Neurofeedback to Reduce Spontaneous Recovery of Threat Expectancy

NCT ID: NCT07122739

Last Updated: 2025-10-03

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-17
• Study Completion Date: 2028-06-30

Brief Summary

This study tests the efficacy of a new behavioral intervention with the goal of reducing spontaneous recovery of threat expectancy in healthy adults. This real-time functional magnetic resonance imaging (fMRI) neurofeedback intervention delivers feedback based on a functional connection between the prefrontal cortex and the hippocampus.

Detailed Description

Exposure therapy remains the most effective evidence-based treatment for a variety of anxiety related disorders; however, fear often returns over time. Pavlovian conditioning and extinction serve as a laboratory model for threat learning and exposure therapy, respectively. Studies utilizing these tasks can help uncover why exposure therapy fails to prevent the return of fear in some individuals. Pilot data suggest that there are specific behavioral phenotypes that individuals exhibit during a test of spontaneous recovery following Pavlovian acquisition and extinction. Specifically, some participants exhibit high spontaneous recovery, despite previously extinguishing their responses. The investigators hypothesize that individuals that exhibit this behavioral phenotype are also individuals for whom exposure therapy would be ineffective. These distinct phenotypes are also associated with different forms of computational inference, as revealed by fitting latent-cause inference models to behavioral data. In the case of individuals that exhibit high spontaneous recovery, latent cause inference modeling suggests that these participants are reinstating a latent cause associated with initial threat learning, which was protected from updating by the formation of a new cause during extinction.

A separate line of work has focused on understanding the behavioral consequences and neural mechanisms of voluntary thought suppression, or inhibitory memory control. This is the process through which an individual can suppress a memory to reduce the influence that it has over future cognition and emotion. The neural mechanisms of retrieval inhibition are well known and involve top-down inhibition from the right dorsal-lateral prefrontal cortex (dlPFC) to the hippocampus.

Here, the investigators aim to test the hypothesis that memory control ability is related to latent cause inference during Pavlovian conditioning and extinction, and by extension is related to spontaneous recovery. The goal of this project is to causally test this hypothesis by using real-time fMRI to directly strengthen individuals' memory control ability. Real-time fMRI (rt-fMRI) neurofeedback is a powerful tool that allows participants to modulate their own neural activity based on external cues (akin to biofeedback). Here, the investigators will provide participants feedback designed to help them increase their memory control ability. Specifically, the investigators will give participants positive feedback whenever the investigators detect negative dlPFC-hippocampal functional connectivity, which is the putative neural signature of successful memory inhibition. A control group will also be included, which will involve the delivery of sham placebo neurofeedback. The investigators predict that, following rt-fMRI neurofeedback, participants who received active neurofeedback aimed at increasing memory control will exhibit lower spontaneous recovery in a Pavlovian conditioning task compared to the control group.

Conditions

Healthy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: BASIC_SCIENCE
• Blinding Strategy: SINGLE

Study Groups

Active Neurofeedback

Active neurofeedback will reinforce negative dlPFC-hippocampal functional connectivity, as this is expected to increase memory control ability.

Group Type: EXPERIMENTAL

Active Real-time fMRI Neurofeedback

Intervention Type: BEHAVIORAL

Active neurofeedback to target a functional connection associated with increased memory control ability

Control Neurofeedback

Participants in the control neurofeedback group will receive the same instructions as the experimental group, but will receive sham neurofeedback.

Group Type: SHAM_COMPARATOR

Sham Real-time fMRI neurofeedback

Intervention Type: BEHAVIORAL

Sham neurofeedback

Interventions

Active Real-time fMRI Neurofeedback

Active neurofeedback to target a functional connection associated with increased memory control ability

Intervention Type: BEHAVIORAL

Sham Real-time fMRI neurofeedback

Sham neurofeedback

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Adults aged 18-50
• No history of psychiatric disorders or neurological disorders affecting the central nervous system.
• Are not currently taking psychoactive medication or drugs of abuse.
• Must be eligible to enter an MRI (i.e., no permanent metal or medical implants)
• Normal color vision
• Right-handed
• Full reading and writing English comprehension
• Must exhibit spontaneous recovery behavior as determined by an experimenter in a prescreening experimental session
• Must be able to provide informed consent

Exclusion Criteria

• Pregnancy (female participants)
• Outside of age range
• History of psychiatric or neurological disease
• Currently taking psychoactive medication or drugs of abuse
• Color blindness
• Primary left-handedness
• Less than full reading and writing English comprehension
• Do not exhibit spontaneous recovery behavior as determined by an experimenter in a prescreening experimental session
• Refusing to provide informed consent

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

Trustees of Princeton University

OTHER

Sponsor Role: lead

Responsible Party

Kenneth Norman

Huo Professor in Computational and Theoretical Neuroscience

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kenneth A. Norman, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Princeton University

Locations

Princeton Neuroscience Institute

Princeton, New Jersey, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Augustin C. Hennings, Ph.D.

Role: CONTACT

gus.hennings@princeton.edu

609-258-5032

Facility Contacts

Augustin C. Hennings, Ph.D.

Role: primary

gus.hennings@princeton.edu

Other Identifiers

P50MH136296

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P50MH136296-8441-33a

Identifier Type: -

Identifier Source: org_study_id