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

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

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).

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.

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