Investigating Neurobiological Mechanisms of Chess as an Add-On Treatment Against Substance Use Disorder
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 108
- 试验地点
- 1
- 主要终点
- change in neural alcohol cue-reactivity
研究概览
简要总结
Neurobiological and neuropsychological approaches to investigate the potential mechanism of action of chess as an add-on therapy (chess based - cognitive remediation treatment, CB-CRT) to reduce cognitive deficits in individuals with alcohol use disorder (AUD) or tobacco use disorder (TUD).
详细描述
The study aims to investigate the potential mechanism of action of chess as a "chess based - cognitive remediation treatment, CB-CRT" to reduce cognitive deficits in individuals with substance use disorder (SUD) seeking treatment using neurobiological and neuropsychological approaches. Furthermore, it will be assessed whether this chess intervention has a generalized positive effect on short-term abstinence. Interestingly, the functional domains and associated underlying neuronal networks observed to be affected in individuals with SUD overlap significantly with those that could be strengthened by chess-based cognitive training or formal chess. Specifically, strengthening of cortical control regions (dorsolateral prefrontal cortex, DLPFC) and brain areas relevant for decision-making (orbitofrontal cortex, OFC) could prevent future relapse. Therefore, chess as an add-on therapy to complement other standard treatments of SUD could lead to improved therapeutic outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •severe alcohol (AUD) or tabacco use disorder (SUD) according to DSM-5
- •abstinence from alcohol for at least 72 hours (AUD)
- •sufficient ability to communicate with investigators and answer questions in both written and verbal format
- •ability to provide fully informed consent and to use self-rating scales
- •main diagnosis AUD: inpatient or outpatient treatment in our clinic
- •main diagnosis TUD: participation in 6 weeks smoking cessation treatment
- •Normal or corrected to normal vision
- •Signed consents for data security
排除标准
- •severe internal, neurological, and/or psychiatric comorbidities; other Axis I mental disorders other than TUD according to ICD-10 and DSM 5 (except for other substance use disorders - if AUD or TUD is still the main diagnosis -, ADHD, remitted depression, mild or moderate depression, adjustment disorder, generalized anxiety disorder, phobias, panic disorder or other mild or moderate personality disorders) in the last 12 months
- •Severe withdrawal symptoms (CIWA-Ar > 7; Sullivan et al. 1989)
- •alcohol intoxication (>0‰)
- •history of brain injury
- •severe cognitive impairments
- •common exclusion criteria for MRI (e.g. metal, claustrophobia, pregnancy)
- •suicidality or endangerment of others
- •positive Covid-19 screening
研究组 & 干预措施
CB-CRT AUD group
experimental group AUD: patients receive standard clinical therapy and an add-on chess based - cognitive remediation treatment (CB-CRT)
干预措施: Standard therapy for AUD plus Chess-based cognitive treatment (Behavioral)
Control group AUD
control group: patients with AUD receive standard clinical therapy
干预措施: Standard therapy for AUD (Behavioral)
CB-CRT TUD group
experimental group TUD: patients receive standard smoking cessation therapy and an add-on CB-CRT
干预措施: Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment (Behavioral)
Control group TUD
control group: patients with TUD receive standard smoking cessation therapy
干预措施: Standard therapy for TUD (Behavioral)
结局指标
主要结局
change in neural alcohol cue-reactivity
时间窗: 2 time points: before and after 6 weeks chess-based cognitive training
fMRI alcohol cue-reactivity task (Vollstädt-Klein et al. 2010)
Change in mental flexibility
时间窗: 2 time points: before and after 6 weeks SCP
\[Dimensional Change Card Sort (Zelazo et al. 2014)\]
change in neural working memory processes
时间窗: 2 time points: before and after 6 weeks chess-based cognitive training
fMRI working memory task "N-back" (Charlet et al. 2014)
Change in attentional capacity
时间窗: 2 time points: before and after 6 weeks SCP
\[d2 Test of Attention (Brickenkamp 2002)\].
Change in impulsivity
时间窗: 3 time points: before and after 6 weeks SCP plus after 3 months
impulsivity measured with BIS scale \[Barratt impulsiveness scale (Patton et al. 1995)\];range 15-60; total score will be used; high values represent high impulsivity
change in neural tobacco cue-reactivity
时间窗: 2 time points: before and after 6 weeks chess-based cognitive training
fMRI tobacco cue-reactivity task (Vollstädt-Klein et al. 2011)
change in neural correlates of inhibition
时间窗: 2 time points: before and after 6 weeks chess-based cognitive training
fMRI stop-signal task (Whelan et al. 2012)
substance use (alcohol consumption and tabacco use)
时间窗: 3 months follow-up after the end of treatment
self-report
Change in working memory capacity
时间窗: 2 time points: before and after 6 weeks SCP
working memory capacity measured by letter-number sequencing task of the \[Wechsler Memory Scale (Kent 2013)\]; raw values will be transformed to IQ-like scales (mean 100, SD 15); the higher the value, the higher the working memory capacity
Change in decision-making
时间窗: 2 time points: before and after 6 weeks SCP
\[Iowa Gambling Task (Bechara et al. 1994)\]
次要结局
- change in functional connectivity within the salience network (SN) and executive control network (ECN)(2 time points: before and after 6 weeks therapy and chess-based cognitive training)