Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial

Background: Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD. Objective: To evaluate the...

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Autores principales:	Macha Dubuson, Charles Kornreich, Marie-Anne Vanderhasselt, Chris Baeken, Florent Wyckmans, Clémence Dousset, Catherine Hanak, Johannes Veeser, Salvatore Campanella, Armand Chatard, Nemat Jaafari, Xavier Noël
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	tDCS Prefrontal cortex Inhibitory control training Alcohol cue Alcohol use disorder Relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/30fefd6269bc4896afeba4b26bf965af
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spelling	oai:doaj.org-article:30fefd6269bc4896afeba4b26bf965af2021-11-20T05:02:53ZTranscranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial1935-861X10.1016/j.brs.2021.10.386https://doaj.org/article/30fefd6269bc4896afeba4b26bf965af2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1935861X21006331https://doaj.org/toc/1935-861XBackground: Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD. Objective: To evaluate the clinical efficacy of five sessions of 2 mA bilateral transcranial direct current stimulation (tDCS) for 20 min over the dorsolateral prefrontal cortex (DLPFC) (left cathodal/right anodal) combined with alcohol cue inhibitory control training (ICT) as part of rehabilitation. The secondary outcomes were executive functioning (e.g. response inhibition) and craving intensity, two mechanisms strongly related to abstinence. Methods: A randomized clinical trial with patients (n = 125) with severe AUD at a withdrawal treatment unit. Each patient was randomly assigned to one of four conditions, in a 2 [verum vs. sham tDCS] x 2 [alcohol cue vs. neutral ICT] factorial design. The main outcome of treatment was the abstinence rate after two weeks or more (up to one year). Results: Verum tDCS improved the abstinence rate at the 2-week follow-up compared to the sham condition, independently of the training condition (79.7% [95% CI = 69.8–89.6] vs. 60.7% [95% CI = 48.3–73.1]; p = .02). A priori contrasts analyses revealed higher abstinence rates for the verum tDCS associated with alcohol cue ICT (86.1% [31/36; 95% CI = 74.6–97.6]) than for the other three conditions (64% [57/89; 95% CI = 54–74]). These positive clinical effects on abstinence did not persist beyond two weeks after the intervention. Neither the reduction of craving nor the improvement in executive control resulted specifically from prefrontal-tDCS and ICT. Conclusions: AUD patients who received tDCS applied to DLPFC showed a significantly higher abstinence rate during the weeks following rehabilitation. When combined with alcohol specific ICT, brain stimulation may provide better clinical outcomes. Trial Registration: ClinicalTrials.gov number NCT03447054 https://clinicaltrials.gov/ct2/show/NCT03447054.Macha DubusonCharles KornreichMarie-Anne VanderhasseltChris BaekenFlorent WyckmansClémence DoussetCatherine HanakJohannes VeeserSalvatore CampanellaArmand ChatardNemat JaafariXavier NoëlElsevierarticletDCSPrefrontal cortexInhibitory control trainingAlcohol cueAlcohol use disorderRelapseNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Stimulation, Vol 14, Iss 6, Pp 1531-1543 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tDCS Prefrontal cortex Inhibitory control training Alcohol cue Alcohol use disorder Relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	tDCS Prefrontal cortex Inhibitory control training Alcohol cue Alcohol use disorder Relapse Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Macha Dubuson Charles Kornreich Marie-Anne Vanderhasselt Chris Baeken Florent Wyckmans Clémence Dousset Catherine Hanak Johannes Veeser Salvatore Campanella Armand Chatard Nemat Jaafari Xavier Noël Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
description	Background: Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD. Objective: To evaluate the clinical efficacy of five sessions of 2 mA bilateral transcranial direct current stimulation (tDCS) for 20 min over the dorsolateral prefrontal cortex (DLPFC) (left cathodal/right anodal) combined with alcohol cue inhibitory control training (ICT) as part of rehabilitation. The secondary outcomes were executive functioning (e.g. response inhibition) and craving intensity, two mechanisms strongly related to abstinence. Methods: A randomized clinical trial with patients (n = 125) with severe AUD at a withdrawal treatment unit. Each patient was randomly assigned to one of four conditions, in a 2 [verum vs. sham tDCS] x 2 [alcohol cue vs. neutral ICT] factorial design. The main outcome of treatment was the abstinence rate after two weeks or more (up to one year). Results: Verum tDCS improved the abstinence rate at the 2-week follow-up compared to the sham condition, independently of the training condition (79.7% [95% CI = 69.8–89.6] vs. 60.7% [95% CI = 48.3–73.1]; p = .02). A priori contrasts analyses revealed higher abstinence rates for the verum tDCS associated with alcohol cue ICT (86.1% [31/36; 95% CI = 74.6–97.6]) than for the other three conditions (64% [57/89; 95% CI = 54–74]). These positive clinical effects on abstinence did not persist beyond two weeks after the intervention. Neither the reduction of craving nor the improvement in executive control resulted specifically from prefrontal-tDCS and ICT. Conclusions: AUD patients who received tDCS applied to DLPFC showed a significantly higher abstinence rate during the weeks following rehabilitation. When combined with alcohol specific ICT, brain stimulation may provide better clinical outcomes. Trial Registration: ClinicalTrials.gov number NCT03447054 https://clinicaltrials.gov/ct2/show/NCT03447054.
format	article
author	Macha Dubuson Charles Kornreich Marie-Anne Vanderhasselt Chris Baeken Florent Wyckmans Clémence Dousset Catherine Hanak Johannes Veeser Salvatore Campanella Armand Chatard Nemat Jaafari Xavier Noël
author_facet	Macha Dubuson Charles Kornreich Marie-Anne Vanderhasselt Chris Baeken Florent Wyckmans Clémence Dousset Catherine Hanak Johannes Veeser Salvatore Campanella Armand Chatard Nemat Jaafari Xavier Noël
author_sort	Macha Dubuson
title	Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
title_short	Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
title_full	Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
title_fullStr	Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
title_full_unstemmed	Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial
title_sort	transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: a randomized placebo-controlled clinical trial
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/30fefd6269bc4896afeba4b26bf965af
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Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial

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