Grant: CIHR Fellowship

Alcohol use disorders (AUDs) are highly prevalent in Canada. Research that focuses on improving treatments for AUDs will make positive impacts on Canadian society. Most persons with AUDs have deficits in executive functions, which serve as barriers to treatment progress and to reducing harmful use. Executive functions are mental processes that allow us to filter distractions, prioritize tasks, set goals, and control unhelpful impulses. But, with AUDs, there is a breakdown of executive functions. Without intact executive abilities, those with AUDs cannot "put the brake" on their strong impulses to drink and thus have trouble reducing use despite their best intentions to do so. It has been proposed recently that computerized cognitive training may be useful for repairing executive dysfunction in substance abusers, leading to reductions in use and relapse. While promising, data for cognitive training in AUD treatment are scarce and limited outcomes of existing work suggest a need for improved methods. Accordingly, noninvasive brain stimulation has been shown recently to enhance learning during cognitive training, indicating that this method may be useful for augmenting current treatment approaches. However, this remains untested. This study will be the first to examine the innovative hypothesis that the application of brain stimulation will enhance cognitive training effects and; therefore, will reduce harmful drinking outcomes in a sample of AUD patients attending a 21-day residential treatment program. The proposed work will contribute to our understanding of executive dysfunction as a brain-based mechanism underlying AUDs. Results also have the potential to make cognitive evaluation and remediation a routine part of residential treatment. Cognitive deficits - which are known obstacles to addiction treatment - need to be considered to provide the most effective patient-centered care possible. The proposed study is an important first step in this direction.