Combining Cognitive Training With tDCS to Enhance Memory Inhibition in Young Binge Drinkers
Condition: Binge Drinking
MeSH terms: Binge Drinking
Study type: Interventional

Summary: 
      This study protocol aims to examine the behavioral and electroencephalographic (EEG)
      correlates of memory inhibition (MI) among college binge drinkers (BDs). A second objective
      is to evaluate an alcohol-specific MI training protocol using cognitive training (CT) and
      transcranial direct current stimulation (tDCS) while its effects on behavioral and EEG
      outcomes are assessed. Along with poor MI abilities, we hypothesized that BDs would show
      alterations in the amplitude of several event-related potentials (ERPs) linked to MI (e.g.,
      N2 and late parietal positivity) as well as abnormal functional connectivity (FC) patterns
      within/between regions associated with MI (e.g., dorsolateral prefrontal cortex [DLPFC] and
      hippocampal/parahippocampal regions). Results should also demonstrate the effectiveness of
      the training protocol, with BDs exhibiting an improved capacity to suppress alcohol-related
      memories after both combined and cognitive MI training, along with a significant reduction in
      alcohol use and craving in the short/medium-term. Furthermore, this protocol should also lead
      to significant modifications in the ERP and FC patterns, reflecting stronger MI capabilities
      and reduced alcohol cue reactivity in trained BD participants.
    

Detailed description: 
      The present study protocol aims to examine the behavioral and EEG correlates of MI,
      specifically those related to the suppression of alcohol-related memories, among young BDs.
      For this purpose, 45 BDs and 45 age-matched non/low-drinkers (N/LDs) will be assessed by EEG
      while performing the Think/No-Think Alcohol (TNTA) task, a paradigm that evaluates
      alcohol-related MI (Pre-training EEG assessment). The TNTA is divided into three phases: 1)
      the Learning phase, 2) the Think/No-Think (TNT) phase and 3) the Memory-Test phase. During
      the learning phase, participants will be asked to associate and memorize 36 pairs of neutral
      objects + alcoholic/non-alcoholic pictures. Then, only the neutral objects will be presented,
      and participants will have to try to remember the picture (alcoholic/non-alcoholic image)
      that was associated with this neutral object and answer three questions about the beverage
      depicted, the orientation of the picture and the number of people present in it. After the
      learning phase, the Think/No -Think phase will comprehend two conditions: in the Think
      condition (depicted in the neutral images with a green frame),participants are presented with
      the object and they will be instructed to "think of the previously learned
      alcoholic/non-alcoholic picture and keep it in mind during the entire presentation of the
      object". In the No-Think condition (depicted by neutral images with a red frame) they will be
      asked "not to let the previously associated picture enter your consciousness". In the memory
      test phase, the 36 neutral images will be presented again, including the 12 neutral objects
      of the baseline condition that were not presented in the TNT phase. Participants will be
      asked to recall - answering the same three questions of the learning phase - the image
      (alcoholic/non-alcoholic) that was initially associated with the neutral object.

      During this pre-training session, psychological (i.e., craving levels), behavioral (i.e.,
      alcohol consumption, recall accuracy and MI performance), and neurofunctional (i.e., ERPs and
      FC) variables will be assessed.

      In addition, this study aims to evaluate an alcohol-specific MI intervention protocol using
      cognitive training and tDCS while its effects on behavioral and EEG outcomes are assessed.
      For that, BDs will be randomly assigned to one of three training groups: combined
      intervention (active CT and active tDCS applied over the right DLPFC), cognitive intervention
      (active CT and sham tDCS), or control intervention (sham CT and sham tDCS). Training will
      occur in three consecutive days (i.e., Tuesday, Wednesday, and Thursday), in three sessions.
      MI will be re-assessed in BDs after the last training session through a post-training EEG
      assessment. N/LDs will only perform the pre-training EEG assessment. Alcohol use and craving
      will also be measured both 10-days and 3-months post-training in order to monitor short- and
      medium-term effects of the MI training in the alcohol craving and consumption levels.
      Furthermore, behavioral and EEG data will be collected during the performance of an alcohol
      cue reactivity (ACR) task before and after the MI training sessions, in order to evaluate
      potential attentional bias towards alcoholic stimuli. Overall, this intervention protocol
      aims to investigate whether this training is able 1) to enhance MI capabilities and to reduce
      alcohol attentional bias, and 2) to decrease craving and/or alcohol use -monitoring up to
      three months after protocol implementation- in trained BD participants.
    

Intervention name(s): Active tDCS; Sham tDCS; Active CT; Sham CT
Intervention type(s): Device; Device; Behavioral; Behavioral
Intervention description(s): 20 minutes of 2.0 mA direct current applied over the right DLPFC; 15 seconds of 2.0 mA direct current applied over the right DLPFC; Active memory inhibition CT (i.e., training of memory inhibition specifically for alcohol-related memories).; Sham memory inhibition CT (i.e., participants have to categorize alcoholic and non-alcoholic images but they do not have to inhibit the memories related to these images).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: BDs will be randomly distributed for one of three training conditions: Combined Training (i.e, active tDCS and active CT), Cognitive Training (i.e., sham tDCS and active CT), and Control (i.e., sham tDCS and sham CT).
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Alcohol; Craving; Binge Drinking; College Students; Memory Inhibition; Alcohol-Related Memories; Randomized Controlled Trial; Intervention Protocol; Cognitive Training; Transcranial Direct-Current Stimulation (tDCS); Electroencephalography (EEG); Event-Related Potentials (ERPs); Functional Connectivity