Music therapy (MT) is a promising adjunctive intervention for substance use disorder (SUD), yet multi-modal studies integrating neural, psychometric and qualitative measures are lacking.We conducted a mixed-methods pilot study with sixteen participants from a community-based substance-use treatment service to explore adjunctive MT plus standard treatment (ST) compared with ST alone. Participants received either six weekly MT sessions plus ST or ST alone. Assessments included resting-state and event-related electroencephalography, psychometric measures and semi-structured interviews addressing craving, affective symptoms, inhibitory control and participants’ therapeutic experiences.Craving Thermometer ratings suggested immediate reductions in present-moment craving after MT sessions, indicating that the conscious perception of craving improvement may emerge primarily in the immediate post-session window. Baseline-adjusted analyses showed no significant group differences at post intervention in Brief Substance Craving Scale scores or resting-state beta power z-scores, although the latter showed a larger descriptive reduction in the MT group. MT and ST differed significantly in post-intervention frontal alpha asymmetry after baseline adjustment, identifying affective-motivational processing as a candidate domain for future research. The MT group also showed a nominal, non-significant increase in P3d amplitude during a Go/NoGo task, suggesting response-inhibition-related EEG activity as a candidate signal for future investigation. Qualitative themes contextualised these findings by highlighting craving reduction, emotional reflection, reluctance to discuss craving and therapeutic connection.This pilot supports combining session-level, psychometric, qualitative and EEG measures in community-based MT for SUD. Future trials with larger samples, robust allocation, clearer comparators and longer-term follow-up are needed.Trial registration. NCT********, Registered * January 20**.
Preclinical evidence demonstrates that various forms of exercise can attenuate conditioned place preference (CPP) and self-administration of psychostimulants and opioids. However, the underlying neurobiological mechanisms behind how exercise attenuates drug CPP and self-administration remains unclear. Of particular interest is the role of dopamine receptor-expressing medium spiny neurons (MSNs) in the nucleus accumbens (NAc), as their activity becomes dysregulated after chronic substance use. Functional differences in D1R and D2R MSNs has been observed alongside neurobiological adaptations related to exercise and drug-seeking behaviors. Here, we review mainly preclinical evidence for exercise attenuating psychostimulant and opioid CPP and self-administration along with observed neurobiological adaptations in NAc circuitry. Additionally, we propose utilizing miniscopes to further parse the role of D1R and D2R MSNs during exercise and drug self-administration in vivo.
Background Early life stress (ELS) is a risk factor for alcohol use disorder (AUD) and may contribute to heterogeneity in clinical presentation. Using the Addictions Neuroclinical Assessment (ANA) framework, this study examined (1) associations between ELS and ANA domains within AUD; and (2) effects of AUD and ELS on ANA domains using a case–control design. Methods Adults with AUD (n=100) and controls (n=95) completed the Adverse Childhood Experiences (ACE) Questionnaire and phenotypic battery. Participants were classified as no-ELS, moderate-ELS, or high-ELS. Within AUD, ELS group differences in ANA domains were tested with univariate ANOVA. For case–control analyses, ELS and AUD effects were examined using 2 (AUD, control) × 3 (ELS groups) ANOVAs. Linear regression examined associations between continuous ACE scores and ANA domains. Results In AUD, the high-ELS group exhibited elevated negative emotionality versus no-ELS and moderate-ELS groups (p=0.008), with no effects on incentive salience or executive dysfunction (p’s>0.06). In case-control analyses, there were main effects of AUD and ELS (p’s<0.001) on negative emotionality. The AUD group reported greater negative emotionality than controls, and those with high-ELS reported greater negative emotionality than no-ELS or moderate-ELS groups. An AUDxELS interaction on executive dysfunction (p=0.03) revealed controls with no-ELS demonstrated the least executive dysfunction. When ELS was modeled continuously, findings were consistent for negative emotionality, but the AUDxELS interaction for executive dysfunction was not observed (p=0.16). Conclusion Findings support a clinically distinct AUD subtype defined by high-ELS and elevated negative emotionality and suggest independent effects of AUD and ELS on this domain.
Craving is a complex construct that is not fully understood. Craving for alcohol is an important motivator of alcohol use, a known risk factor for return-to-drinking, and one of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria for alcohol use disorder (AUD). Craving can be assessed retrospectively over a defined period (tonic) or in response to alcohol cues in real-time, e.g., through alcohol cue exposure (CE) paradigms (phasic). We conducted exploratory analyses of a clinical study including three matched groups: currently drinking (CD, N=9) and abstinent (AB, N=10) people with AUD and healthy controls (HC, N=12). During two alcohol CE sessions (CE1, CE2), tonic craving was assessed using the Penn Alcohol Craving Scale (PACS) and the Obsessive-Compulsive Drinking Scale (OCDS). Phasic craving was assessed using the Alcohol Urge Questionnaire (AUQ) alongside the Alcohol Attention Scale (AAS). The CD group showed higher AUQ and AAS than AB and HC groups (main effect of group, CE1: P=.048; CE2: P=.047). Group differences were also observed for tonic craving: the CD group reported higher PACS scores than HC (P=.001), while AB and CD groups showed higher OCDS scores than HC (HC vs. CD P<.0001, HC vs. AB P=.015). PACS scores correlated positively with OCDS (r=0.565, P=.001) and AUQ (r=0.595, P=.0004) scores in the full sample; within-group analyses showed a positive correlation between PACS and AUQ only in the AB group. Given the small sample size, these exploratory results should be considered preliminary and require confirmation in larger studies.
