BACKGROUND
Alcohol use disorder has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting in cognitive training. The advent of computer-based interventions may leverage these improvements, but RCTs of digital interactive-based interventions are still scarce.
OBJECTIVE
The aim is to explore whether a cognitive training approach using virtual reality exercises based on activities of daily living is feasible for improving cognitive function of patients with alcohol use disorder undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs.
METHODS
A two-arm pilot randomized controlled trial with a sample of 36 individuals recovering from alcohol use disorder in a therapeutic community assigned to a therapist-guided virtual reality-based cognitive training combined with treatment-as-usual or a control group with treatment-as-usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre and post assessments, including global cognition, executive functions, attention, visual memory and cognitive flexibility.
RESULTS
In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled in the statistical analysis for each individual outcome. Results indicate effects (P < .05) of the intervention on attention (in 2 out of 5 outcomes) and cognitive flexibility (in 2 out of 6 outcomes), with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies.
CONCLUSIONS
Overall data suggest specific contributions of reality-based cognitive training in improving attention ability and cognitive flexibility of patients recovering from alcohol use disorder.
CLINICALTRIAL
ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345
Virtual Reality Cognitive Training in Individuals with Alcohol Use Disorder Undergoing Residential Treatment: A Pilot Randomized Controlled Trial (Preprint)
