Deep brain stimulation of the nucleus accumbens in treatment-resistant alcohol use disorder: A double-blind randomized controlled multi-center trial
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Treatment resistance in alcohol use disorders (AUD) is a major problem for affected individuals and for society. In the search of new treatment options, few case studies using deep brain stimulation (DBS) of the nucleus accumbens have indicated positive effects in AUD. Here we report a double-blind randomized controlled trial comparing active DBS ("DBS-EARLY ON") against sham stimulation ("DBS-LATE ON") over 6 months in n = 12 AUD inpatients. This 6-month blind phase was followed by a 12-month unblinded period in which all patients received active DBS. Continuous abstinence (primary outcome), alcohol use, alcohol craving, depressiveness, anxiety, anhedonia and quality of life served as outcome parameters. The primary intention-to-treat analysis, comparing continuous abstinence between treatment groups, did not yield statistically significant results, most likely due to the restricted number of participants. In light of the resulting limited statistical power, there is the question of whether DBS effects on secondary outcomes can nonetheless be interpreted as indicative of an therapeutic effect. Analyses of secondary outcomes provide evidence for this, demonstrating a significantly higher proportion of abstinent days, lower alcohol craving and anhedonia in the DBS-EARLY ON group 6 months after randomization. Exploratory responder analyses indicated that patients with high baseline alcohol craving, depressiveness and anhedonia responded to DBS. The results of this first randomized controlled trial are suggestive of beneficial effects of DBS in treatment-resistant AUD and encourage a replication in larger samples.
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In that RCT, secondary outcome analyses showed a significantly higher proportion of abstinent days, lower alcohol craving, and lower anhedonia in the DBS group.
“However, secondary outcome analyses showed a significantly higher proportion of abstinent days, lower alcohol craving, and anhedonia in the DBS group.”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [115]
In that RCT, findings suggested that patients with high baseline alcohol craving, depression, and anhedonia responded positively to DBS.
“Furthermore, findings suggested that patients with high baseline alcohol craving, depression, and anhedonia responded positively to DBS”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [115]
In a recent RCT of 12 AUD inpatients comparing DBS to sham stimulation over 6 months, the primary intention-to-treat analysis did not yield statistically significant results for continuous abstinence.
“In a recent RCT with 12 AUD inpatients, comparing DBS to sham stimulation over 6 months, the primary intention-to-treat analysis did not yield statistically significant results for continuous abstinence.”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [115]
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Modulation of Alcohol Use Disorder by Brain Stimulation
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Thalamostriatal circuit as a therapeutic target of alcohol use disorder
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Neurobiology of deep brain stimulation for psychiatric disorders
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Neuromodulation (Brain Stimulation) Technologies for Treatment of Substance Use Disorders
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The Future of Alcohol Use Disorder Treatment and Research
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- Authors
- Bach, P., Luderer, M., Müller, U. J., Jakobs, M., Baldermann, J. C., Voges, J., Kiening, K., Lux, A., Visser-Vandewalle, V., the DeBraSTRA study group, Klosterkötter, J., Huys, D., Sommer, W., Weber, T., Bogerts, B., Kuhn, J., & Mann, K.
- Affiliations
- Heidelberg University (DE)
- Goethe University Frankfurt (DE)
- University Hospital Magdeburg (DE)
- University Hospital Heidelberg (DE)
- University of Cologne (DE)
- University Hospital Cologne (DE)
- Die Johanniter (DE)
- Corresponding author
- Bach, Patrick
- ORCID
- Venue
- Translational Psychiatry
- Published
- 2023-02-08
- Volume
- 13
- Issue
- 1
- Pages
- 49-49
- ISSN
- 2158-3188 (ISSN-L)
- PMC
- PMC9908935
- OpenAlex
- W4319593946
- Cited by
- 65
- References
- 72
- Citations by year
- 2026: 17 · 2025: 20 · 2024: 19 · 2023: 9
- FWCI
- 11.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Translational Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Deutsche Forschungsgemeinschaft (Bo 799/8-1)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- deep brain stimulation, nucleus accumbens, alcohol craving, anhedonia, continuous abstinence, depressiveness, quality of life, responder analysis
- MeSH terms
- Ethanol, Alcoholism, Double-Blind Method, Humans, Nucleus Accumbens, Quality of Life, Treatment Outcome, Deep Brain Stimulation, Anhedonia
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