Overview
Functional magnetic resonance imaging (fMRI) is a brain scan that monitors blood flow to map brain activity. Parts of the brain that are more active consume more oxygen, driven by the blood-oxygen-level dependent (BOLD) response.
fMRI scans were instrumental in determining substance use disorders to be more than moral failings by demonstrating that parts of the brain functioned differently in response to chronic substance use. When presenting someone with a clinical diagnosis of SUD cues associated with their past use, the fMRI can capture increased blood flow to the limbic system and prefrontal cortex that coincide with cravings or urges to use. These individuals may also show reduced brain activation in brain networks associated with impulse control and inhibition. Recent studies show that we can even predict the risk of relapse or completing treatment from cue-exposure scanning based on activity in the insula and cingulate cortex. The same types of scans can also show that the hot spots that light up as a reaction to cues dampen over time as the brain heals.
Real-time fMRI neurofeedback (rtfMRI-nf) is a new technology that allows patients to see a representation of their own brain while practicing techniques that dampen the hot spots, giving them visual feedback as they gain experience in the practice of self-regulation.