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Substance Use DisordersChess_SUDNCT04057534

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

A study testing Standard therapy for AUD plus Chess-based cognitive treatment, Standard therapy for AUD and Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment in people with Substance Use Disorders, run by Central Institute of Mental Health, Mannheim at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

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). Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Substance Use Disorders
What is being tested?
Standard therapy for AUD plus Chess-based cognitive treatment, Standard therapy for AUD and Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
1 siteGermany
Study dates
1 Apr 2020to 17 Nov 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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

Who cannot join

  • 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

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Klinik für Abhängiges Verhalten, Zentralinstitut für Seelische Gesundheit

    Mannheim

Other trials in Germany

About this study

Official title: 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).

Read the detailed description

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.

Being tested
Standard therapy for AUD plus Chess-based cognitive treatment, Standard therapy for AUD, Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment, Standard therapy for TUD
Keywords
Alcohol Dependence, Alcoholism, Craving, Cognitive Change, cognitive remediation, Chess based cognitive training, Working Memory, Decision Making, Executive Control, Chess, fMRI, Nicotine use disorder, Tobacco use disorder
Medical subject headings
Substance-Related Disorders, Alcoholism, Tobacco Use Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standard therapy for AUD plus Chess-based cognitive treatmentBehavioural

    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 AUDBehavioural

    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 treatmentBehavioural

    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 TUDBehavioural

    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.

Study groups in NCT04057534
Study groupRoleWhat they receive
CB-CRT AUD groupExperimentalexperimental group AUD: patients receive standard clinical therapy and an add-on chess based - cognitive remediation treatment (CB-CRT)
Receives: Behavioral: Standard therapy for AUD plus Chess-based cognitive treatment
Control group AUDActive comparatorcontrol group: patients with AUD receive standard clinical therapy
Receives: Behavioral: Standard therapy for AUD
CB-CRT TUD groupExperimentalexperimental group TUD: patients receive standard smoking cessation therapy and an add-on CB-CRT
Receives: Behavioral: Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment
Control group TUDActive comparatorcontrol group: patients with TUD receive standard smoking cessation therapy
Receives: Behavioral: Standard therapy for TUD

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. change in neural alcohol cue-reactivity

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

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

  2. change in neural tobacco cue-reactivity

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

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

  3. change in neural correlates of inhibition

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

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

  4. substance use (alcohol consumption and tabacco use)

    self-report

    Measured: 3 months follow-up after the end of treatment

  5. change in neural working memory processes

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

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

  6. Change in working memory capacity

    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

    Measured: 2 time points: before and after 6 weeks SCP

  7. Change in impulsivity

    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

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

  8. Change in decision-making

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

    Measured: 2 time points: before and after 6 weeks SCP

  9. Change in mental flexibility

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

    Measured: 2 time points: before and after 6 weeks SCP

  10. Change in attentional capacity

    [d2 Test of Attention (Brickenkamp 2002)].

    Measured: 2 time points: before and after 6 weeks SCP

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

    [measured with fMRI]

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

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Aug 2019
  2. Study start1 Apr 2020
  3. Primary completion17 Nov 2023
  4. Study completion17 Nov 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04057534
Sponsor's protocol ID
Chess_SUD
Acronym
Chess_SUD
Status last verified
Mar 2024
First submitted
12 Aug 2019
Last updated
29 Mar 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: For protection of personal rights, and due to the sensitivity of the clinical and neuroimaging data, data will not be made publicly available. Upon direct request by other researchers and in mutual agreements (e.g., regarding data protection), anonymized data can be made available. Upon request, analysis procedures and codes will be shared with other researchers.

Publications

  • Adinoff B. Neurobiologic processes in drug reward and addiction. Harv Rev Psychiatry. 2004 Nov-Dec;12(6):305-20. doi: 10.1080/10673220490910844.

    PubMed 15764467
  • Fauth-Buhler M, de Rover M, Rubia K, Garavan H, Abbott S, Clark L, Vollstadt-Klein S, Mann K, Schumann G, Robbins TW. Brain networks subserving fixed versus performance-adjusted delay stop trials in a stop signal task. Behav Brain Res. 2012 Nov 1;235(1):89-97. doi: 10.1016/j.bbr.2012.07.023. Epub 2012 Jul 20.

    PubMed 22820235
  • Amidzic O, Riehle HJ, Fehr T, Wienbruch C, Elbert T. Pattern of focal gamma-bursts in chess players. Nature. 2001 Aug 9;412(6847):603. doi: 10.1038/35088119. No abstract available.

