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Abrantes AM, Browne J, Stein MD, Anderson B, Iacoi S, Barter S, Shah Z, Read J, Battle C. A lifestyle physical activity intervention for women in alcohol treatment: A pilot randomized controlled trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209406. [PMID: 38759733 DOI: 10.1016/j.josat.2024.209406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 03/20/2024] [Accepted: 05/14/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Compared to men, women with alcohol use disorder (AUD) are more likely to drink to manage stress and negative affect. Given women's risk for poor drinking outcomes, it is critical to develop and test interventions that target these affective factors. Physical activity improves negative affect and has emerged as a promising adjunct to AUD treatment and, thus, may be especially valuable for women. METHODS Fifty women with AUD (49.9 ± 12.0 years of age) participated in either a 12-week telephone-delivered lifestyle physical activity plus Fitbit (LPA + Fitbit) or a health education contact (HEC) control intervention following a partial hospital addictions treatment program. The study examined changes in drinking behaviors, mental health outcomes, and physical activity engagement post-intervention using both conventional test statistics and standard effect sizes. RESULTS Higher rates of continuous abstinence during the 12-week period were observed in the LPA + Fitbit condition (55.6 %) than in the HEC condition (33.6 %); odds ratio = 2.97. However, among women who drank any alcohol during the 12-weeks, slightly higher rates of heavy drinking and drinks/day were observed among women in the LPA + Fitbit condition. Significant differences for improved mental health outcomes (including depression, anxiety, negative affect, positive affect, perceived stress, and behavioral activation) and increased self-reported physical activity were consistently observed among participants in the LPA + Fitbit condition, relative to HEC. CONCLUSIONS The LPA + Fitbit program had a positive impact on alcohol abstinence, mental health, and physical activity in adult women receiving treatment for AUD. Future research should continue to investigate the optimal implementation strategies, duration, and intensity of LPA interventions in the context of a fully-powered RCT.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital, Providence, RI, United States of America; Alpert Medical School of Brown University, Providence, RI, United States of America.
| | - Julia Browne
- Alpert Medical School of Brown University, Providence, RI, United States of America; Research Service, VA Providence Healthcare System, Providence, RI, United States of America
| | - Michael D Stein
- Butler Hospital, Providence, RI, United States of America; Boston University School of Public Health, Boston, MA, United States of America
| | | | - Sydney Iacoi
- Butler Hospital, Providence, RI, United States of America
| | - Sarah Barter
- Butler Hospital, Providence, RI, United States of America
| | - Zainab Shah
- Butler Hospital, Providence, RI, United States of America
| | - Jennifer Read
- University of Buffalo, Buffalo, NY, United States of America
| | - Cynthia Battle
- Butler Hospital, Providence, RI, United States of America; Alpert Medical School of Brown University, Providence, RI, United States of America; Women & Infants' Hospital of Rhode Island, Providence, RI, United States of America
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Brevers D, Billieux J, de Timary P, Desmedt O, Maurage P, Perales JC, Suárez-Suárez S, Bechara A. Physical Exercise to Redynamize Interoception in Substance use Disorders. Curr Neuropharmacol 2024; 22:1047-1063. [PMID: 36918784 DOI: 10.2174/1570159x21666230314143803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 03/16/2023] Open
Abstract
Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.
