Alcohol use disorder
Research Papers
Biofeedback Interventions for Impulsivity-related Processes in Addictive Disorders
Abstract Purpose of Review Biofeedback is a promising technique that has been used as a treatment tool for different psychological disorders. In this regard, central (neurofeedback) and peripheral psychophysiological signals are presented as comprehensible stimuli with the aim of training specific processes. This review summarizes recent evidence about its use for the treatment of impulsivity-related processes in addictive disorders. Recent Findings Neurofeedback (NFB) protocols, based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI), have focused on substance use disorders. Biofeedback protocols using peripheral measures have been mainly based on heart rate variability and focused on behavioral addictions. EEG-NFB reported good results in the reduction of hyperarousal, impulsivity and risk taking in alcohol use disorder, and decreased rates of smoking and less craving in nicotine addiction. In fMRI-NFB, effective NFB performance has been related with better clinical outcomes in substance use disorders; however, its implication for treatment is still unclear. Heart rate variability biofeedback results are scarce, but some interventions have been recently designed aimed at treating behavioral addictions. Summary In addictive disorders, biofeedback interventions for impulsivity-related processes have shown promising results, although the literature is still scarce. Further research should aim at proving the effectiveness of biofeedback protocols as a treatment option for impulsivity in addictive disorders.
View Full Paper →The efficacy of neurofeedback for alcohol use disorders - a systematic review
Background: Alcoholism is a serious social, economic and public health problem. Alcoholism can affect the gastrointestinal, neurological, cardiovascular and respiratory systems, and it can be fatal, costing the healthcare system huge amounts of money. Despite the availability of cognitive-behavioural and psychosocial therapies, alcoholism has a high recurrence rate and a dismal prognosis, with a wide inter-individual variation. As a result, better or adjuvant therapies that improve or facilitate alcoholism therapy are required. We conducted a systematic review to look into the published studies that reported the effectiveness of non-pharmacological neurofeedback (NF) interventions in patients with alcohol use disorders (AUDs). Methods: PubMed, Google Scholar, The Cochrane Library, Science Direct and Clinicaltrial.gov were searched until 4 April 2022. Original articles of any design reporting on the use of NF approaches in the treatment of AUDs were included. Information related to study design, participants, control group, neuromodulation therapy, number of sessions and key findings of the study were extracted. The Joanna Briggs Institute’s (JBI) Critical Appraisal Checklist for Studies was used to assess the quality of studies. Results: A total of 20 research articles (including 618 participants) were retrieved and included for qualitative analysis. The sample size ranged from 1 (case report) to 80, with years of publication ranging from 1977 to 2022. Nine of the 20 articles included in the study were conducted in the United States, followed by Germany, the United Kingdom, India, the Netherlands and South Korea. Out of the 20 studies included, 8 (40%) had a moderate risk of bias, while the other, i.e. 60% had a low risk of bias. The effectiveness of various neurological treatments in the treatment of AUDs was established in these 20 studies. There have been 11 studies on EEG NF training, three studies on real-time FMRI NF, two studies each on transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), and one study each on deep brain stimulation (DBS) and theta burst stimulation (TBS). These alternative neurological therapies have been demonstrated to lower alcohol cravings and consumption temporarily, reduce anxiety and depression scores, reduce relapse rates and increase control of brain activity. Conclusions: The use of various neuromodulation approaches to the treatment of AUD shows promise. However, more research with larger sample size is required.
View Full Paper →Preventing relapse in alcohol disorder with EEG-neurofeedback as a neuromodulation technique: A review and new insights regarding its application
Alcohol Use Disorder (AUD) has a disconcertingly high relapse rate (70–80% within a year following withdrawal). Preventing relapse or minimizing its extent is hence a challenging goal for long-term successful management of AUD. New perspectives that rely on diverse neuromodulation tools have been developed in this regard as care supports. This paper focuses on electroencephalogram-neurofeedback (EEG-NF), which is a tool that has experienced renewed interest in both clinical and research areas. We review the literature on EEG-based neurofeedback studies investigating the efficacy in AUD and including at least 10 neurofeedback training sessions. As neurofeedback is a form of biofeedback in which a measure of brain activity is provided as feedback in real-time to a subject, the high degree of temporal resolution of the EEG interface supports optimal learning. By offering a wide range of brain oscillation targets (alpha, beta, theta, delta, gamma, and SMR) the EEG-NF procedure increases the scope of possible investigations through a multitude of experimental protocols that can be considered to reinforce or inhibit specific forms of EEG activity associated with AUD-related cognitive impairments. The present review provides an overview of the EEG-NF protocols that have been used in AUD and it highlights the current paucity of robust evidence. Within this framework, this review presents the arguments in favor of the application of EEG-NF as an add-on tool in the management of alcohol disorders to enhance the cognitive abilities required to maintain abstinence more specifically, with a focus on inhibition and attentional skills.
View Full Paper →Conflict-related medial frontal theta as an endophenotype for alcohol use disorder
Diminished cognitive control in alcohol use disorder (AUD) is thought to be mediated by prefrontal cortex circuitry dysregulation. Research testing the relationship between AUD and specific cognitive control psychophysiological correlates, such as medial frontal (MF) theta-band EEG power, is scarce, and the etiology of this relationship is largely unknown. The current report tested relationship between pathological alcohol use through young adulthood and reduced conflict-related theta at age 29 in a large prospective population-based twin sample. Greater lifetime AUD symptomatology was associated with reduced MF theta power during response conflict, but not alpha-band visual attention processing. Follow-up analyses using cotwin control analysis and biometric modeling suggested that genetic influences, and not the consequences of sustained AUD symptomatology, explained the theta-AUD association. Results provide strong evidence that AUD is genetically related to diminished conflict-related MF theta, and advance MF theta as a promising electrophysiological correlate of AUD-related dysfunctional frontal circuitry.
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