Effects of Low-Level Laser Stimulation With and Without Fear Extinction Training

NCT ID: NCT02926352

Last Updated: 2022-12-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

112 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-01

Study Completion Date

2020-05-04

Brief Summary

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There are two specific aims for this study. Aim 1 is to test whether low-level laser therapy (LLLT) can enhance the efficacy of fear extinction training in the modification of pathological fear. Aim 2 is to investigate the efficacy of low-level laser therapy (LLLT) as a stand-alone intervention for anxiety/phobias.

Detailed Description

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Preliminary research with non-human animals suggests that LLLT (i.e., ultra low doses of transcranial infrared light) can enhance the retention of fear extinction learning by up regulating neuronal metabolic activity when applied to the ventromedial prefrontal cortex (vmPFC). Furthermore, evidence from a previous uncontrolled trial with humans suggests that LLLT (outside the context of extinction training) can lead to a significant decrease in symptoms of depression and anxiety when applied to the right and left dorsolateral prefrontal cortices (dlPFC). The first aim of this study is to test whether LLLT can boost fear reduction after extinction training in humans. A second aim of this study is to investigate the efficacy of LLLT as a stand-alone anxiolytic intervention in a randomized controlled trial.

Individuals between the ages of 18-65 with elevated fear in any of one of four domains (e.g., fear of enclosed spaces, fear of contamination, fear of public speaking, or anxiety sensitivity) are randomly assigned to one of four treatment arms (1) Extinction Training with LLLT, (2) Extinction Training with Sham LLLT, (3) LLLT alone, or (4) Sham LLLT alone.

To determine eligibility, all participants undergo an online prescreen and a face-to-face screening assessment. Participants who qualify for the study then complete a baseline (pre-treatment) assessment, followed immediately by the treatment procedure and a post-treatment assessment. Participants return to the lab an average of 14 days after treatment to complete a follow-up assessment. Participants complete two behavioral approach tests (in the treatment context and in the generalization context) at baseline, post-treatment, and follow-up, and a battery of self-report questionnaires at baseline and follow-up.

Conditions

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Phobias Claustrophobia Social Phobia

Keywords

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LLLT LLLS Low-Level Laser Stimulation Low-Level Laser Therapy Low-Level Light Therapy Transcranial infrared light stimulation Near-infrared light Photobiomodulation Fear Extinction Exposure Therapy Claustrophobia Fear of enclosed spaces Fear of contamination Fear of public speaking Anxiety sensitivity Cytochrome oxidase Memory consolidation Cognitive enhancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Extinction Training with LLLT

Participants will receive one-session of fear extinction training tailored to the participant's specific fear domain. 15 minutes after fear extinction, participants will receive 8 minutes of Low-Level Laser Therapy stimulation. The laser will be directed at two areas on the forehead: bilateral frontal points Fp1 and Fp2 (on the EEG electrode placement system; to stimulate the vmPFC). Each area will be stimulated for 4 minutes. Treatment will consist of alternating between each of these points after each minute.

Group Type EXPERIMENTAL

Extinction Training

Intervention Type BEHAVIORAL

Up to 40 min. of self-directed repeated exposure to a fear-provoking situation.

Low-Level Laser Therapy

Intervention Type DEVICE

1064nm light used to modulate a biological function and induce a therapeutic effect.

Extinction Training with Sham LLLT

Participants will receive one-session of fear extinction training tailored to the participant's specific fear. 15 minutes after fear extinction, participants will receive 8 minutes of Sham Low-Level Laser Therapy stimulation. The laser will be directed at two areas on the forehead: bilateral frontal points Fp1 and Fp2 (on the EEG electrode placement system). The procedure will consist of alternating between each of these points after each minute. However, each point will receive only a brief (5-second) treatment to the intended site on the forehead, followed by 55 seconds of no treatment, for each one-minute cycle, functioning as a placebo dose of the treatment.

Group Type ACTIVE_COMPARATOR

Extinction Training

Intervention Type BEHAVIORAL

Up to 40 min. of self-directed repeated exposure to a fear-provoking situation.

Sham Low-Level Laser Therapy

Intervention Type DEVICE

Placebo dose version of LLLT.

LLLT alone

Participants will receive 8 minutes of Low-Level Laser Therapy stimulation. The laser will be targeted first at the left forehead point F3 and then at the right forehead point F4 (on the EEG electrode placement system). F3 corresponds with the left dorsolateral prefrontal cortex and F4 corresponds with the right dorsolateral prefrontal cortex. Each area will be stimulated for 4 minutes. Treatment will consist of alternating between each of these points after each minute.

Group Type EXPERIMENTAL

Low-Level Laser Therapy

Intervention Type DEVICE

1064nm light used to modulate a biological function and induce a therapeutic effect.

Sham LLLT alone

Participants will receive 8 minutes of Sham Low-Level Laser Therapy stimulation. The laser will be targeted first at the left forehead point F3 and then at the right forehead point F4 (on the EEG electrode placement system). The procedure will consist of alternating between each of these points after each minute. However, each point will receive only a brief (5-second) treatment to the intended site on the forehead, followed by 55 seconds of no treatment, for each one-minute cycle, functioning as a placebo dose of the treatment.

Group Type SHAM_COMPARATOR

Sham Low-Level Laser Therapy

Intervention Type DEVICE

Placebo dose version of LLLT.

Interventions

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Extinction Training

Up to 40 min. of self-directed repeated exposure to a fear-provoking situation.

Intervention Type BEHAVIORAL

Low-Level Laser Therapy

1064nm light used to modulate a biological function and induce a therapeutic effect.

Intervention Type DEVICE

Sham Low-Level Laser Therapy

Placebo dose version of LLLT.

Intervention Type DEVICE

Other Intervention Names

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Exposure Therapy LLLT Sham LLLT

Eligibility Criteria

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Inclusion Criteria

1. Ages 18-65
2. Behavioral Approach Test (BAT) peak fear rating equal to or greater than 50/100 on both BATs (i.e., treatment and generalization contexts).

Exclusion Criteria

1. High risk for suicide as determined by a clinical assessment, which will occur if a participant indicates that they are currently experiencing suicidal ideation on the depression module of the Mini International Neuropsychiatric Inventory, or on item 9 of the Beck Depression Inventory.
2. Psychotropic medication taken within the past 4 weeks.
3. Currently Receiving treatment for the fear domain in question.
4. Presence of a medical condition (i.e., pregnancy, seizure disorder, respiratory disorder, cardiovascular disease) that would contraindicate participation in one or more treatment or assessment activities as determined by a Medical History Questionnaire.
5. Active neurological condition (such as epilepsy or stroke) as determined by a Medical History Questionnaire.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Texas at Austin

OTHER

Sponsor Role lead

Responsible Party

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Michael J. Telch

Director of the Laboratory for the Study of Anxiety Disorders

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael J. Telch, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Texas at Austin

Locations

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Laboratory for the Study of Anxiety Disorders

Austin, Texas, United States

Site Status

Countries

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United States

References

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Zaizar ED, Papini S, Gonzalez-Lima F, Telch MJ. Singular and combined effects of transcranial infrared laser stimulation and exposure therapy on pathological fear: a randomized clinical trial. Psychol Med. 2023 Feb;53(3):908-917. doi: 10.1017/S0033291721002270. Epub 2021 Jul 21.

Reference Type RESULT
PMID: 34284836 (View on PubMed)

Related Links

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https://doi.org/10.1017/S0033291721002270

Primary Outcomes Results Paper

Other Identifiers

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2013-12-0068

Identifier Type: -

Identifier Source: org_study_id