Neuromodulation Applications in Alcohol Use Disorder

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1. Development of fMRI Neurofeedback During the past two years we have worked with collaborators in NIMH and developed and implemented several neurofeedback prototypes for the Siemens 3T Prisma scanner. We have nearly completed the stage 1 of this study and preparing to start the intervention stage. We have conducted and presented interim analyses at scientific conferences. We found that across runs, participants improved their ability volitionally control cue reactivity related neural activity with the purpose of down-regulate craving for appetitive food and alcoholic beverages. In conducting the prototype stage, we developed a guideline for the utility of real time fMRI neurofeedback (Fede et al., 2020) 2. TMS Neuromodulation of Negative Urgency We are in the process of initiating another collaborative study in order to assess how negative urgency relates to impulsive decision-making in individuals with alcohol use disorder (AUD); and to characterize the associated hemodynamic response in prefrontal areas during using functional near infrared spectroscopy (fNIRS) imaging. A pilot sample of healthy volunteers and participants with AUD will be recruited to develop and test a novel task intended to induce negative urgency by provoking a strong negative emotional state via combined exposure to both painful stimuli and visual aversive stimuli, and subsequently testing impulsive decision-making. Moreover, we will test whether negative urgency can be modulated via prefrontal stimulation using repetitive transcranial magnetic stimulation (rTMS), as this technique has been shown to affect top-down regulatory circuits (prefrontal-limbic) during emotion regulation and impulsive decision-making, which are the two key components of negative urgency.