A clinical trial with combined transcranial direct current stimulation and alcohol approach bias retraining. (27th October 2016)

• Record Type: Journal Article
• Authors: den Uyl, Tess E.; Gladwin, Thomas E.; Rinck, Mike; Lindenmeyer, Johannes; Wiers, Reinout W.
• Is Part Of: Addiction biology. Volume 22:Number 6(2017)
• Page Start: 1632
• Page End: 1640
• Publication Date: 2016-10-27
• Subjects: alcoholism -- CBM -- tDCS; Substance abuse -- Periodicals; Substance abuse -- Physiological aspects -- Periodicals; Substance-Related Disorders -- periodicals; 616.86
• DOI: 10.1111/adb.12463
• Languages: English
• ISSNs: 1355-6215

Abstract

Abstract: 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. Abstract : This study investigated whether 2 mA of transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex could enhance effects of four sessions of cognitive bias modification (CBM). No strong evidence for a specific enhancement effect of tDCS on CBM was found. In a post‐hoc analysis, tDCS combined with CBM did show a promising trend on treatment outcome.