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Affiliation(s)
- Damien Brevers
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Adult Psychiatry, Cliniques universitaires Saint-Luc and Institute of Neuroscience (IoNS), UCLouvain, Brussels, Belgium
| | - Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
| | - José Cesar Perales
- Mind, Brain, and Behavior Research Center (CIMCYC), Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Samuel Suárez-Suárez
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Antoine Bechara
- Department of Psychology, University of Southern California, Los Angeles, California, CA, USA
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Towers EB, Shapiro DA, Abel JM, Bakhti-Suroosh A, Kupkova K, Auble DT, Grant PA, Lynch WJ. Transcriptional Profile of Exercise-Induced Protection Against Relapse to Cocaine Seeking in a Rat Model. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:734-745. [PMID: 37881559 PMCID: PMC10593899 DOI: 10.1016/j.bpsgos.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
Background Exercise has shown promise as a treatment for cocaine use disorder; however, the mechanism underlying its efficacy has remained elusive. Methods We used a rat model of relapse (cue-induced reinstatement) and exercise (wheel running, 2 hours/day) coupled with RNA sequencing to establish transcriptional profiles associated with the protective effects of exercise (during early withdrawal [days 1-7] or throughout withdrawal [days 1-14]) versus noneffective exercise (during late withdrawal [days 8-14]) against cocaine-seeking and sedentary conditions. Results As expected, cue-induced cocaine seeking was highest in the sedentary and late-withdrawal exercise groups; both groups also showed upregulation of a Grin1-associated transcript and enrichment of Drd1-Nmdar1 complex and glutamate receptor complex terms. Surprisingly, these glutamate markers were also enriched in the early- and throughout-withdrawal exercise groups, despite lower levels of cocaine seeking. However, a closer examination of the Grin1-associated transcript revealed a robust loss of transcripts spanning exons 9 and 10 in the sedentary condition relative to saline controls that was normalized by early- and throughout-withdrawal exercise, but not late-withdrawal exercise, indicating that these exercise conditions may normalize RNA mis-splicing induced by cocaine seeking. Our findings also revealed novel mechanisms by which exercise initiated during early withdrawal may modulate glutamatergic signaling in dorsomedial prefrontal cortex (e.g., via transcripts associated with non-NMDA glutamate receptors or those affecting signaling downstream of NMDA receptors), along with mechanisms outside of glutamatergic signaling such as circadian rhythm regulation and neuronal survival. Conclusions These findings provide a rich resource for future studies aimed at manipulating these molecular networks to better understand how exercise decreases cocaine seeking.
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Affiliation(s)
- Eleanor Blair Towers
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
- Medical Scientist Training Program, University of Virginia, Charlottesville, Virginia
| | - Daniel A. Shapiro
- Center for Brain Immunology and Glia, Department of Neuroscience, University of Virginia, Charlottesville, Virginia
| | - Jean M. Abel
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
| | - Anousheh Bakhti-Suroosh
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
| | - Kristyna Kupkova
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia
| | - David T. Auble
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, Virginia
| | - Patrick A. Grant
- Department of Biomedical Science, Florida Atlantic University, Boca Raton, Florida
| | - Wendy J. Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia
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Shay JES, Vannier A, Tsai S, Mahle R, Diaz PM, Przybyszewski E, Challa PK, Patel SJ, Suzuki J, Schaefer E, Goodman RP, Luther J. Moderate-high intensity exercise associates with reduced incident alcohol-associated liver disease in high-risk patients. Alcohol Alcohol 2023; 58:472-477. [PMID: 37565935 PMCID: PMC10493517 DOI: 10.1093/alcalc/agad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/26/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Therapies to prevent alcohol-associated liver disease (ALD) in high-risk patients are needed. AIMS In this retrospective association study, we examined whether patients with alcohol use disorder (AUD) who reported greater exercise were less likely to develop liver disease. METHODS In this retrospective cohort study, we used the Mass General Brigham Biobank to investigate the impact of both moderate-high and light-intensity exercise on the development of ALD in patients with AUD, using clinician-provided diagnostic International Classification of Diseases 10 codes. Exercise was evaluated using a questionnaire completed after an AUD diagnosis, and before evidence of liver disease. Cox regressions were used to generate hazard ratios (HRs) for the development of ALD. RESULTS 1987 patients met inclusion criteria. These patients were followed for an average of 10.7 years. In multivariable analyses, we found that patients that reported at least 2.5 h of moderate-high intensity exercise/week (confidence interval recommendation for exercise) were less likely to develop ALD compared to patients that did not exercise (HR: 0.26, 95%CI: 0.085-0.64, P = 0.007). Indeed, each hour of moderate-high intensity exercise was associated with progressively decreasing odds of developing ALD (HR: 0.76, 95%CI: 0.58-0.91, P = 0.02). Conversely, patients who did not engage in any moderate-high intensity exercise were more likely to develop ALD (HR: 2.76, 95%CI: 1.44-5.40, P = 0.003). CONCLUSIONS In our cohort, patients with AUD who reported moderate-high intensity exercise showed a lower association with incidence of ALD development than patients who did not exercise.
