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Relapse Prevention in Alcohol Dependency by Transcranial Direct Current Stimulation Supported Cue Exposure Therapy

Not Applicable
Conditions
Alcohol Dependency
Interventions
Device: tDCS
Behavioral: Cue Exposure Therapy
Registration Number
NCT02228486
Lead Sponsor
University Hospital Tuebingen
Brief Summary

Relapse is a major risk in substance abuse disorders, which is closely related to craving for a substance, describing a strong urge for consumption. Cue-exposure therapy is an intervention aiming at the reduction of perceived craving by repeated confrontation. It is based on the assumption that craving drops after repeated exposure without the reinforcing experience elicited by consumption. In the present study, patients with alcohol dependency take part in nine cue-exposure training sessions. Each session consists of mood induction reflecting a high risk situation with subsequent in vivo confrontation with one's preferred alcoholic beverage followed by the training of coping strategies. During the cue-exposure, patients focus on perceiving automatic responses to alcohol-related cues. We hypothesize that especially patients exhibiting initially high reactions to such cues should profit from this intervention the most. The reactions are measured on a subjective (craving) and physiological level (hemodynamics of the prefrontal cortex, heart rate variability, electrodermal activity). Furthermore, we want to strengthen the expected training effects during the cue-exposure by an activating transcranial direct current stimulation of the dorsolateral prefrontal cortex, which has been shown to be hypoactive in substance abuse disorders. We investigate how the cue-exposure training affects the processing of alcoholic cues (cue-reactivity) and its relation to clinical symptoms of alcohol dependency.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Clinical diagnosis of an alcohol dependence (F10.2)
  • abstinence motivation
Exclusion Criteria
  • epileptic seizures
  • acute psychotic episode
  • another substance use disorder besides nicotine dependency (F17.2)
  • acute withdrawal symptoms

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Cue Exposure Therapy and verum tDCSCue Exposure TherapyDuring alcohol cue exposure, an active tDCS with a duration of 15 minutes and 2 mA is applied to the left dorsolateral prefrontal cortex (F3, anode) and a reference electrode placed over Fp2 (electrode positions determined by the international 10-20 system). The electrodes are rectangular (35cm2).
Cue Exposure Therapy and verum tDCStDCSDuring alcohol cue exposure, an active tDCS with a duration of 15 minutes and 2 mA is applied to the left dorsolateral prefrontal cortex (F3, anode) and a reference electrode placed over Fp2 (electrode positions determined by the international 10-20 system). The electrodes are rectangular (35cm2).
Cue Exposure Therapy and sham tDCSCue Exposure TherapyDuring alcohol cue exposure, a placebo tDCS is used with electrodes placed over the left dorsolateral prefrontal cortex (F3, anode) and a reference electrode placed over Fp2 (electrode positions determined by the international 10-20 system). The electrodes are rectangular (35cm2). There is a 20 second ramp going up until 2 mA and back to 0 again at the beginning and the end of the placebo stimulation with no active stimulation during the cue exposure.
Primary Outcome Measures
NameTimeMethod
alcohol consumption dayssix months
Secondary Outcome Measures
NameTimeMethod
Maximum subjective alcohol craving during alcohol cue-exposure (10-point scale)5 weeks

During alcohol cue-exposure, subjects rate the subjective craving regularly on a scale from 0 to 10.

subjective rating of self-efficacy (score on a 10 item-scale)6 months

questionnaire (General Self-Efficacy Scale, Schwarzer \& Jerusalem, 1995)

Trial Locations

Locations (1)

Department of Psychiatry and Psychotherapy, University Hospital Tuebingen

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Tuebingen, Baden-Württemberg, Germany

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