par Dousset, Clémence
Président du jury Colin, Cécile
Promoteur Campanella, Salvatore
Co-Promoteur Noël, Xavier
Publication Non publié, 2025-06-25
Thèse de doctorat
Résumé : Given the relapsing-remitting nature of alcohol use disorder, promoting abstinence remains a critical challenge. With alcohol-related harms projected to rise significantly in the coming years, this pressing issue mobilizes professionals across the field to identify innovative targets that can support long-term recovery. From a cognitive perspective, relapse can be attributed to an imbalance in cognitive processing: attentional biases automatically draw the patient's focus toward alcohol-related cues in the environment, consuming significant cognitive resources and leaving insufficient capacity for the brain to generate an effective inhibitory response—thus failing to prevent approach behaviors and (re)consumption, that is the Dual Process Model. On top of this, a lack of interoceptive skills makes patients less aware of their internal states and the evolving impact of alcohol use over time, ultimately reducing their ability to exert self-control over their consumption.As a response to that problematic, I make the hypothesize, informed by Barry Sterman’s theory, that neurofeedback training aimed at enhancing sensorimotor (SMR) power could decrease excessive neural processing of environmental alcohol-related cues. This reduction in sensory processing may free up neural resources that become available and can be recruited by brain networks to implement optimal inhibitory control responses. Additionally, since SMR activity is linked to an internal attentional focus, it may enhance interoceptive awareness, enabling patients to better recognize alcohol’s consequences and facilitate healthier behavioral responses.In this study, patients with alcohol use disorder undergoing detoxification participated in 10 neurofeedback sessions aimed at increasing SMR power. Attentional bias, inhibitory control, and interoceptive skills were assessed using both behavioral and neurophysiological measures. Although the study is still ongoing and no significant interactions have been observed yet, the preliminary results reveal promising trends that are consistent with existing literature and support the initial hypotheses. Thus, in a context where most patients relapse within the first year after detoxification, neurofeedback fits within the neurocognitive paradigm as an empowering intervention. It may act as a crucial lever for the patients to regain control over automatized action schemas triggered by cue reactivity—by re-engaging higher-order executive functions more rapidly and more efficiently, increasing the likelihood of sustained abstinence. In that way, patients may engage in a positive feedback loop that supports ongoing healing.

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