The study aims to examine whether the neurofeedback method (based on functional magnetic resonance imaging \[fMRI\]) can help patients with alcohol dependence to control their urges to drink alcohol and thus to remain abstinent. Potential effects of neurofeedback on abstinence and drinking behaviour will be evaluated based on the comparison between a group of patients receiving multiple sessions of neurofeedback training and a group of patients receiving treatment as usual over the same period of time.
Neurofeedback is a non-invasive neuroscientific tool in which participants receive real-time feedback about their brain activity while undergoing functional magnetic resonance imaging. Previous research has shown that participants can successfully use the feedback to self-regulate their brain responses. In this study patients who have successfully completed a detoxification programme will be trained to down-regulate/upregulate responses of motivational brain regions that are activated during exposure to alcohol/life goal-related stimuli (pictures of alcoholic drinks/life goals related). The investigators hypothesise that learning to self-regulate these neural responses will enable patients to better control craving responses to environmental alcohol cues after detoxification treatment. Patients in the intervention group will undergo 6 neurofeedback training sessions, spread across 4 months. Outcomes of the training will be compared with a group of patients who will not do the neurofeedback training but receive standard treatment (e.g. support groups and medication).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
52
During scanning patients will be exposed to picture stimuli (showing alcoholic drinks and life goals) projected on a screen behind the scanner and viewed through a mirror attached on the MRI head coil. In each session patients will be trained to down-regulate/up-regulate activation levels in brain areas that show reliable responses to the alcohol/life goals pictures in a 'localiser' scan. Self-regulation of these brain responses will then be guided by real-time feedback of alcohol/life goals-cue elicited activation, consisting of changes in the visible alcohol/life goals picture (decreasing size = successful down-regulation; increasing size = successful upregulation). Functional MRI data will be acquired in short blocks having a duration of 5-8 minutes.
School of Medicine, Cardiff University
Cardiff, Wales, United Kingdom
Indices of drinking (continuous) - % days abstinent
Derived from the Timeline Followback Calendar.
Time frame: 4 months after baseline assessment/first training
Indices of drinking (continuous) - drinks per drinking day
Derived from the Timeline Followback Calendar.
Time frame: 4 months after baseline assessment/first training
Indices of drinking (continuous) - % days of 'heavy drinking'
Defined as 8 or more alcohol units per day/men or 6 or more units/women. Derived from the Timeline Followback Calendar.
Time frame: 4 months after baseline assessment/first training
Drinking urges/craving assessed with the Drinking Urges Questionnaire (DUQ)
Time frame: Assessed 4 months, 8 months and 12 months after baseline
Drinking urges/craving assessed with the Obsessive Compulsive Drinking Scale (OCDS)
Time frame: Assessed 4 months, 8 months and 12 months after baseline
Drinking urges/craving (attentional bias) assessed with the alcohol stroop test
Time frame: Assessed 4 months, 8 months and 12 months after baseline
Craving self-ratings during scanning (neurofeedback group only)
Time frame: Assessed 2, 4, 6, 8, 12, 16 weeks after baseline (each training session)
Profile of Mood States Questionnaire
Time frame: Assessed 4 months, 8 months and 12 months after baseline
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Beck Depression Inventory
Time frame: Assessed 4 months, 8 months and 12 months after baseline
Hospital Anxiety and Depression Scale
Time frame: Assessed 4 months, 8 months and 12 months after baseline
NHS Resource Use Questionnaire
Time frame: Assessed 4 months, 8 months and 12 months after baseline
Debriefing Questionnaire (neurofeedback group only)
Time frame: Assessed 2, 4, 6, 8, 12, 16 weeks after baseline (each training session)