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Exercise and Neural Adaptations: Designing a Novel Treatment for Alcohol Addiction

Kelsey Bourbeau, MS; Terence Moriarty, PhD; Micah Zuhl, PhD

Context • Multiple forms of behavioral therapies have been developed to treat alcohol abuse disorders (AUDs). Despite positive outcomes during and immediately after behavioral treatment, 60% to 90% of patients relapse in the year after treatment. Combined approaches have also been developed, but similar high relapse rates have occurred. Aerobic exercise may be an appropriate complimentary treatment for behavioral therapy in AUDs. However, it is critical to identify the appropriate dose of exercise to gain maximal benefit. Objective • This literature review intended to explore the neural components of alcohol addiction, identify the mechanisms by which exercise might influence brain function, characterize the appropriate exercise intervention for AUDs, and ascertain strategies for implementing exercise into behavioral therapy treatment. Design • The research team searched the literature for systematic reviews, descriptive studies, case reports, cross-sectional, along with experimental design studies (both randomized controlled trials and nonrandomized single group). Mechanisms of AUD, neurophysiological adaptations to physical exercise, and exercise interventions in AUD treatment were the primary areas of interest. PubMed, ScienceDirect, Cochrane Library, and Google Scholar databases were searched between 1970 and 2019. Results • Neural mechanisms of AUD identified included abnormal neurotransmission, prefrontal cortex function, and neurogenic processes. Exercise may serve the underlying neurophysiological mechanisms of AUD, and this has been demonstrated in a handful of exercise therapies studied among alcohol abusers. Conclusions • Given the current reviews findings on the neural mechanisms of alcohol addiction, the neurophysiological basis of exercise treatment, and the results of exercise interventions during alcohol treatment the current research team has developed a novel approach to treatment of alcohol addiction by incorporating aerobic interval exercise into traditional, evidence-based, cognitive behavioral therapy. The benefits of exercise may promote and compliment CBT treatment and lead to reduced drinking outcomes.

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