Mindfulness-Based Instruction Does Not Improve Real-Time fMRI Neurofeedback Efficiency in Problematic Alcohol Use
Abstract
Background: Real-time fMRI neurofeedback (rt-fMRI NF) targeting ventral striatal (VS) cue reactivity has been proposed as a tool to support volitional self-regulation in individuals with problematic alcohol use, but training effects remain inconsistent. Regulation strategy is one potentially important but underexamined factor that may influence NF success. This pre-registered randomized, double-blind, sham-controlled study investigated whether mindfulness-based instructions could enhance rt-fMRI NF regulation of VS cue reactivity. Methods: Ninety individuals with problematic alcohol use (AUDIT score > 8) were randomly assigned to one of three groups: (1) VS NF with mindfulness-based instructions, (2) VS NF with neutral instructions, or (3) sham NF (primary auditory cortex) with neutral instructions. Participants completed two training sessions within one week. VS activation during alcohol cue exposure, craving, and associations with trait mindfulness and drinking refusal self-efficacy were assessed. Results: No significant group differences or run-by-group interactions were observed in VS activation across NF runs. Craving ratings did not significantly change over the intervention period and did not differ between groups. VS regulation success was not significantly associated with trait mindfulness or drinking refusal self-efficacy. Conclusions: The present study found no evidence that rt-fMRI NF reduces alcohol cue-related VS activity or craving, even when combined with mindfulness-based instructions. These findings converge with a parallel RCT targeting VS cue reactivity in AUD patients (Halli et al., 2026), and further suggest that downregulating VS cue reactivity via rt-fMRI NF is particularly challenging.
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BibTeX
@misc{zhang2026mindfulnessbased,
title = {{Mindfulness-Based Instruction Does Not Improve Real-Time fMRI Neurofeedback Efficiency in Problematic Alcohol Use}},
author = {Jingying Zhang and Falk Kiefer and Peter Kirsch and Martin Fungisai Gerchen},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/94cwr_v1},
url = {https://osf.io/preprints/psyarxiv/94cwr_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Mindfulness-Based Instruction Does Not Improve Real-Time fMRI Neurofeedback Efficiency in Problematic Alcohol Use
AU - Jingying Zhang
AU - Falk Kiefer
AU - Peter Kirsch
AU - Martin Fungisai Gerchen
PY - 2026
DA - 2026/09/02
PB - PsyArXiv
DO - 10.31234/osf.io/94cwr_v1
UR - https://osf.io/preprints/psyarxiv/94cwr_v1/
AB - Background: Real-time fMRI neurofeedback (rt-fMRI NF) targeting ventral striatal (VS) cue reactivity has been proposed as a tool to support volitional self-regulation in individuals with problematic alcohol use, but training effects remain inconsistent. Regulation strategy is one potentially important but underexamined factor that may influence NF success. This pre-registered randomized, double-blind, sham-controlled study investigated whether mindfulness-based instructions could enhance rt-fMRI NF regulation of VS cue reactivity. Methods: Ninety individuals with problematic alcohol use (AUDIT score > 8) were randomly assigned to one of three groups: (1) VS NF with mindfulness-based instructions, (2) VS NF with neutral instructions, or (3) sham NF (primary auditory cortex) with neutral instructions. Participants completed two training sessions within one week. VS activation during alcohol cue exposure, craving, and associations with trait mindfulness and drinking refusal self-efficacy were assessed. Results: No significant group differences or run-by-group interactions were observed in VS activation across NF runs. Craving ratings did not significantly change over the intervention period and did not differ between groups. VS regulation success was not significantly associated with trait mindfulness or drinking refusal self-efficacy. Conclusions: The present study found no evidence that rt-fMRI NF reduces alcohol cue-related VS activity or craving, even when combined with mindfulness-based instructions. These findings converge with a parallel RCT targeting VS cue reactivity in AUD patients (Halli et al., 2026), and further suggest that downregulating VS cue reactivity via rt-fMRI NF is particularly challenging.
ER -