    PubMed 11493907
  • Atherton M, Zhuang J, Bart WM, Hu X, He S. A functional MRI study of high-level cognition. I. The game of chess. Brain Res Cogn Brain Res. 2003 Mar;16(1):26-31. doi: 10.1016/s0926-6410(02)00207-0.

    PubMed 12589885
  • Bates ME, Buckman JF, Nguyen TT. A role for cognitive rehabilitation in increasing the effectiveness of treatment for alcohol use disorders. Neuropsychol Rev. 2013 Mar;23(1):27-47. doi: 10.1007/s11065-013-9228-3. Epub 2013 Feb 15.

    PubMed 23412885
  • Blasco-Fontecilla H, Gonzalez-Perez M, Garcia-Lopez R, Poza-Cano B, Perez-Moreno MR, de Leon-Martinez V, Otero-Perez J. Efficacy of chess training for the treatment of ADHD: A prospective, open label study. Rev Psiquiatr Salud Ment. 2016 Jan-Mar;9(1):13-21. doi: 10.1016/j.rpsm.2015.02.003. Epub 2015 Apr 22. English, Spanish.

    PubMed 25911280
  • Demily C, Cavezian C, Desmurget M, Berquand-Merle M, Chambon V, Franck N. The game of chess enhances cognitive abilities in schizophrenia. Schizophr Res. 2009 Jan;107(1):112-3. doi: 10.1016/j.schres.2008.09.024. Epub 2008 Nov 7. No abstract available.

    PubMed 18995990
  • Fattahi F, Geshani A, Jafari Z, Jalaie S, Salman Mahini M. Auditory memory function in expert chess players. Med J Islam Repub Iran. 2015 Oct 6;29:275. eCollection 2015.

    PubMed 26793666
  • Goncalves PD, Ometto M, Bechara A, Malbergier A, Amaral R, Nicastri S, Martins PA, Beraldo L, dos Santos B, Fuentes D, Andrade AG, Busatto GF, Cunha PJ. Motivational interviewing combined with chess accelerates improvement in executive functions in cocaine dependent patients: a one-month prospective study. Drug Alcohol Depend. 2014 Aug 1;141:79-84. doi: 10.1016/j.drugalcdep.2014.05.006. Epub 2014 May 24.

    PubMed 24913200
  • Onofrj M, Curatola L, Valentini G, Antonelli M, Thomas A, Fulgente T. Non-dominant dorsal-prefrontal activation during chess problem solution evidenced by single photon emission computerized tomography (SPECT). Neurosci Lett. 1995 Oct 6;198(3):169-72. doi: 10.1016/0304-3940(95)11985-6.

    PubMed 8552313
  • Vollstadt-Klein S, Wichert S, Rabinstein J, Buhler M, Klein O, Ende G, Hermann D, Mann K. Initial, habitual and compulsive alcohol use is characterized by a shift of cue processing from ventral to dorsal striatum. Addiction. 2010 Oct;105(10):1741-9. doi: 10.1111/j.1360-0443.2010.03022.x.

    PubMed 20670348
  • Lally N, Huys QJM, Eshel N, Faulkner P, Dayan P, Roiser JP. The Neural Basis of Aversive Pavlovian Guidance during Planning. J Neurosci. 2017 Oct 18;37(42):10215-10229. doi: 10.1523/JNEUROSCI.0085-17.2017. Epub 2017 Sep 18.

    PubMed 28924006
  • Gerhardt S, Lex G, Holzammer J, Karl D, Wieland A, Schmitt R, Recuero AJ, Montero JA, Weber T, Vollstadt-Klein S. Effects of chess-based cognitive remediation training as therapy add-on in alcohol and tobacco use disorders: protocol of a randomised, controlled clinical fMRI trial. BMJ Open. 2022 Sep 6;12(9):e057707. doi: 10.1136/bmjopen-2021-057707.

    PubMed 36691127

Questions about this trial

What is this clinical trial studying?

A study testing Standard therapy for AUD plus Chess-based cognitive treatment, Standard therapy for AUD and Standard smoking cessation therapy for TUD plus Chess-based cognitive treatment in people with Substance Use Disorders, run by Central Institute of Mental Health, Mannheim at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

change in neural alcohol cue-reactivity (time frame: 2 time points: before and after 6 weeks chess-based cognitive training). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04057534, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Mar 2024.

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