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Affiliation(s)
- Jessica E S Shay
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Augustin Vannier
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, United States
| | - Stephanie Tsai
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Rachel Mahle
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Paige McLean Diaz
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Eric Przybyszewski
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Prasanna K Challa
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Suraj J Patel
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Joji Suzuki
- Addiction Psychiatry, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States
| | - Esperance Schaefer
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Russell P Goodman
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Jay Luther
- MGH Alcohol Liver Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
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Li H, Su W, Cai J, Zhao L, Li Y. Effects of exercise of different intensities on withdrawal symptoms among people with substance use disorder: a systematic review and meta-analysis. Front Physiol 2023; 14:1126777. [PMID: 37234417 PMCID: PMC10208401 DOI: 10.3389/fphys.2023.1126777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Background: Exercise can effectively attenuate withdrawal symptoms and reduce relapse, but it is unknown whether exercise of different intensities produces different results. This study aimed to systematically review the effects of different exercise intensities on withdrawal symptoms among people with substance use disorder (SUD). Methods: Systematic searches for randomized controlled trials (RCTs) on exercise, SUD, and abstinence symptoms were conducted via electronic databases, including PubMed, up to June 2022. Study quality was evaluated using the Cochrane Risk of Bias tool (RoB 2.0) for assessment of risk of bias in randomized trials. The meta-analysis was performed by calculating the standard mean difference (SMD) in outcomes of interventions involving light-, moderate-, and high-intensity exercise for each individual study using Review Manager version 5.3 (RevMan 5.3). Results: In total, 22 RCTs (n = 1,537) were included. Overall, exercise interventions had significant effects on withdrawal symptoms, but the effect size varied with exercise intensity and by outcome measure (i.e., for different negative emotions). Light-, moderate-, and high-intensity exercise reduced cravings after the intervention [SMD = -0.71, 95% CI = (-0.90, -0.52)], and there were no statistical differences between the subgroups (p > 0.05). Light-, moderate-, and high-intensity exercise reduced depression after the intervention [light, SMD = -0.33, 95% CI = (-0.57, -0.09); moderate, SMD = -0.64, 95% CI = (-0.85, -0.42); high, SMD = -0.25, 95% CI = (-0.44, -0.05)], with moderate-intensity exercise producing the best effect (p < 0.05). Only light- and moderate-intensity exercise relieved anxiety after the intervention [light, SMD = -0.48, 95% CI = (-0.71, -0.26); moderate, SMD = -0.58, 95% CI = (-0.85, -0.31)]. Only high-intensity exercise worked in alleviating stress [SMD = -1.13, 95% CI = (-2.22, -0.04)]. Both irritability and restlessness could be improved by light- and moderate-intensity exercise [irritability, SMD = -0.74, 95% CI = (-0.98, -0.50); restless, SMD = -0.72, 95% CI = (-0.98, -0.47)], and there were no statistical differences between the subgroups (p > 0.05). Moderate- and high-intensity exercise decreased withdrawal syndrome after the intervention [moderate, SMD = -0.30, 95% CI = (-0.55, -0.05); high, SMD = -1.33, 95% CI = (-1.90, -0.76)], with high-intensity exercise producing the best effects (p < 0.01). Conclusion: Overall, exercise leads to improvements in withdrawal symptoms in individuals with SUD, but these effects vary significantly between the exercise of different intensities and according to the type of withdrawal symptoms. Moderate-intensity exercise has the greatest benefits in improving depression and anxiety; high-intensity exercise has the greatest benefits in improving withdrawal syndrome. Systematic Review Registration: www.crd.york.ac.uk/PROSPERO/, identifier, CRD42022343791.
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Affiliation(s)
- Hao Li
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Wantang Su
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Jiajia Cai
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Li Zhao
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
| | - Yan Li
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
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de Ternay J, Larrieu A, Sauvestre L, Montègue S, Guénin M, Icard C, Rolland B. Insufficient Physical Activity Is a Global Marker of Severity in Alcohol Use Disorder: Results from a Cross-Sectional Study in 382 Treatment-Seeking Patients. Nutrients 2022; 14:nu14234958. [PMID: 36500988 PMCID: PMC9739230 DOI: 10.3390/nu14234958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Improving physical activity (PA) in patients with alcohol use disorder (AUD) has recently emerged as an important component of the global treatment strategy to improve drinking outcomes and quality of life. However, this new approach should focus on AUD patients with insufficient baseline PA and requires this subgroup to be better characterized. In a population of 382 treatment-seeking AUD patients, PA was assessed using the International Physical Activity Questionnaire, and participants were divided into two groups: insufficient PA group and sufficient PA group. The severity of the AUD was assessed using the DSM-5 criteria, the Alcohol Use Disorder Identification Test, and the Severity of Alcohol Dependence Questionnaire. In logistic regression models, individuals with insufficient PA were more likely than other AUD individuals to present a higher Body Mass Index (p < 0.001), a higher number of AUD DSM-5 criteria (p < 0.05), more frequent opioid use (p < 0.05), higher scores at the Fagerström Test for Nicotine Dependence (p < 0.001), State-Trait Anxiety Inventory (p < 0.001), impulsivity scale (p < 0.05), Pittsburgh Sleep Quality Inventory (p < 0.05), and lower WHO Quality of Life (p < 0.001) scores. In AUD, an insufficient baseline PA is associated with several markers of severity, and physical exercise interventions should be part of a multimodal treatment program integrating the global impairments of patients.
