interventions
Domain C: Specific interventions for impaired control and loss of control
The focus of Domain C is on modifying learning and control mechanisms in people with substance misuse. Interventions will begin by examining the modification of learning and the effects of physical activity on cognitive control. We will examine cognitive, emotional and behavioural training, as well as neurobiological interventions, such as brain stimulation or specific pharmacological therapies, directed at the mechanisms identified in Domain A and Domain B. To achieve this, domain C will use the information on risk and protective factors observed in domain A under real-life conditions, as well as the paradigms on learning processes and executive control from domain B and their computational modelling. Domain C will therefore be more and more able to identify the most efficient intervention strategies to strengthen control mechanisms and modify maladaptive learning mechanisms. This will then result in specific mechanism-based interventions for alcohol dependent individuals as well as for individuals suffering from other addictions.
C01: Modification of the imbalance between cognitive control and habitual behavior in addictive disorders
In this study, we investigate the imbalance between cognitive control and habitual behaviour in treatment-seeking smokers, its neural correlates and how this can be modified with two interventions. The first intervention (cognitive remediation therapy aimed at improving inhibitory control and executive functions) is hypothesised to influence top-down processing, whereas the second intervention (a learning-based approach through implicit pathways and context modulation) should modify bottom-up processes. Project lead: Prof. Dr. Sabine Vollstädt-Klein, Central Institute for Mental Health, Mannheim Prof. Dr. Gordon Feld, Central Institute for Mental Health, Mannheim Prof. Dr. Karen Ersche, Central Institute for Mental Health, Mannheim
C02: Neuromodulation and mindfulness as therapeutic treatment in abstinent patients with AUD
Mindfulness-based interventions have been shown to effectively reduce cue reactivity and alcohol intake in individuals with alcohol use disorder (AUD), possibly by enhancing behavioral control and modulating prefrontal brain regions. Additionally, neuromodulation has been suggested as a treatment for AUD, as it can improve behavioral control through modulation of frontal midline theta (FMΘ) oscillations. C02 aims to investigate the effect of transcutaneous vagus nerve stimulation (tVNS) as an adjunct treatment to a mindfulness-based relapse prevention (MBRP) program in detoxified patients with AUD. In addition, we will uncover the causal role of FMΘ oscillations for MBI-related increase of behavioral control using closed-loop transcranial alternating current stimulation (cl-tACS), a novel method to directly enhance or suppress brain oscillations at specific frequencies. This will not only elucidate the causal role of FMΘ in MBRP, but also open up new avenues to specifically increase behavioral control in AUD using innovative neuromodulation techniques. Project Leaders: Prof. Dr. Anne Beck, HMU Health and Medical University Potsdam Prof. Dr. Nina Romanczuk-Seiferth, MSB Medical School Berlin Prof. Dr. Surjo R. Soekadar, Charité – Universitätsmedizin Berlin Project Collaborators: Dr. Annika Rosenthal, HMU Health and Medical University Potsdam, Charité – Universitätsmedizin Berlin Dr. Maria Garbusow, MSB Medical School Berlin - mit unter Team gelistet werden? Björn Apfel, Charité – Universitätsmedizin Berlin David Haslacher, Charité – Universitätsmedizin Berlin
C03: Modification of reactivity to alternative reinforcing stimuli and cognitive control through exercise therapy in human tobacco use disorder
This project will investigate whether acute and/or chronic stress exposure can exacerbate PIT effects and whether such effects influence the loss or regaining of control over substance use in currently non-detoxified, i.e. continuing users, with mild to moderate alcohol use disorder. Participants will be recruited from the A01/S01 cohort, providing the opportunity to track their substance use over one year. Currently active smokers with tobacco use disorder will also be studied using a general PIT paradigm to compare cognitive and neurobiological correlates in people with alcohol versus tobacco use disorder. Finally, a specific PIT paradigm for individuals with alcohol use disorder will be developed and its neurobiological correlates measured. Project management: Prof. Dr. Dr. Andreas Heinz, Charité - Universitätsmedizin Berlin PD Dr. Maximilian Pilhatsch, Technical University of Dresden Project collaborators: Matt Belanger, Dresden University of Technology Hao Chen, Dresden University of Technology Dr Claudia Ebrahimi, Charité - University Medicine Berlin Pascale Fischbach, Dresden University of Technology Dr. Maria Garbusow, Charité - University Medicine Berlin Angela Hentschel, Dresden University of Technology Carlotta Riemerschmid, Charité - University Medicine Berlin Prof. Dr. Michael N. Smolka, Dresden University of Technology
C04: Modifying cue reactivity using neurofeedback in people with AUD
We will use the alcohol deprivation effect (ADE) rat model to identify individual animals that develop alcohol dependence. For this, we will identify individual differences in the tendency to attribute particular value to those stimuli that predict reward. We will investigate whether this predicts the development of alcohol dependence. We will examine specific Pavlovian mechanisms including PIT. Building on these studies, we will apply neuromodulatory interventions to influence the attribution of special motivational value to alcohol stimuli and measure their molecular correlates. In a further step, we will investigate the preventive efficacy of neuromodulatory interventions against the development of dependent behaviour. Project management: Prof. Dr. Josef Priller, Charité - Universitätsmedizin Berlin Prof. Dr. Christine Winter, Charité - University Medicine Berlin Project collaborators: Dr. Chotima Böttcher, Charité - Universitätsmedizin Berlin Dr. Ravit Hadar, Charité - University Medicine Berlin Aileen Hakus, Charité - Universitätsmedizin Berlin
C05: Towards causal insights into contextual influences on substance use: Incorporating momentary interventions into everyday life
The purpose of project C05 is explained in a video.