People with greater network controllability—the ability to efficiently distribute neural control inputs across the brain's white matter—moderated their alcohol consumption. In a randomized controlled study, participants primed to mindfully respond to alcohol cues, compared to those who naturally reacted, reported reduced craving, though craving did not differ from a baseline group. Mindful regulation of alcohol cues involved more effortful control of neural dynamics across cognitive control and attention subnetworks compared to natural reactions in the baseline group, and this effort persisted in the mindful group's natural reactions. More effortful neural states had shorter intrinsic timescales, explaining how mindful attention promotes being present by quickly discontinuing past processing.
Poor surgical outcomes after microvascular decompression for trigeminal neuralgia are linked to maladaptive central neural reorganization rather than ineffective surgery. Among 60 patients, those with poor outcomes showed enhanced functional connectivity between default mode, somatomotor, and control networks and subcortical limbic structures (amygdala, nucleus accumbens, hippocampus) compared to those with good outcomes. A classifier using these connections achieved 86% accuracy in distinguishing outcome groups. Longer disease duration correlated with decreased fractional anisotropy in sensorimotor white matter tracts. The findings suggest that pain becomes cognitively and affectively 'self-embedded', transitioning from a sensory event to a persistent self-referential narrative that sustains pain even after peripheral trigger removal, reframing some trigeminal neuralgia as a central network disorder.