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A clinical trial with combined transcranial direct current stimulation and alcohol approach bias retraining
Author(s) -
Uyl Tess E.,
Gladwin Thomas E.,
Rinck Mike,
Lindenmeyer Johannes,
Wiers Reinout W.
Publication year - 2017
Publication title -
addiction biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.445
H-Index - 78
eISSN - 1369-1600
pISSN - 1355-6215
DOI - 10.1111/adb.12463
Subject(s) - transcranial direct current stimulation , abstinence , craving , cognitive bias modification , psychology , neuromodulation , stimulation , dorsolateral prefrontal cortex , randomized controlled trial , neuroplasticity , physical medicine and rehabilitation , brain stimulation , prefrontal cortex , audiology , medicine , psychiatry , cognition , neuroscience , addiction , cognitive bias
Two studies showed an improvement in clinical outcomes after alcohol approach bias retraining, a form of Cognitive Bias Modification (CBM). We investigated whether transcranial direct current stimulation (tDCS) could enhance effects of CBM. TDCS is a neuromodulation technique that can increase neuroplasticity and has previously been found to reduce craving. One hundred alcohol‐dependent inpatients (91 used for analysis) were randomized into three experimental groups in a double‐blind parallel design. The experimental group received four sessions of CBM while receiving 2 mA of anodal tDCS over the dorsolateral prefrontal cortex (DLPFC). There were two control groups: One received sham stimulation during training and one received active stimulation at a different moment. Treatment outcomes were abstinence duration (primary) and relapse after 3 and 12 months, craving and approach bias (secondary). Craving and approach bias scores decreased over time; there were no significant interactions with experimental condition. There was no effect on abstinence duration after three months (χ2(2) = 3.53, p = 0.77). However, a logistic regression on relapse rates after one year (standard outcome in the clinic, but not‐preregistered) showed a trend when relevant predictors were included; relapse was lower in the condition receiving active stimulation during CBM only when comparing to sham stimulation ( B = 1.52, S.E. = .836, p = .07, without predictors: p = .19). No strong evidence for a specific enhancement effect of tDCS on CBM was found. However, in a post‐hoc analysis, tDCS combined with CBM showed a promising trend on treatment outcome. Important limitations are discussed, and replication is necessary to find more reliable effects.