Mindfulness-Based Instruction Does Not Improve Real-Time fMRI Neurofeedback Efficiency in Problematic Alcohol Use
PsyArXiv Preprints September 2, 2026 preprint DOI: osf:94cwr_v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized, double-blind, sham-controlled trial Preregistered |
|---|---|
| Sample size | 90 |
| Population | Individuals with problematic alcohol use (AUDIT score > 8) |
| Duration | Two training sessions within one week |
| Measures | AUDIT, ventral striatal activation during alcohol cue exposure, craving ratings, trait mindfulness, drinking refusal self-efficacy |
| Topics | Meditation |
| Keywords | Alcohol FMRI Neurofeedback Ventral striatum Clinical psychology |
| Key findings | Real-time fMRI neurofeedback targeting ventral striatal cue reactivity did not significantly reduce ventral striatal activation or craving, even when combined with mindfulness-based instructions. Regulation success was not significantly associated with trait mindfulness or drinking refusal self-efficacy, and the authors note these results converge with a parallel randomized controlled trial in alcohol use disorder patients. |
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.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |