Targeted Plasticity Therapy for Posttraumatic Stress Disorder

NCT ID: NCT04064762

Last Updated: 2023-01-05

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-16

Study Completion Date

2024-04-30

Brief Summary

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Posttraumatic stress disorder is a debilitating condition that develops in the aftermath of a traumatic experience, leading to hyperarousal, heightened anxiety, and uncontrolled fear that can be driven by intrusive memories or trauma reminders. The Texas Biomedical Device Center has developed a novel technique, termed targeted plasticity therapy (TPT), to boost neuroplasticity in conjunction with various forms of rehabilitation, including prolonged exposure therapy. The technique involves stimulation of the vagus nerve. The purpose of this open-label pilot study is to assess the safety of using a new device to deliver vagus nerve stimulation to reduce symptom severity in participants with PTSD when paired with prolonged exposure therapy. Additionally, the study will assess the prospective benefit of the system and garner an initial estimate of efficacy for a subsequent trial.

Detailed Description

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Conditions

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Post Traumatic Stress Disorder

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Vagus Nerve Stimulation + Prolonged Exposure Therapy

Study treatment is vagus nerve stimulation (VNS) delivered during Prolonged Exposure Therapy.

Group Type EXPERIMENTAL

Paired Vagus Nerve Stimulation

Intervention Type DEVICE

Stimulation of the vagus nerve that is paired with Prolonged Exposure Therapy.

Interventions

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Paired Vagus Nerve Stimulation

Stimulation of the vagus nerve that is paired with Prolonged Exposure Therapy.

Intervention Type DEVICE

Other Intervention Names

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VNS vagus nerve stimulation paired VNS

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed with chronic PTSD for at least 3 months based on the DSM-5 criteria (PSSI-5 score of 9-45)
* Appropriate candidate for VNS implantation
* Adult, aged 18-64
* Provision of signed and dated informed consent form
* Willingness to comply with all study procedures and availability for the duration of the study
* Right vocal cord has normal movement when assessed by laryngoscopy
* Women of reproductive potential must use contraceptive protection

Exclusion Criteria

* PSSI-5 score of 46 or greater (very severe symptoms)
* Current substance dependence
* Currently undergoing prolonged exposure therapy elsewhere
* Concomitant clinically significant brain injuries
* Prior injury to vagus nerve
* Prior or current treatment with vagus nerve stimulation
* Participant receiving any therapy (medication or otherwise) that would interfere with VNS
* Planning to become pregnant, currently pregnant, or lactating
* Clinical complications that hinder or contraindicate the surgical procedure
* Cognitive impairment that would interfere with study participation, confirmed by medical evaluation (will be assessed through chart review and with the Cognistat)
* Psychological conditions such as schizophrenia, bipolar disorder, or psychosis that could interfere with study participation and follow-up
* Participation in other interventional clinical trial
* Participants with known immunodeficiency including participants who are receiving or have received chronic corticosteroids, immunosuppressants, immunostimulating agents or radiation therapy within 6 months
* Significant comorbidities or conditions associated with high risk for surgical or anesthetic survival (e.g. renal failure, unstable cardiac disease, poorly controlled diabetes, immunosuppression, etc.).
* Active neoplastic disease.
* Significant local circulatory problems that would interfere with device implantation and communication, (e.g. thrombophlebitis and lymphedema).
* Any condition which, in the judgment of the Investigator, would preclude adequate evaluation of device's safety and performance.
* Incarceration or legal detention
* Non-English speaking
* Patients who are acutely suicidal and/or have been admitted for a suicide attempt
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Defense Advanced Research Projects Agency

FED

Sponsor Role collaborator

The University of Texas at Dallas

OTHER

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role collaborator

Baylor Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael Kilgard, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Texas at Dallas

Robert Rennaker, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Texas at Dallas

Seth Hays, PhD

Role: STUDY_DIRECTOR

University of Texas at Dallas

Jane Wigginton, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas Southwestern Medical Center

Michael Foreman, MD FACS

Role: PRINCIPAL_INVESTIGATOR

Baylor Health Care System

Mark Powers, PhD

Role: STUDY_DIRECTOR

Baylor Health Care System

Richard Naftalis, MD, FAANS, FACS

Role: STUDY_DIRECTOR

Baylor Health Care System

Ann Marie Warren, PhD

Role: STUDY_DIRECTOR

Baylor Health Care System

Jasper Smits, PhD

Role: STUDY_DIRECTOR

The University of Texas at Austin

Locations

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Baylor University Medical Center

Dallas, Texas, United States

Site Status

Countries

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United States

References

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American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.

Reference Type BACKGROUND

Corson K, Gerrity MS, Dobscha SK. Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 item. Am J Manag Care. 2004 Nov;10(11 Pt 2):839-45.

Reference Type BACKGROUND
PMID: 15609737 (View on PubMed)

Engineer ND, Riley JR, Seale JD, Vrana WA, Shetake JA, Sudanagunta SP, Borland MS, Kilgard MP. Reversing pathological neural activity using targeted plasticity. Nature. 2011 Feb 3;470(7332):101-4. doi: 10.1038/nature09656. Epub 2011 Jan 12.

Reference Type BACKGROUND
PMID: 21228773 (View on PubMed)

Foa EB, Ehlers A, Clark DM, Tolin DF, Orsillo SM. The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychol Assess 11(3): 303-314, 1999.

Reference Type BACKGROUND

Foa EB, McLean CP, Zang Y, Zhong J, Powers MB, Kauffman BY, Rauch S, Porter K, Knowles K. Psychometric properties of the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5). Psychol Assess. 2016 Oct;28(10):1166-1171. doi: 10.1037/pas0000258. Epub 2015 Dec 21.

Reference Type BACKGROUND
PMID: 26691504 (View on PubMed)

Foa EB, McLean CP, Zang Y, Zhong J, Rauch S, Porter K, Knowles K, Powers MB, Kauffman BY. Psychometric properties of the Posttraumatic Stress Disorder Symptom Scale Interview for DSM-5 (PSSI-5). Psychol Assess. 2016 Oct;28(10):1159-1165. doi: 10.1037/pas0000259. Epub 2015 Dec 21.

Reference Type BACKGROUND
PMID: 26691507 (View on PubMed)

Gilboa-Schechtman E, Foa EB, Shafran N, Aderka IM, Powers MB, Rachamim L, Rosenbach L, Yadin E, Apter A. Prolonged exposure versus dynamic therapy for adolescent PTSD: a pilot randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):1034-42. doi: 10.1016/j.jaac.2010.07.014. Epub 2010 Sep 6.

Reference Type BACKGROUND
PMID: 20855048 (View on PubMed)

Goodson J, Helstrom A, Halpern JM, Ferenschak MP, Gillihan SJ, Powers MB. Treatment of posttraumatic stress disorder in U.S. combat veterans: a meta-analytic review. Psychol Rep. 2011 Oct;109(2):573-99. doi: 10.2466/02.09.15.16.PR0.109.5.573-599.

Reference Type BACKGROUND
PMID: 22238857 (View on PubMed)

Hays SA, Rennaker RL, Kilgard MP. Targeting plasticity with vagus nerve stimulation to treat neurological disease. Prog Brain Res. 2013;207:275-99. doi: 10.1016/B978-0-444-63327-9.00010-2.

Reference Type BACKGROUND
PMID: 24309259 (View on PubMed)

Hembree EA, Rauch SAM, Foa EB. Beyond the manual: The insider's guide to Prolonged Exposure therapy for PTSD. Cogn Behav Pract 10(1): 22-30, 2003.

Reference Type BACKGROUND

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.

Reference Type BACKGROUND
PMID: 11556941 (View on PubMed)

Powers MB, Halpern JM, Ferenschak MP, Gillihan SJ, Foa EB. A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin Psychol Rev. 2010 Aug;30(6):635-41. doi: 10.1016/j.cpr.2010.04.007. Epub 2010 May 2.

Reference Type BACKGROUND
PMID: 20546985 (View on PubMed)

Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57.

Reference Type BACKGROUND
PMID: 9881538 (View on PubMed)

Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.

Reference Type BACKGROUND
PMID: 16717171 (View on PubMed)

Powers MB, Hays SA, Rosenfield D, Porter AL, Gallaway H, Chauvette G, Smits JAJ, Warren AM, Douglas M, Naftalis R, Wigginton JG, Foreman M, Kilgard MP, Rennaker RL. Vagus nerve stimulation therapy for treatment-resistant PTSD. Brain Stimul. 2025 May-Jun;18(3):665-675. doi: 10.1016/j.brs.2025.03.007. Epub 2025 Mar 15.

Reference Type DERIVED
PMID: 40097094 (View on PubMed)

Other Identifiers

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N66001-15-2-4057

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

019-280

Identifier Type: -

Identifier Source: org_study_id

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