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SO380

Mindfulness meditation combined with transcutaneous auricular vagus nerve stimulation in alcohol use disorder: a randomized study

MINDFULNESS MEDITATION COMBINED WITH TRANSCUTANEOUS AURICULAR VAGUS NERVE STIMULATION FOR ALCOHOL USE DISORDER: A RANDOMIZED TRIAL

Adding concurrent active transcutaneous auricular vagus nerve stimulation to mindfulness meditation significantly improved inhibitory control under negative affect, and this effect was accompanied by increased brain–heart interplay.

The aim was to examine whether concurrent transcutaneous auricular vagus nerve stimulation (taVNS) enhances mindfulness meditation (MM) by targeting impaired inhibitory control under negative affect, a core mechanism maintaining alcohol use disorder (AUD), and whether brain–heart interplay (BHI) serves as a mediating physiological pathway. Sixty-three patients with AUD were randomized to receive active taVNS (n = 32) or sham taVNS (n = 31) during MM sessions administered twice daily for 10 days. Inhibitory control was measured by no-go accuracy on a color-based go/no-go task using angry-face distractors; resting tonic BHI was measured by heart rate variability–electroencephalography coupling (HRV–EEG coupling). Secondary outcomes were time to first relapse, craving, negative affect, emotion regulation, mindfulness, and sleep quality. Improvement in angry-face no-go accuracy was significantly greater in the MM plus active taVNS group than in the sham group (p < 0.001); whereas post-treatment accuracy in the sham group remained strongly dependent on baseline performance (p < 0.001), accuracy in the active group was uniformly high regardless of baseline performance (p = 0.798). In the table of predictors of change, the group effect was significant (β = 0.202; 95% confidence interval 0.075 to 0.319; B = 0.051; p = 0.014), while baseline angry-face no-go accuracy was a strong inverse predictor (β = -0.849; 95% confidence interval -1.076 to -0.558; p < 0.001); age, years of education, age at first alcohol use, and baseline craving were not significant. A significant increase in BHI was observed only in the active taVNS group, which also showed earlier and more pronounced reductions in anxiety and craving. The poster’s conclusion states that the combination of MM and taVNS is an effective and safe treatment for men with AUD, that taVNS supports MM by strengthening brain–heart interplay, and that the findings support targeting BHI in mechanism-based interventions. Clinically, the portability and noninvasive nature of the taVNS device, together with the flexibility of delivering MM in group or individual settings, suggest the possibility of home-based treatment support.

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