Gibson Benjamin C, Votaw Victoria R, Stein Elena R, Clark Vincent P, Claus Eric, Witkiewitz Katie
Psychology Department, University of New Mexico, Logan Hall, MSC03-2220, 1 University of New Mexico, Albuquerque, NM 87131.
The Mind Research Network, Department of Translational Neuroscience, 1101 Yale Blvd. NE, Albuquerque, NM 87106.
Mindfulness (N Y). 2022 Jan;13(1):92-103. doi: 10.1007/s12671-021-01768-5. Epub 2021 Nov 26.
Mindfulness-Based Relapse Prevention (MBRP) and transcranial direct current stimulation (tDCS) have each demonstrated efficacy in improving outcomes in those with alcohol use disorder (AUD), however a recent study that combined MBRP with tDCS found tDCS provided no additional benefit to MBRP for AUD. Differences in treatment adherence between active versus sham tDCS groups may have contributed to this result. The current study examined whether treatment adherence interacted with tDCS condition in predicting post-treatment mindfulness and craving.
This study was a secondary data analysis from a randomized sham-controlled trial comparing MBRP paired with tDCS. Linear regression analyses were conducted examining the interaction between tDCS condition and two measures of treatment adherence (i.e., number of groups attended, number of tDCS administrations) on post-treatment mindfulness and craving.
There was no effect of treatment adherence by tDCS condition in predicting mindfulness, however the interaction between treatment adherence and tDCS condition significantly predicted post-treatment craving. There was a significant negative association between treatment adherence and post-treatment craving in the sham group, but there was no association in the active tDCS group.
MBRP coupled with sham stimulation led to significant reductions in self-reported craving when patients attended more sessions and received a greater number of sham tDCS administrations, while no relationship was observed between treatment adherence and craving among those who received active tDCS. This result provides tentative evidence that, rather than improve the effects of MBRP on craving, this active tDCS protocol provides no additional benefit to MBRP in reducing craving.
PRE-REGISTRATION: This study was registered with clinicaltrials.gov (NCT02861807).
基于正念的复发预防（MBRP）和经颅直流电刺激（tDCS）在改善酒精使用障碍（AUD）患者的治疗效果方面均已显示出疗效，然而，最近一项将MBRP与tDCS相结合的研究发现，tDCS并未给AUD患者的MBRP治疗带来额外益处。主动tDCS组与假刺激tDCS组之间治疗依从性的差异可能导致了这一结果。本研究探讨了治疗依从性与tDCS条件在预测治疗后正念和渴望方面是否存在相互作用。
本研究是一项随机假刺激对照试验的二次数据分析，该试验比较了MBRP与tDCS联合治疗。进行线性回归分析，以检验tDCS条件与两种治疗依从性测量指标（即参加的组数、tDCS治疗次数）对治疗后正念和渴望的相互作用。
tDCS条件下的治疗依从性对正念预测没有影响，然而，治疗依从性与tDCS条件之间的相互作用显著预测了治疗后的渴望。在假刺激组中，治疗依从性与治疗后渴望之间存在显著负相关，但在主动tDCS组中没有相关性。
当患者参加更多疗程并接受更多次数的假刺激tDCS治疗时，MBRP联合假刺激可显著降低自我报告的渴望，而在接受主动tDCS治疗的患者中，未观察到治疗依从性与渴望之间的关系。这一结果提供了初步证据，表明这种主动tDCS方案在减少渴望方面并未给MBRP带来额外益处，而不是改善MBRP对渴望的影响。
本研究已在clinicaltrials.gov（NCT02861807）注册。
