Effect of deactivation of activity patterns related to smoking cue reactivity on nicotine addiction

Junjie Bu, Kymberly D. Young, Wei Hong, Ru Ma, Hongwen Song, Ying Wang, Wei Zhang, Michelle Hampson, Talma Hendler, Xiaochu Zhang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


With approximately 75% of smokers resuming cigarette smoking after using the Gold Standard Programme for smoking cessation, investigation into novel therapeutic approaches is warranted. Typically, smoking cue reactivity is crucial for smoking behaviour. Here we developed a novel closed-loop, smoking cue reactivity patterns EEG-based neurofeedback protocol and evaluated its therapeutic efficacy on nicotine addiction. During an evoked smoking cue reactivity task participants' brain activity patterns corresponding to smoking cues were obtained with multivariate pattern analysis of all EEG channels data, then during neurofeedback the EEG activity patterns of smoking cue reactivity were continuously deactivated with adaptive closed-loop training. In a double-blind, placebo-controlled, randomized clinical trial, 60 nicotine-dependent participants were assigned to receive two neurofeedback training sessions (∼1 h/session) either from their own brain (n = 30, real-feedback group) or from the brain activity pattern of a matched participant (n = 30, yoked-feedback group). Cigarette craving and craving-related P300 were assessed at pre-neurofeedback and post-neurofeedback. The number of cigarettes smoked per day was assessed at baseline, 1 week, 1 month, and 4 months following the final neurofeedback visit. In the real-feedback group, participants successfully deactivated EEG activity patterns of smoking cue reactivity. The real-feedback group showed significant decrease in cigarette craving and craving-related P300 amplitudes compared with the yoked-feedback group. The rates of cigarettes smoked per day at 1 week, 1 month and 4 months follow-up decreased 30.6%, 38.2%, and 27.4% relative to baseline in the real-feedback group, compared to decreases of 14.0%, 13.7%, and 5.9% in the yoked-feedback group. The neurofeedback effects on craving change and smoking amount at the 4-month follow-up were further predicted by neural markers at pre-neurofeedback. This novel neurofeedback training approach produced significant short-term and long-term effects on cigarette craving and smoking behaviour, suggesting the neurofeedback protocol described herein is a promising brain-based tool for treating addiction.

Original languageEnglish
Pages (from-to)1827-1841
Number of pages15
Issue number6
StatePublished - 1 Jun 2019


FundersFunder number
National Natural Science Foundation of China31771221, 31471071, 61773360, 71874170
National Natural Science Foundation of China
National Key Research and Development Program of China2016YFA0400900, 2018YFC0831101
National Key Research and Development Program of China
Fundamental Research Funds for the Central Universities


    • closed-loop
    • multivariate pattern analysis
    • neurofeedback
    • nicotine addiction
    • smoking cue reactivity


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