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Affiliation(s)
- Julia de Ternay
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Correspondence:
| | - Agathe Larrieu
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Laura Sauvestre
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Solène Montègue
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Monique Guénin
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Christophe Icard
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
| | - Benjamin Rolland
- Service Universitaire d’Addictologie de Lyon (SUAL), Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69678 Lyon, France
- Centre de Recherche en Neurosciences de Lyon (Psychiatric Disorders, PSYR2), Université Claude Bernard Lyon 1, Inserm U1028, CNRS UMR 5292, 69100 Lyon, France
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Gunillasdotter V, Andréasson S, Hallgren M, Jirwe M. Exercise as treatment for alcohol use disorder: A qualitative study. Drug Alcohol Rev 2022; 41:1642-1652. [PMID: 36073088 PMCID: PMC9826429 DOI: 10.1111/dar.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/18/2022] [Accepted: 07/26/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Exercise is a promising treatment option for individuals with alcohol use disorder, but qualitative studies are lacking. Our aim was to explore experiences of yoga and aerobic exercise among non-treatment-seeking adults with alcohol use disorder. METHODS Semi-structured qualitative interviews (face-to-face or telephone) with 12 participants from a randomised controlled trial. Qualitative content analysis was used to analyse data. RESULTS One main category was identified, motivating and maintaining a lifestyle change, including four generic categories: (i) Initiating factors for lifestyle change, which describes how the concept of a lifestyle change initiated participants change; (ii) Influencing lifestyle change, explains how mood-enhancing effects from exercise influence exercise behaviours; (iii) Influencing physical and mental health, which describes how improvements in physical and mental health influence self-confidence and self-esteem; and (iv) Influencing alcohol consumption, which describes how exercise reduced alcohol cravings and that success in changing exercise behaviours made participants take healthier decisions regarding their alcohol intake. DISCUSSION AND CONCLUSIONS Exercise may help reduce alcohol intake, especially when presented in the context of a lifestyle change. Being able to self-select the type of exercise may increase compliance and optimise these benefits. Intentional planning and positive results from exercise may strengthen the individual's self-efficacy and increase the motivation to change behaviours associated with alcohol consumption.
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Affiliation(s)
- Victoria Gunillasdotter
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Sven Andréasson
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Psychiatry Research SwedenStockholm Health ServicesStockholmSweden
| | - Mats Hallgren
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Maria Jirwe
- Department of Health SciencesSwedish Red Cross UniversityHuddingeSweden,Department of Neurobiology, Care Sciences and SocietyKarolinska InstitutetHuddingeSweden
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Stevenson BL, Kunicki ZJ, Brick L, Blevins CE, Stein M, Abrantes AM. Using Ecological Momentary Assessments and Fitbit Data to Examine Daily Associations Between Physical Activity, Affect and Alcohol Cravings in Patients with Alcohol Use Disorder. Int J Behav Med 2022; 29:543-552. [PMID: 34750719 PMCID: PMC9079186 DOI: 10.1007/s12529-021-10039-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Preliminary studies show that structured physical activity (PA) interventions can reduce negative affect and alcohol use in patients recovering from alcohol use disorder (AUD). The current study tested whether the association between PA, affect, and alcohol cravings can be observed in patients' natural environments (i.e., without a structured intervention) as well. METHOD Twenty-five participants with AUD completed 3 weeks of ecological momentary assessment (EMA) monitoring and wore Fitbit devices to measure physical activity directly after discharge from partial hospitalization treatment for AUD. PA was operationalized as total steps and consecutive 10-min bouts of moderate-intensity exercise (100 steps/minute). RESULTS Only 56% of participants engaged in any bouts of moderate-intensity physical activity throughout the 3-week study period (mode = 1 bout), and participants logged an average of 8183 steps/day (SD = 5560). Daily steps were associated with a higher positive affect and lower alcohol cravings, and with higher positive affect the next day, but the effects were very small. No relationships were observed between PA and affect or alcohol cravings at the hourly level except a random effect signifying that bouts of PA were either positively associated or not associated with negative affect in the next hour for different participants. CONCLUSIONS Overall, results suggest that naturalistic PA may be beneficial for a small subset of patients in recovery from AUD, but the majority did not engage in regular exercise or experience improvements in affect and cravings as a result of PA.
