Clinical trial NCT04057534: Neurobiological Mechanisms of Chess as an Add-On Treatment Against SUD
Official title: Investigating Neurobiological Mechanisms of Chess as an Add-On Treatment Against Substance Use Disorder
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Substance Use Disorders
Keywords: Alcohol Dependence
Alcoholism
Craving
Cognitive Change
cognitive remediation
Chess based cognitive training
Working Memory
Decision Making
Executive Control
Chess
fMRI
Nicotine use disorder
Tobacco use disorder
Lead sponsor: Central Institute of Mental Health, Mannheim
Sponsor class: OTHER
First posted: 2019-08-15
Enrollment: 108
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: 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).

Detailed description: 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.

Eligibility criteria: 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

Primary outcomes:
measure: change in neural alcohol cue-reactivity
timeFrame: 2 time points: before and after 6 weeks chess-based cognitive training
measure: change in neural tobacco cue-reactivity
timeFrame: 2 time points: before and after 6 weeks chess-based cognitive training
measure: change in neural correlates of inhibition
timeFrame: 2 time points: before and after 6 weeks chess-based cognitive training
measure: substance use (alcohol consumption and tabacco use)
timeFrame: 3 months follow-up after the end of treatment
measure: change in neural working memory processes
timeFrame: 2 time points: before and after 6 weeks chess-based cognitive training
measure: Change in working memory capacity
timeFrame: 2 time points: before and after 6 weeks SCP
measure: Change in impulsivity
timeFrame: 3 time points: before and after 6 weeks SCP plus after 3 months
measure: Change in decision-making
timeFrame: 2 time points: before and after 6 weeks SCP
measure: Change in mental flexibility
timeFrame: 2 time points: before and after 6 weeks SCP
measure: Change in attentional capacity
timeFrame: 2 time points: before and after 6 weeks SCP
Secondary outcomes:
measure: change in functional connectivity within the salience network (SN) and executive control network (ECN)
timeFrame: 2 time points: before and after 6 weeks therapy and chess-based cognitive training
Other outcomes:
Locations:
city: Mannheim
country: Germany
facility: Klinik für Abhängiges Verhalten, Zentralinstitut für Seelische Gesundheit
Study officials:
affiliation: Central Institute of Mental Health, Mannheim
name: Sabine Vollstädt-Klein, Prof. Dr.
role: PRINCIPAL_INVESTIGATOR
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