Neuromodulation of Motivation and Reward Oscillations (NEMO)

November 3, 2026 updated by: Rick James Macatee, Florida State University

Delta and Theta-Frequency Transcranial Alternating Stimulation Neuromodulation of Motivation and Reward Oscillations in Disorder of Reward Dysfunction.

Cannabis use disorder (CUD) and major depressive disorder (MDD) are among the most prevalent psychiatric conditions in the United States, affecting an estimated 20.6 million and 21 million adults respectively. Both disorders are characterized by anhedonia, diminished motivation, and blunted neural reward sensitivity. This shared dysregulated reward-processing may reflect a common prefrontal oscillatory dysfunction, centralized in mesolimbic dopaminergic reward pathways. This proposed project aims to investigate if transcranial alternating current (tACS) can modulate motivational behaviours and neural reward responsivity in participants with MDD and/or CUD during an effortful reward task. The investigators hypothesize that delta transcranial alternating current stimulation will produce a greater neural reward responsivity (RewP), and motivational behaviour during an effortful reward task.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Disrupted reward processing is a transdiagnostic feature that plays a central role in the development, and maintenance of anhedonia in Cannabis Use Disorder (CUD) and Major Depressive Disorder (MDD). Reward positivity (RewP) is an event-related potential (ERP) component derived from electroencephalogram (EEG) data, associated with motivation, reward responsivity and valuation. This neural signature originates in the medial and dorsolateral prefrontal cortexes. In MDD, reduced RewP has been associated with decreased willingness to expend effort for reward. Research of CUD and RewP is scarce, but dampened RewP has been demonstrated across different substances use disorders (SUDs) in response to monetary reward tasks. Taken together, these findings signal an emerging research frontier to establish RewP as a clinical biomarker and create a compelling mandate for causal investigation. Low-frequency neural oscillations are the key mechanisms facilitating long-distance prefrontal connectivity and interregional communication. Delta oscillations (2.5Hz) in medial and left lateral prefrontal cortexes are closely linked to RewP and reward prediction error signaling, while theta oscillations (6Hz) index cognitive control and prefrontal regulatory engagement during reward processing. Disruptions in both bands have been well documented in MDD, to a more limited extent, in cannabis-using populations. The proposed experiment will causally test whether sham, delta, and theta frequency tACS can alter motivation and reward responsivity (behaviourally [Effort behaviour] and neurally [RewP, delta power]), in participants with disorder of reward dysfunction, CUD, MDD, and healthy controls. Findings from the proposed study will aid in mechanistic understanding of prefrontal circuits underlying reward impairment in CUD and MDD, and ultimately enable for the development of novel brain stimulation techniques to target disorder-maintaining anhedonia. The investigators hypothesise that delta tACS will modulate reward responsivity in participants with disorders of reward. Such that, during the EEfRT Task delta stimulation will enhance reward responsive goal directed behaviour (Behavioral H1) and delta phase connectivity between left lateral and medial frontal electrodes (Neural H1) at effort decision period. As well as greater reward positivity (RewP; Neural 2), and win vs. loss delta power and phase coherence at feedback (Neural H3).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
54

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Zoe Howell Doctoral Student PI, M.Res.
  • Phone Number: 850-644-2445
  • Email: brains@psy.fsu.edu

Study Locations

  • United States
    • Florida
      • Tallahassee, Florida, United States, 32306-4301
        • Not yet recruiting
        • The BRAINS Lab at Florida State University
        • Contact:
      • Tallahassee, Florida, United States, 32306-4301
        • Recruiting
        • The Riddle Lab at Florida State University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 55 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria (General):

  • Aged between 18 - 55 years old.
  • Able to provide informed consent
  • Have normal to corrected vision
  • Willing to comply with all study procedures and be available for the duration of the study
  • Speak and understand English.
  • Negative THC saliva test and alcohol breathalyzer at all lab visits.
  • Negative UTOX for any substance other than THC.

Exclusion Criteria (General):

  • Mania history (Bipolar I, or current mania).
  • Psychosis history.
  • Current suicide intent (score >4 on C-SRSS, or intent >0 on SRA)
  • Current moderate-to-severe SUD or AUD (Except CUD and nicotine for NEMO-CUD).
  • Current pregnancy.
  • Seizure, neurological conditions, or brain surgery history.
  • Implanted medical devices (e.g., cochlear implants, cardiac pacemakers).
  • Change in psychotropic medication in the past 3 months (i.e., medication needs to be stable for 12 weeks).
  • Use of seizure threshold lowering medication (e.g., Stimulants, Benzos, SNRIs, Antipsychotics [Adderall, Vyvanse, Xanax, Wellbutrin, Cymbalta, Lithium] - SSRIs not exclusionary).

