RESUMO
Up to 80% of individuals seeking treatment fail in their attempts at sobriety. This study investigated whether 1) a cognitive remediation therapy (CRT) program augmented with a brain-computer interface (BCI) to influence brain performance metrics would increase participants' self-agency by restoring cognitive control performance; and 2) that ability increase would produce increased sobriety rates, greater than published treatment rates. The study employed a retrospective chart review structured to replicate a switching replication methodology (i.e., waitlist group) using a pre-test and post-test profile analysis quasi-experimental design. Participants' records were organized into treatment and non-treatment groups. Adult poly-substance users were recruited from alcohol and other drugs (AOD) use outpatient programs and AOD use treatment centers in the United States. Participants volunteered for pre- and post-testing without treatment (n = 121) or chose to enter the treatment program (n = 200). The treatment group engaged in a 48-session BCI/CRT augmented treatment program. Pre- and post-treatment measures comprised 14 areas from the Woodcock-Johnson Cognitive Abilities III Assessment Battery. An 18-month follow-up assessment measured maintenance of sobriety. After testing the difference for all variables across time between test groups, a significant multivariate effect was found. In addition, at 18 months post-treatment, 89% of the treatment group maintained sobriety, compared to 31% of the non-treatment group. Consistent with addiction neurobehavioral imbalance models, traditional treatment programs augmented with BCI/CRT training, focused on improving cognitive control abilities, may strengthen self-control and improve sobriety rates.
RESUMO
This study is a retrospective chart review of 200 clients who participated in a non-verbal restorative cognitive remediation training (rCRT) program between 2012 and 2020. Each client participated in the program for about 16 weeks, and the study as a whole occurred over a five-year period. The program was applied to effect proper neural functional remodeling needed to support resilient, flexible, and adaptable behaviors after encountering a mild closed head traumatic brain injury (mTBI). The rCRT program focused on improving functional performance in executive cognitive control networks as defined by fMRI studies. All rCRT activities were delivered in a semi-game-like manner, incorporating a brain-computer interface (BCI) that provided in-the-moment neural network performance integrity metrics (nPIMs) used to adjust the level of play required to properly engage long-term potentiation (LTP) and long-term depression (LTD) network learning rules. This study reports on t-test and Reliable Change Index (RCI) changes found within individual cognitive abilities' performance metrics derived from the Woodcock-Johnson Cognitive Abilities III Test. We compared pre- and post-scores from seven cognitive abilities considered dependent on executive cognitive control networks against seven non-executive control abilities. We observed significant improvements (p < 10-4) with large Cohen's deffect sizes (0.78-1.20) across 13 of 14 cognitive ability domains with a medium effect size (0.49) on the remaining one. The mean percent change for the pooled trained domain was double that observed for the pooled untrained domain, at 17.2% versus 8.3%, respectively. To further adjust for practice effects, practice effect RCI values were computed and further supported the effectiveness of the rCRT (trained RCI 1.4-4.8; untrained RCI 0.-08-0.75).
