Efficacy of a cognitive training program targeting inhibition in alcohol use disorder: a randomized controlled trial

Background

More and more studies aim to improve the neurocognitive functioning in alcohol use disorder (AUD), but very few studies have focused on the efficacy of programs training inhibitory-control. The “Let’s train” program intends inhibition training on general tasks which does not refer to alcohol.

Methods

In this processual perspective of aiming to retrain deficits involved in addiction in itself and not only due to alcohol toxicity, we conducted an add-on single-blinded randomized controlled trial, in AUD, assessing the efficacy of a 6-week computerized cognitive training program targeting inhibition as compared to sham training, neutral on inhibition (n=226). In both arms the program was computerized and dispensed twice a week with at least one session on site by week, followed by a debriefing by a neuropsychologist, the other either session being dispensed on site or online at home, during 6 weeks. Main inclusion criteria were current alcohol use dis AUD order, recently detoxified (7 to 30 days of abstinence) and at least a high drinking risk level according to the WHO classification. We recruited patients at 5 centers in France from February 2019 to February 2023. Patients were stratified by center and by level of cognitive impairment at the MoCA (<26, ≥26). Efficacy outcomes were the change in the number of heavy drinking days, in the total alcohol consumption (g/day) assessed with the Timeline Follow Back, the change in Alcohol Quality of life scale (AQoLS), Clinical Global Index severity , the impulsivity subscale of the  Difficulties in Emotion Regulation Scale , the multifactorial impulsivity scale UPPS assessing positive and negative Urgency, Premeditation, Perseverance and Sensation seeking in short version,  the Emotion Regulation Questionnaire , and the Stop-Signal Reaction Time  that assesses the ability to inhibit a prepotent response at 6 and 12 weeks. 

Results

At inclusion, patients were 49.5 years old in mean, 67.0% male. Mean number of DSM-5 criteria for AUD was 8.6. In mean, AQoLS score was 48.5 and MoCA score was 26.4. Efficacy analysis are on progress. 

Conclusions

The results of this large randomized controlled trial will inform on the efficacy of cognitive training targeting inhibition in AUD.