New Therapeutic Strategies for Inhibitory Control in Alcoholism
Condition: Alcoholism
MeSH terms: Alcoholism
Study type: Interventional

Summary: 
      This experimental research studies the efficacy of two different treatments for inhibitory
      control improvement in alcohol-dependent individuals, one consisting of Retrieval-Extinction
      Learning ( alcohol AAT Task) and the other consisting in rTMS of the right dorsolateral
      prefrontal cortex.
    

Detailed description: 
      The main purpose of this study is to demonstrate the efficacy of two different treatments for
      inhibitory control improvement (measured by the modified Stop signal task): a behavioral
      treatment based on Retrieval-Extinction Learning, through the AAT (Alcohol Approach Avoiding
      Task) and a treatment based on the neuromodulation of prefrontal cortex through the rTMS
      (repetitive transcraneal magnetic stimulation) technique. To carry out this study, 105
      alcoholic patients will be compared for clinical variables (abstinence/relapses),
      self-informed (UPPS) and behvavioral impulsivity (Stop signal task), along with biological
      measures for polymorphism determinations. Alcohol-dependent individuals will be divided into
      4 groups of study (1:1 proportion for Retrieval-Extinction Learning with AAT and 2:1 (double
      for the effective technique comparing to placebo/control) for rTMS): Group 1 (N=30): exposure
      to an alcohol-related video followed by AAT; Group 2 (N=30): neutral-content video followed
      by AAT; Group 4 (30): active stimulation rTMS (10 Hz) ; Group 4 (N=15): placebo stimulation
      SAM.
    

Intervention name(s): Retrieval-Extinction Learning; rTMS; SAM
Intervention type(s): Behavioral; Other; Other
Intervention description(s): The intervention consists of the accomplishment of the task of approach-avoidance of alcohol during 4 days of training. Subjects are instructed to respond with an approach movement (pulling a lever) to neutral images and to respond with avoidance movement (pushing the lever) to images of alcohol.; Previous to rTMS completion, MRI scans were performed in order to determinate the motor threshold trough 1Hz stimuli and locate the desired area with the neuronavigator. Motor threshold is defined as the stimulus with less intensity, able to generate a motor potential of at least 50 µV in 10 trials. Next, patients were called for 5 times per week, along 2 weeks, for receiving brain stimulation with Magstim Rapid coil. rTMS is performed at 10 Hz, during 4.9 seconds,for each set of stimuli (20), with a interval between sets of 30 seconds.; Previous to rTMS completion, MRI scans were performed in order to determinate the motor threshold trough 1Hz stimuli and locate the desired area with the neuronavigator. Motor threshold is defined as the stimulus with less intensity, able to generate a motor potential of at least 50 µV in 10 trials. Next, patients were called for 5 times per week, along 2 weeks, for receiving brain stimulation with SAM coil.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: rTMS; AAT; Alcohol-Dependence; Relapses