Working Memory Training in Alcohol Use Disorder: A Randomized Controlled Trial

Abstract

Background Alcohol use disorder (AUD) is associated with cognitive deficits such as impaired executive functions, which are hypothesized to contribute to the progression of the disease and worsen treatment outcome. Training of working memory (WM) to improve cognitive functions and thereby reduce alcohol use has been proposed as a novel treatment strategy. Methods Patients with AUD (n = 50) who were recruited to an outpatient addiction clinic were randomized to receive 5 weeks of active WM training or control training. Participants had weekly follow‐up visits, and all cognitive training sessions were done online at home. Primary outcomes were WM function and change in self‐reported heavy drinking. Secondary outcomes were craving, other drinking outcomes, and performance on a range of neuropsychological tasks from the Cambridge Neuropsychological Test Automated Battery. Results The active training group demonstrated a significantly greater improvement in verbal WM compared with the control group. No statistically significant effect of training was found on the primary drinking outcome, but a trend was observed indicating that WM training reduces the number of drinks per drinking occasion. WM training had no statistically significant effect on any of the other neuropsychological tasks. Conclusions Cognitive training can improve WM function in individuals with AUD, suggesting that such interventions are feasible to administer in this patient population. The results do not support an effect of WM training on heavy drinking or transfer effects to other cognitive domains. Future studies should evaluate WM training as an adjunct to evidence‐based treatments for AUD to assess potential synergistic effects.

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

“…As shown by the results, working memory training using this tool enhanced performance on a near-transfer task in 20 patients (68% male with a mean age = 42.5 years old) with alcohol dependence who reported drinking during the previous 6 months (r 2 = 0.15) (Snider et al, 2018). Furthermore, cognitive training was also related to behavioural changes as a trend was found between working memory training and the reduction of drinks per drinking occasion (from 7.07 drinks to 5.58 drinks in the intervention group v. 5.58 drinks to (Khemiri et al, 2019). Verbal learning and verbal memory: One study assessed the effect of a computerised training tool (Posit Science software®) for the enhancement of verbal learning and memory (Bell, Vissicchio, & Weinstein, 2016).…”

Association of parental substance use disorder with offspring cognition: a population family‐based study

“…Secondly, treatment and psychoeducation programmes for SUD should take into consideration that cognitive deficits observed in SUD may not completely resolve despite abstinence, as the cognitive deficits could, in part, be a manifestation of elevated genetic risk for SUD. For instance, targeting cognitive deficits through cognitive training has been proposed as a novel treatment strategy in SUD , with limited or no effect in clinical populations so far . The results of the current study highlight the importance for treatment studies to also assess SUD family history, as this may be an important moderating factor for treatment response, specifically when investigating cognitive test outcomes.…”

Random Forest Classification of Alcohol Use Disorder Using EEG Source Functional Connectivity, Neuropsychological Functioning, and Impulsivity Measures

“…Specifically, the identification of specific connectivity patterns in discrete frequency bands in different stages of AUD may aid in diagnostic and intervention strategies based on brain circuits. These may include connectivity-guided clinical applications such as transcranial magnetic stimulation (e.g., [170]), deep brain stimulation (e.g., [171]), neurofeedback (e.g., [172]), and cognitive training [173], which have been implemented in neuropsychiatric conditions including alcohol/drug addiction and are becoming important tools for treating AUD.…”