Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
Mind Research Network, Albuquerque, New Mexico.
Alcohol Clin Exp Res. 2019 Jun;43(6):1296-1307. doi: 10.1111/acer.14053. Epub 2019 May 9.
Mindfulness-based relapse prevention (MBRP) and transcranial direct current stimulation (tDCS) have independently shown benefits for treating alcohol use disorder (AUD). Recent work suggests tDCS may enhance mindfulness. The combination of MBRP and tDCS may provide synergistic benefits and may target both behavioral and neurobiological dysfunctions in AUD. The goal of this double-blind sham-controlled randomized trial was to examine the efficacy of a rolling group MBRP treatment combined with tDCS among individuals interested in reducing their drinking.
Individuals who were interested in reducing their alcohol use (n = 84; 40.5% female; mean age = 52.3; 98.9% with current AUD) were randomized to receive active (2.0 milliamps) or sham (0.0 milliamps) anodal tDCS (5 cm × 3 cm electrode) of the right inferior frontal gyrus with the 5 cm × 3 cm cathodal electrode applied to the left upper arm, combined with 8 weeks of outpatient MBRP rolling group treatment. Assessments were conducted at baseline, posttreatment, and 2 months following treatment. The primary outcome was drinks per drinking day, and secondary outcomes were percent heavy drinking days, self-reported craving, alcohol cue reactivity in an alcohol cue task, and response inhibition in a stop signal reaction time task.
Results indicated significant reductions in drinks per drinking day over time, B(SE) = -0.535 (0.16), p = 0.001, and a significant dose effect for number of groups attended, B(SE) = -0.259 (0.11), p = 0.01. There were also significant effects of time and dose for number of groups attended on secondary outcomes of percent heavy drinking days and alcohol cue reactivity. There were no effects of active versus sham tDCS on primary or secondary outcomes.
Findings from the current study provide initial support for the effectiveness of rolling group MBRP as an outpatient treatment for drinking reduction. The current study did not find additive effects of this tDCS protocol in enhancing MBRP among individuals with drinking reduction goals.
基于正念的复发预防（MBRP）和经颅直流电刺激（tDCS）已分别显示出对治疗酒精使用障碍（AUD）的益处。最近的研究表明，tDCS 可能会增强正念。MBRP 和 tDCS 的结合可能会提供协同益处，并可能针对 AUD 中的行为和神经生物学功能障碍。这项双盲假对照随机试验的目的是研究对有减少饮酒意愿的个体进行滚动组 MBRP 治疗与 tDCS 联合治疗的疗效。
对有减少饮酒意愿的个体（n=84；40.5%为女性；平均年龄 52.3；98.9%为当前 AUD）进行随机分组，接受真刺激（2.0 毫安）或假刺激（0.0 毫安），刺激右侧下额叶，使用 5cm×3cm 电极，5cm×3cm 阴极电极贴在左上臂，同时进行 8 周的门诊 MBRP 滚动组治疗。在基线、治疗后和治疗后 2 个月进行评估。主要结局是饮酒量，次要结局是重度饮酒天数、自我报告的渴望、酒精线索任务中的酒精线索反应和停止信号反应时间任务中的反应抑制。
结果表明，随着时间的推移，饮酒量显著减少，B（SE）=-0.535（0.16），p=0.001，参加的小组数量存在显著的剂量效应，B（SE）=-0.259（0.11），p=0.01。时间和剂量对参加小组数量的影响也显著影响次要结局中的重度饮酒天数和酒精线索反应。真刺激和假刺激 tDCS 对主要或次要结局均无影响。
本研究结果初步支持滚动组 MBRP 作为减少饮酒的门诊治疗方法的有效性。本研究未发现该 tDCS 方案在增强有减少饮酒意愿的个体的 MBRP 方面有附加作用。
