Real Time fMRI and Quitting Smoking

Recruitment & Eligibility

Inclusion Criteria

Treatment-seeking smokers between the ages of 18 and 65, reporting consumption of at least 10 cigarettes per day for at least the past 6 months;
Planning to live in the area for at least the next month;
Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the combined consent and HIPAA form;
Able to communicate fluently in English (speaking, writing, and reading).

Exclusion Criteria

Smoking Behavior:

Use of chewing tobacco or snuff or cigars;
Current enrollment or plans to enroll in another smoking cessation program or research study in the next month;
Current or anticipated (within the next month) use of smoking cessation medications or nicotine replacement therapy (NRT);
A baseline carbon monoxide (CO) reading less than 10ppm.

Alcohol/Drugs:

Current alcohol consumption that exceeds 25 standard drinks/week;
Positive breath alcohol concentration test (BrAC greater than or equal to 0.01) at intake; a. Participants testing positive for breath alcohol with a reading equal to or greater than .08 (the legal driving limit) or who are visibly impaired will be instructed not to drive themselves home after the appointment. If a participant needs to use a phone to call for a safe ride home, an office telephone will be made available to the participant.

Medication:

Current use or recent discontinuation (within the past 30 days at the time of Intake) of:

Smoking cessation medication (e.g., Zyban, Wellbutrin, Wellbutrin SR, Chantix, NRT);
Anti-psychotic medications;
Any medication that could compromise participant safety as determined by the Principal Investigator and/or Study Physician;

Daily use of:
Opiate-containing medications for chronic pain.

Medical/Neuropsychiatric:

Women who are pregnant, planning a pregnancy, and/or breast feeding. All female subjects of childbearing potential will undergo a urine pregnancy test at Intake and at each scan session.
History of epilepsy or a seizure disorder;
History of stroke;
Self-reported brain (or CNS) or spinal tumor;
Self-reported history of head trauma;
Self-reported history or current diagnosis of psychosis.

fMRI-Related:

Self-reported use of pacemakers, certain metallic implants, or presence of metal in the eye as contraindicated for fMRI;
Self-reported history of claustrophobia;
Being left-handed;
Color blindness;
Weight greater than 250lbs at intake;
Self-reported history of gunshot wounds;
Any impairment preventing participants from using the response pad necessary for the computer tasks;
Circumstances or conditions that may interfere with magnetic resonance imaging (MRI).

General Exclusion:

Any medical condition, illness, disorder, or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator;
Enrollment or plans to enroll in another research study;
Inability to provide informed consent or complete any of the study tasks as determined by the Principal Investigator.

Study & Design

Arm && Interventions

Group	Intervention	Description
Real-time neurofeedback training group	Realtime biofeedback using fMRI	We propose to use rt-fMRI neurofeedback training to help smokers consciously modulate activation in areas related to cravings and self-control in order to improve control smoking urges. In this arm, participants will complete four sessions: an intake session and 3 neurofeedback scanning visits. The primary outcome is the ability to resist smoking during a validated smoking lapse paradigm. Secondary outcomes include changes in brain activity in areas related to craving and self-control, and self-reported craving for cigarettes.

Primary Outcome Measures

Name	Time	Method
Smoking Lapse Paradigm	Study session 3 (scan day 3)	Time (sec) to first cigarette during a 50 minute monitored smoking lapse period in smoking laboratory

Secondary Outcome Measures

Name	Time	Method
Cue induced brain signal change	Study session 3 (scan day 3)	Change in mean percent signal change for Cue minus Neutral contrasts in activated brain regions

Recruitment & Eligibility