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Affiliation(s)
| | - Zachary J Kunicki
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Leslie Brick
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Claire E Blevins
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Butler Hospital, 345 Blackstone Blvd, Providence, RI, 02906, USA.
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Pennington DL, Reavis JV, Cano MT, Walker E, Batki SL. The Impact of Exercise and Virtual Reality Executive Function Training on Cognition Among Heavy Drinking Veterans With Traumatic Brain Injury: A Pilot Feasibility Study. Front Behav Neurosci 2022; 16:802711. [PMID: 35391785 PMCID: PMC8981916 DOI: 10.3389/fnbeh.2022.802711] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/22/2022] [Indexed: 12/19/2022] Open
Abstract
Executive function (EF) underlies self-control deficits in alcohol use disorder (AUD) and traumatic brain injury (TBI). Cognitive training is a promising adjunctive treatment targeting TBI- and AUD- related cognitive dysfunction. However, major limitations related to compliance and generalizability in the field of cognitive training exist. Physical activity is associated with enhanced cognitive performance across several executive functions and may enhance the benefits of cognitive training. Virtual reality provides multisensory embodied experiences which are likely to engage brain networks more efficiently than standard cognitive training systems, ultimately resulting in greater near- and far-transfer effects. This pilot study aimed to obtain feasibility data and a preliminary assessment of an enriched virtual reality (VR) EF training (EFT) intervention combined with exercise (NCT03786276). Using an 8-week randomized adaptive design study, 30 AUD treatment seeking U.S. Veterans completed nine sessions of exercise-only (n = 15) or gameplay control (n = 15) over 3 weeks, followed by a week-4 repeat assessment in Phase 1. Twenty-three participants completed and moved onto Phase II, where they completed up to nine sessions of VR-EFT plus exercise and completed a week-8 end-of-study assessment. Primary outcomes included feasibility to retain participants, usability, and satisfaction of using VR-EFT. Secondary and exploratory outcomes included within group assessment of change in cognitive function, alcohol use, alcohol craving, and post-concussive symptoms among the three treatment conditions.VR-EFT was feasible with moderate usability and high acceptability ratings.The most common VR-related adverse effect was motion sickness (n = 2/16, 12.5%). The VR-EFT condition was associated with significant improvement in inhibition-switching and visual scanning (both p < 0.05) during Phase II. Exercise-only was associated with significant improvements in cognitive inhibition, cognitive flexibility, reductions in alcohol craving, and number of standard alcohol drinks per week (all p ≤ 0.05). The gaming-control condition was associated with improvement in cognitive flexibility and visuospatial immediate recall (both p < 0.05) during Phase 1. Recruitment and retention of U.S. veterans with AUD and TBI into an exercise plus VR-EFT intervention is feasible, but technological barriers may impact usability. VR-EFT was associated with improvement in executive function domains that were targeted in as little as 3-week and nine sessions of VR-EFT exposure. Results are promising and indicate the need for a larger controlled investigation to assess the efficacy of VR-EFT to enhance treatment outcomes among AUD treatment-seeking U.S. veterans with co-occurring AUD and TBI. Clinical Trial Registration www.ClinicalTrials.gov, Identifier: NCT03786276.
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Affiliation(s)
- David L. Pennington
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA, United States
| | - Jill V. Reavis
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA, United States
- Department of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Monique T. Cano
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States
| | - Erica Walker
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA, United States
| | - Steven L. Batki
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States
- Northern California Institute for Research and Education (NCIRE), San Francisco, CA, United States
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Camarini R. How good is exercise for people with alcohol use disorder? Alcohol Clin Exp Res 2022; 46:371-373. [PMID: 34978073 DOI: 10.1111/acer.14770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Rosana Camarini
- Departamento de Farmacologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
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