Neurobiological Mechanisms of Chess as an Add-On Treatment Against SUD

Central Institute of Mental Health, Mannheim108 enrolled

Overview

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).

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

108

Conditions

Substance Use Disorders

Interventions

Standard therapy for AUD plus Chess-based cognitive treatmentBEHAVIORAL

Behavioral: standard AUD Cognitive Behavioral Therapy (CBT) in Clinical setting. Patients who voluntarily submit to enter a qualified detoxification treatment program will be examined, either in-patient, out-patient, or in a day-clinic setting at the Department of Addictive Behaviour and Addiction Medicine. Additional, the experimental group receives chess based cognitive remediation treatment (CB-CRT) for 1,5 hours three times a week. The tasks of the treatment were created by our cooperation partner, the psychologist Juan Antonio Montero. He is currently successfully applying this battery as an add-on therapy. The training battery is designed to strengthen cognitive functioning in specific domains such as short-term memory, focal attention, selective attention, pattern recognition, visuospatial abilities, metacognition and also inhibition.

Standard therapy for AUDBEHAVIORAL

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 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 Exclusion Criteria: * 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

Locations (1)

Klinik für Abhängiges Verhalten, Zentralinstitut für Seelische Gesundheit

Mannheim, Germany

Outcomes

Primary Outcomes

change in neural alcohol cue-reactivity

fMRI alcohol cue-reactivity task (Vollstädt-Klein et al. 2010)

Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

change in neural tobacco cue-reactivity

fMRI tobacco cue-reactivity task (Vollstädt-Klein et al. 2011)

Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

change in neural correlates of inhibition

fMRI stop-signal task (Whelan et al. 2012)

Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

substance use (alcohol consumption and tabacco use)

self-report

Time frame: 3 months follow-up after the end of treatment

change in neural working memory processes

fMRI working memory task "N-back" (Charlet et al. 2014)

Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

Change in working memory capacity

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

Time frame: 2 time points: before and after 6 weeks SCP

Change in impulsivity

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

Time frame: 3 time points: before and after 6 weeks SCP plus after 3 months

Data from ClinicalTrials.gov

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Neurobiological Mechanisms of Chess as an Add-On Treatment Against SUD

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes