The use of qEEG in predicting relapse among AUD Veterans to improve treatment and function

点击翻译按钮获取中文摘要

Alcohol Use Disorder (AUD) is a varied and complex psychiatric disorder involving the interactions of behavior, environment, and genetic risk factors and has a significant adverse impact on functioning. To improve functioning for those suffering from AUD, it is imperative that we understand the modifiable risk factors for each Veteran across various domains, to discover how to better predict relapse. There is extensive literature demonstrating the deleterious effects of chronic alcohol abuse can have on brain function. There has been less attention, however, devoted to translational research that focuses on methods that may provide more accurate diagnosis and predict relapse among individuals with AUD, which in turn may guide treatment plans and better meet the medical and psychiatric needs of Veterans and improve functioning. The use of neuro-electrophysiological measures provides a potentially powerful way to assist in predicting the likelihood of relapse, with the potential of informing the best type and length of treatment necessary for each individual. Quantitative electroencephalogram (qEEG) has shown encouraging predictive power of relapse, especially when using fast beta activity isolated in the frontal lobes. Specifically, beta activity and the dysfunction observed in the frontal lobes may serve as an accurate predictor of alcohol relapse. Despite promising research in this field, only a handful of empirical studies exist that describe the use and predictive accuracy of beta activity for determining whether an individual will relapse, and no study to-date attempted to adapt these findings for clinical utility. Currently, the measurement of beta activity is a relatively ambiguous description of brain activity and would benefit from further investigation into its possible clinical and neuropsychological meaning along with potential functional correlates. The frontal lobes are implicated in executive functioning processes, including planning, response inhibition/impulse control, problem-solving, set-shifting, and goal-directed behavior. Many of these cognitive functions play a crucial role in substance use treatment completion and outcomes. Therefore, to better understand the neuropsychological meaning of the beta dysfunction within the frontal lobes and to provide insight and cross-validation of possible covarying cognitive function related to beta dysfunction, the assessment of executive functioning via measures is needed. In addition, there has been much research investigating the role of impulsivity and craving within the addiction literature. Craving has been shown to predict the probability of relapse as well as the extent of consumption following abstinence. Research has also demonstrated a positive association between cue-induced craving affect beta activity. Lastly, quality of life has been demonstrated to improve with more prolonged remission, and it has been suggested that higher levels of life satisfaction may protect against future relapse. Given these established findings, we will ask participants to complete a battery of alcohol-related and clinical and functional questionnaires and neuropsychological tests to explore the relationships between beta activity, cognitive function, and addiction in order to improve the quality of life of Veterans with AUD. This pilot study has two primary aims: 1) to assess the feasibility and acceptability of the proposed qEEG and other physiological, neuropsychological, clinical, and functional measures assessment to predict alcohol relapse among Veterans with AUD being discharged from an inpatient acute psychiatric and detoxification unit and 2) to investigate possible differences in EEG activity and connectivity among Veterans who relapse and those who do not and explore possible physiological, neuropsychological, clinical, and functional covariates to improve the Veterans’ functioning and quality of life.