain Centre Imaging Unit, Department of Radiology, The University of Melbourne, Australia.
⁷ Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; Department of Biomedical Engineering, The University of Melbourne, Australia.
⁸ Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral and Health Sciences, Faculty of Health, Australian Catholic University, Australia. Electronic address: [email protected].

PMID: 39197715
DOI: 10.1016/j.neubiorev.2024.105865

Abstract

Introduction: Real-time functional magnetic resonance based-neurofeedback (fMRI-neurofeedback) is a neuromodulation tool where individuals self-modulate brain function based on real-time feedback of their brain activity. fMRI-neurofeedback has been used to target brain dysfunction in substance use disorders (SUDs) and to reduce craving, but a systematic synthesis of up-to-date literature is lacking.

Method: Following PRISMA guidelines, we conducted a systematic review of all the literature that examined the effects of fMRI-neurofeedback on individuals with regular psychoactive substance use (PROSPERO pre-registration = CRD42023401137).

Results: The literature included 16 studies comprising 446 participants with SUDs involving alcohol, tobacco, and cocaine. There is consistent between-condition (e.g., fMRI-neurofeedback versus control), less consistent pre-to-post fMRI-neurofeedback, and little intervention-by-time effects on brain function in prefrontal-striatal regions and craving.

Conclusion: The evidence for changes in brain function/craving was early and inconsistent. More rigorous experiments including repeated measure designs with placebo control conditions, are required to confirm the efficacy of fMRI-neurofeedback in reducing brain alterations and craving in SUDs.

Keywords: Addiction; Craving; Cue-reactivity; FMRI-neurofeedback; Functional MRI; Neuromodulation; Substance use disorder; Systematic review.

Publication types

Systematic Review
Review

MeSH terms

Brain* / diagnostic imaging
Brain* / physiology
Brain* / physiopathology
Craving / physiology
Humans
Magnetic Resonance Imaging*
Neurofeedback* / methods
Substance-Related Disorders* / diagnostic imaging
Substance-Related Disorders* / physiopathology
Substance-Related Disorders* / therapy