The efficacy of neurofeedback for alcohol use disorders - a systematic review

Abstract

Background Alcoholism is a serious social, economic, and public health problem. Alcoholism can affect the gastrointestinal, neurological, cardiovascular, and respiratory systems, and it can be fatal, costing the healthcare system huge amounts of money. Despite the availability of cognitive-behavioral and psychosocial therapies, alcoholism has a high recurrence rate and a dismal prognosis, with a wide inter-individual variation. As a result, better or adjuvant therapies that improve or facilitate alcoholism therapy are required. We conducted a systematic review to look into the published studies that reported the effectiveness of non-pharmacological neurofeedback interventions in patients with alcohol use disorders. Methods PubMed, Google Scholar, The Cochrane Library, Science Direct, and Clinicaltrial.gov were searched until April 04, 2022. Original articles of any design reporting on the use of neurofeedback approaches in the treatment of alcohol use disorders were included. Information related to study design, participants, control group, neuromodulation therapy, number of sessions, and key findings of the study were extracted. The Joanna Briggs Institute’s (JBI) Critical Appraisal Checklist for Studies was used to assess the quality of studies. Results 20 research articles (including 618 participants) were retrieved and included for qualitative analysis. The sample size ranged from one (case report) to eighty, with years of publication ranging from 1977 to 2022. Nine of the 20 articles included in the study were conducted in the United States, followed by Germany, the United Kingdom, India, the Netherlands, and South Korea. Out of the 20 studies included, 8 (40%) had a moderate risk of bias, while the other i.e., 60% had a low risk of bias. The effectiveness of various neurological treatments in the treatment of alcohol use disorders was established in these 20 studies. There have been 11 studies on EEG neurofeedback training, three studies on real-time FMRI neurofeedback, two studies each on transcranial direct current stimulation and transcranial magnetic stimulation, and one study each on deep brain stimulation and theta burst stimulation. These alternative neurological therapies have been demonstrated to lower alcohol cravings and consumption temporarily, reduce anxiety and depression scores, reduce relapse rates, and increase control of brain activity. Conclusion: The use of various neuromodulation approaches to the treatment of alcohol use disorder shows promise. However, more research with larger sample size is required.