Background: Real-time functional magnetic resonance imaging (rtfMRI) is used for neurofeedback training (NFT).
Preliminary results suggest that it can help patients to control their symptoms. This study uses rtfMRI NFT for
relapse prevention in alcohol dependence.
Methods/design: Participants are alcohol-dependent patients who have completed a detoxification programme
within the past 6 months and have remained abstinent. Potential participants are screened for eligibility, and those
who are eligible are randomly assigned to the treatment group (receiving rtfMRI NFT in addition to treatment as
usual) or the control group (receiving only treatment as usual). Participants in both groups are administered
baseline assessments to measure their alcohol consumption and severity of dependence and a variety of
psychological and behavioural characteristics that are hypothesised to predict success with rtfMRI NFT. During the
following 4 months, experimental participants are given six NFT sessions, and before and after each session various
alcohol-related measures are taken. Participants in the control group are given the same measures to coincide with
their timing in the experimental group. Eight and 12 months after the baseline assessment, both groups are
followed up with a battery of measures. The primary research questions are whether NFT can be used to teach
participants to down-regulate their brain activation in the presence of alcohol stimuli or to up-regulate their brain
activation in response to pictures related to healthy goal pursuits, and, if so, whether this translates into reductions
in alcohol consumption. The primary outcome measures will be those derived from the functional brain imaging
data. We are interested in improvements (i.e., reductions) in participants’ alcohol consumption from pretreatment
levels, as indicated by three continuous variables, not simply whether or not the person has remained abstinent.
The indices of interest are percentage of days abstinent, drinks per drinking day, and percentage of days of heavy
drinking. General linear models will be used to compare the NFT group and the control group on these measures.
Discussion: Relapse in alcohol dependence is a recurring problem, and the present evaluation of the role of rtfMRI
in its treatment holds promise for identifying a way to prevent relapse.