Specific CUD Inclusion:

  • Avg. 6+ cannabis use days per week over the past 3-months, and 24+ cannabis use days in the past 30 days.
  • Primary delta-9 or THC-A cannabis flower or vape concentrate user.
  • Current moderate-to-severe CUD (4+ criteria in the past year, at least one criterion other than craving must be met in the past three months).
  • Cannabis is the primary substance of use (Nicotine dependence is allowable)
  • Not currently receiving treatment for cannabis, planning to immediately quit or reduce use.
  • Lifetime history of MDE/PDD must have lifetime anhedonia symptom and/or heavy cannabis user (3+ sessions daily for at least past year including the past 3-months and past 30 days).

Specific MDD Inclusion:

  • Current MDE diagnosis.
  • No lifetime history of severe SUD.
  • No current moderate-to-severe SUD.
  • 100% of NEMO-MDD participants elevated anhedonia on TEPS-C (i.e., 32 or lower on TEPS-C subscale).

Specific Control Inclusion:

  • No current or historical psychiatric diagnosis.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Delta tACS

All participants receive delta (2.5 Hz), theta (6 Hz), and sham tACS across three separate sessions, separated by a 7-10 day washout. Session order is randomised and counterbalanced using a balanced Latin square, within each diagnostic group (CUD, MDD, healthy control). Stimulation is interleaved between the 8 blocks of the EEfRT (e.g., block 1 with stimulation, block 2 without, etc.). EEG activity will be recorded throughout the non-stimulation 4 blocks and proceeding interleaved non-stimulation blocks.
Device: Transcranial Alternating Current Delta Stimulation.

Approximately 20-minutes of delta stimulation (2.5Hz) applied to F3 (returns AF7, FC5, FC1) and AFz (returns Fp1, Fp2, F2). Transcranial Alternating Current Stimulation Device is NeuroConn DC-Stimulator MC.
Active Comparator: Theta tACS

All participants receive delta (2.5 Hz), theta (6 Hz), and sham tACS across three separate sessions, separated by a 7-10 day washout. Session order is randomised and counterbalanced using a balanced Latin square, within each diagnostic group (CUD, MDD, healthy control). Stimulation is interleaved between the 8 blocks of the EEfRT (e.g., block 1 with stimulation, block 2 without, etc.). EEG activity will be recorded throughout the non-stimulation 4 blocks and proceeding interleaved non-stimulation blocks.
Device: Transcranial Alternating Current Theta Stimulation

Approximately 20-minutes of theta stimulation (6Hz) applied to F3 (returns AF7, FC5, FC1) and AFz (returns Fp1, Fp2, F2). Transcranial Alternating Current Stimulation Device is NeuroConn DC-Stimulator MC.
Sham Comparator: Sham tACS

All participants receive delta (2.5 Hz), theta (6 Hz), and sham tACS across three separate sessions, separated by a 7-10 day washout. Session order is randomised and counterbalanced using a balanced Latin square, within each diagnostic group (CUD, MDD, healthy control). Stimulation is interleaved between the 8 blocks of the EEfRT (e.g., block 1 with stimulation, block 2 without, etc.). EEG activity will be recorded throughout the non-stimulation 4 blocks and proceeding interleaved non-stimulation blocks.
Device: Transcranial Alternating Current Stimulation Sham

The tACS stimulation is briefly turned on and off over the course of 15-30 seconds.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Effort-updating behavior during decision period.
Time Frame: Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

The % of hard effort choices selected following a win versus following a loss.
Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.
Delta phase coherence between left lateral and medial frontal electrodes during decision period following a win versus following a loss.
Time Frame: Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Electrical activity of the brain will be recorded via EEG during performance of the task and neurostimulation. Delta phase connectivity between left lateral and medial frontal electrodes during the decision period following a win versus following a loss.
Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.
Reward positivity amplitude
Time Frame: Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Electrical activity of the brain will be recorded via EEG during performance of the task and neurostimulation. Reward positivity amplitude to wins vs. losses.
Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Delta event-related spectral power
Time Frame: Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Electrical activity of the brain will be recorded via EEG during performance of the task and neurostimulation. Delta power to wins vs. losses.
Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.
Delta intertrial phase coherence
Time Frame: Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Electrical activity of the brain will be recorded via EEG during performance of the task and neurostimulation. Delta intertrial phase coherence to wins vs. losses.
Baseline (Day 0), Sham Session (Day 1-10, or Day 10-20, or Day 20-30), Theta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30), Delta Stim. Session (Day 1-10, or Day 10-20, or Day 20-30). Specific range depends on particular counterbalanced order.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Florida State University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Richard J Macatee, Ph.D., Florida State University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 26, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 9, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 9, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 3, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • STUDY00007710

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The IPD will only be shared under reasonable request. The investigators might not share IPD in order to keep participant confidentiality paramount.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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