Comparison of LORETA Z score Neurofeedback and Cognitive Rehabilitation in terms of their Effectiveness in Reducing Craving in Opioid Addicts

Background: Previous studies have shown that conventional neurofeedback and cognitive modification treatments have led to numerous psychological improvements in patients suffering from substance use disorders. However, effectiveness of LORETA (Low-Resolution Brain Electromagnetic Tomography) Z score neurofeedback (LZNFB) and Cognitive rehabilitation therapy on reducing of opioid craving has yet to be investigated. Thus, aim of the present study was to compare effectiveness of LZNFB and Cognitive rehabilitation therapy with methadone maintenance treatment (MMT) in reduction of craving in patients with opioid use disorder. Methods: Thirty patients with opioid use disorder undergoing MMT were randomly assigned into three groups: LZNFB with MMT, Cognitive rehabilitation with MMT (as experimental groups), and MMT alone Control group. The LZNFB and Cognitive rehabilitation groups received 20 and 15 sessions of treatment, respectively. The three groups were assessed using a number of questionnaires as well as Dot-Probe Task at pre-test, post-test, and one-month follow-up. Results: The results showed that both experimental groups accomplished significantly greater reduction in opioid craving than MMT alone group at post-test and follow up (P<0.05). The LZNFB with MMT group showed higher decrease in opioid craving than the Cognitive rehabilitation with MMT group. In addition, Cognitive rehabilitation group experienced greater improvement on attentional bias towards craving cues than LZNFB with MMT group at post-test and follow up. Finally, LZNFB with MMT group and Cognitive rehabilitation with MMT group got higher scores on the recovery assessment scale than MMT alone group at post-test and follow up. According to results of this study, LZNFB training is more effective than Cognitive Rehabilitation in decreasing of craving and improving quality of life in addiction to opioids. Conclusion: The findings of the current study provided preliminary support for the effectiveness of LZNFB and Cognitive rehabilitation on reduction of opioid craving, improvement of attentional bias towards craving cues and quality of life among Iranian opioids use patients.