Skip to main content
OpenTrials
Completed

NCT Number: NCT04057534

Neurobiological Mechanisms of Chess as an Add-On Treatment Against SUD

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).

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Substance Use Disorders Alcohol-Related Disorders Alcoholism Chemically-Induced Disorders Mental Disorders Substance-Related Disorders Tobacco Use Disorder

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Klinik für Abhängiges Verhalten, Zentralinstitut für Seelische Gesundheit

Mannheim, Germany

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Standard therapy for AUD plus Chess-based cognitive treatment

Behavioral

Behavioral: standard AUD Cognitive Behavioral Therapy (CBT) in Clinical setting.

Patients who voluntarily submit to enter a qualified detoxification treatment program will be examined, either in-patient, out-patient, or in a day-clinic setting at the Department of Addictive Behaviour and Addiction Medicine. Additional, the experimental group receives chess based cognitive remediation treatment (CB-CRT) for 1,5 hours three times a week. The tasks of the treatment were created by our cooperation partner, the psychologist Juan Antonio Montero. He is currently successfully applying this battery as an add-on therapy. The training battery is designed to strengthen cognitive functioning in specific domains such as short-term memory, focal attention, selective attention, pattern recognition, visuospatial abilities, metacognition and also inhibition.

Standard therapy for AUD

Behavioral

Behavioral: standard AUD Cognitive Behavioral Therapy (CBT) in Clinical setting. Patients who voluntarily submit to enter a qualified detoxification treatment program will be examined, either in-patient, out-patient, or in a day-clinic setting at the Department of Addictive Behaviour and Addiction Medicine.

Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment

Behavioral

Behavioral: standard smoking cessation therapy for TUD in group therapy setting.

Patients who voluntarily submit to enter a qualified smoking cessation program will be examined in an out-patient setting at the Department of Addictive Behaviour and Addiction Medicine. They receive a six-week standard therapy (one 1,5 hours group therapy per week). Additional, the experimental group receives chess based cognitive remediation treatment (CB-CRT) for 1,5 hours three times a week. The tasks of the treatment were created by our cooperation partner, the psychologist Juan Antonio Montero. He is currently successfully applying this battery as an add-on therapy. The training battery is designed to strengthen cognitive functioning in specific domains such as short-term memory, focal attention, selective attention, pattern recognition, visuospatial abilities, metacognition and also inhibition.

Standard therapy for TUD

Behavioral

Behavioral: standard smoking cessation therapy for TUD in group therapy setting.

Patients who voluntarily submit to enter a qualified smokind cessation program will be examined in an out-patient setting at the Department of Addictive Behaviour and Addiction Medicine. They receive a six-week standard therapy (one 1,5 hours group therapy per week). Additional, the experimental group receives chess based cognitive remediation treatment (CB-CRT) for 1,5 hours three times a week.

Primary outcomes

  1. change in neural alcohol cue-reactivity

    Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

    fMRI alcohol cue-reactivity task (Vollstädt-Klein et al. 2010)

  2. change in neural tobacco cue-reactivity

    Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

    fMRI tobacco cue-reactivity task (Vollstädt-Klein et al. 2011)

  3. change in neural correlates of inhibition

    Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

    fMRI stop-signal task (Whelan et al. 2012)

  4. substance use (alcohol consumption and tabacco use)

    Time frame: 3 months follow-up after the end of treatment

    self-report

  5. change in neural working memory processes

    Time frame: 2 time points: before and after 6 weeks chess-based cognitive training

    fMRI working memory task "N-back" (Charlet et al. 2014)

  6. Change in working memory capacity

    Time frame: 2 time points: before and after 6 weeks SCP

    working memory capacity measured by letter-number sequencing task of the [Wechsler Memory Scale (Kent 2013)]; raw values will be transformed to IQ-like scales (mean 100, SD 15); the higher the value, the higher the working memory capacity

  7. Change in impulsivity

    Time frame: 3 time points: before and after 6 weeks SCP plus after 3 months

    impulsivity measured with BIS scale [Barratt impulsiveness scale (Patton et al. 1995)];range 15-60; total score will be used; high values represent high impulsivity

  8. Change in decision-making

    Time frame: 2 time points: before and after 6 weeks SCP

    [Iowa Gambling Task (Bechara et al. 1994)]

  9. Change in mental flexibility

    Time frame: 2 time points: before and after 6 weeks SCP

    [Dimensional Change Card Sort (Zelazo et al. 2014)]

  10. Change in attentional capacity

    Time frame: 2 time points: before and after 6 weeks SCP

    [d2 Test of Attention (Brickenkamp 2002)].

Secondary outcomes

  1. change in functional connectivity within the salience network (SN) and executive control network (ECN)

    Time frame: 2 time points: before and after 6 weeks therapy and chess-based cognitive training

    [measured with fMRI]

Sponsors and collaborators

Lead sponsor

Central Institute of Mental Health, Mannheim

Other

Registry information

Official study title

Investigating Neurobiological Mechanisms of Chess as an Add-On Treatment Against Substance Use Disorder

Acronym: Chess_SUD

Important dates

Study start
2020
Primary completion
2023
Study completion
2023
First posted
Aug 15, 2019
Registry last updated
Mar 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.