Decreases in the Late Positive Potential to Alcohol Images Among Alcohol Treatment Seekers Following Mindfulness-Based Relapse Prevention

Abstract

Aim Heightened craving among individuals with alcohol use disorder (AUD) has been attributed to a hypersensitivity to alcohol cues in attentional brain networks. Active mindfulness training has been shown to help improve attentional control. Here, we examined alcohol cue-related hypersensitivity among individuals with AUD who received rolling group mindfulness-based relapse prevention (MBRP) in combination with transcranial direct current stimulation (tDCS), over right inferior frontal gyrus. Methods Participants (n = 68) viewed a series of emotionally negative, emotionally neutral and alcohol-related images. Following image presentation, participants were asked to rate their level of craving for the alcohol cues, and their level of negative affect evoked by neutral and negative cues. During the task, electroencephalogram (EEG) was recorded to capture an event-related component shown to relate to emotionally salient stimuli: the late positive potential (LPP). Participants who completed a follow-up EEG (n = 37) performed the task a second time after up to eight sessions of MBRP coupled with active or sham tDCS. Results We found that both craving ratings and the LPP significantly decreased in response to alcohol cues from pre- to post-treatment, but not for other image cues. The magnitude of alcohol image craving reductions was associated with the number of MBRP group sessions attended. Active tDCS was not associated with craving ratings, but it was associated with greater LPP amplitudes across image types. Conclusions Taken together, these results suggest that disruption of alcohol-cue hypersensitivity in people with AUD may be a target mechanism of MBRP.

How Should Transcranial Direct Current Stimulation be Used in Populations With Severe Alcohol Use Disorder? A Clinically Oriented Systematic Review

“…48 However, the 4 studies that attempted to combine tDCS with cognitive interventions in SAUD have used tasks involving the retraining of automatic processes (ie, attentional alcohol-related biases) 66,67 or mindfulness. 70,71 Although these interventions showed encouraging results at the behavioral level, 78 these tasks, recruiting a low level of cognitive resources, often reach a ceiling effect which prevents tDCS stimulation from any further performance improvement, and do not involve the recruitment of frontal brain areas. It is therefore difficult to draw conclusions on the effectiveness of this combination based on the available results.…”

Behavioral response bias and event‐related brain potentials implicate elevated incentive salience attribution to alcohol cues in emerging adults with lower sensitivity to alcohol

“…Finally, given that training to reverse attentional and approach biases (cognitive bias modification; CBM) can improve AUD treatment outcomes [98][99][100][101][102], additional research incorporating neurocognitive measures (e.g. [103][104][105]) may aid identification of treatment mechanisms to improve clinical outcomes.…”

Mindfulness augmentation for anxiety through concurrent use of transcranial direct current stimulation: a randomized double-blind study

“…Several studies have been conducted on the combination of tDCS and mindfulness. One combined tDCS and mindfulness-based training to enhance working memory and another investigated the therapeutic effects of a combination of tDCS and mindfulness-based relapse prevention on alcohol dependence 48 – 50 .…”