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Modulación del afrontamiento ansioso

2 de noviembre de 2026 actualizado por: Medical University of South Carolina

Modelado y modulación de mecanismos de escape, evitación y enfoque en el espectro del trastorno de ansiedad

This is a study to find out if a device that temporarily alters brain activity (repetitive transcranial magnetic stimulation, rTMS) might be used to change how people with anxiety or related concerns cope with feared or anxiety-producing situations. The study is recruiting people who recently started treatment for anxiety or a related concern. The study involves 3 visits to the Medical University of South Carolina. At the first visit, participants do interviews and surveys asking about anxiety and related concerns, and they also do tasks where they see and react to emotional pictures while their brain activation is measured. At the next two visits, participants receive rTMS, which works by rapidly turning a focused magnetic field on and off repeatedly over the head in a way that passes directly through the hair, scalp, and skull and onto the brain and can temporarily increase brain activity under the magnetic field. After rTMS, participants do two tasks where they see and react to emotional situations while wearing sensors on their hand, arms, face, and head.

Each visit in this study is expected to last between 2 - 4 hours. This is not a treatment study, but the study is being conducted with the hope that it will help improve treatment in the future.

Descripción general del estudio

Estado

Reclutamiento

Tipo de estudio

Intervencionista

Inscripción (Estimado)

80

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Christopher T Sege, PhD
  • Número de teléfono: 8437928465
  • Correo electrónico: sege@musc.edu

Ubicaciones de estudio

    • South Carolina
      • Charleston, South Carolina, Estados Unidos, 29425
        • Reclutamiento
        • Medical University of South Carolina
        • Contacto:
          • Christopher T Sege
          • Número de teléfono: 978-764-1480
          • Correo electrónico: sege@musc.edu

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 65 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • 18 - 65 y.o.
  • Meets criteria for an anxiety disorder (Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Specific Phobia), posttraumatic stress disorder, obsessive- compulsive disorder, or current adjustment disorder with anxiety
  • Is currently seeking mental health treatment
  • Is able to read consent document and provide informed consent.
  • English is a first or primary fluent language.

Exclusion Criteria:

  • Current alcohol or substance use disorder of more than mild severity (as defined by DSM-5 and determined using standardized self-report instruments)
  • Lifetime diagnosis of psychotic disorder or bipolar mania
  • Presence of neurological disorder that contraindicates TMS or neurophysiological recording: Seizure disorder Lifetime history of traumatic brain injury with loss of consciousness Neurodegenerative disorder (e.g., Alzheimer's Disease, Parkinson's Disease, Frontotemporal Dementia)
  • Presence of other medical disorder that would make it too uncomfortable to sit or lie still for long recording periods
  • Presence of standard contraindications for MRI or rTMS Metal in the body Currently pregnant Claustrophobia Significant sensitivity to noise Medical conditions or treatments that lower seizure threshold History of severe brain injury History of seizures/ epilepsy
  • Currently taking anticholinergic mediation, neuroleptic medication, or sedative/ hypnotic medication Note: SSRI, cholinesterase inhibitors or NMDA receptor antagonists are allowed if patient has been on a stable regimen of four weeks prior to enrollment
  • Currently taking chronic opiate medications or substances
  • Currently taking naltrexone

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Ciencia básica
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Neurostimulation Group

On one study day, participants will complete experimental tasks during functional magnetic resonance imaging. On two other study days, participants will complete tasks before and after receiving repetitive transcranial magnetic stimulation (rTMS). All participants will receive rTMS to ventromedial prefrontal cortex on one study day, and to pre-supplementary motor area on another study day.

Two stimulation procedures will be used, one for ventromedial prefrontal cortex and one for pre-supplementary motor area. For both targets, 3 sessions of 600 pulses at 110% of resting motor threshold will be presented over 30 minutes. For ventromedial cortex, a session will involve intermittent theta burst triplets at 50 Hz for 2 seconds and repeated every 10 seconds for a total of 190 seconds. For pre-supplementary motor area, a session will involve continuous theta burst presented in 3-pulse bursts with 15 pulses/ sec.

A repetitive Transcranial Magnetic Stimulation (rTMS) MagVenture MagPro TMS System will be used to deliver intermittent theta burst to ventromedial prefrontal cortex, and continuous theta burst to pre-supplementary motor area.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in Fear-Potentiated Startle Reflex
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Fear-potentiated startle is measured during an experimental task in which participants prepare to avoid, escape, or simply be exposed to aversive pictures. Fear-potentiated startle measures motivational activation during the preparation period.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Speed to Initiate Avoidance Behavior
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Reaction time to initiate flight is measured in an experimental task in which participants can win money but also must evade a slow, moderate, or fast virtual predator. Reaction time measures behavioral tendency to approach or avoid.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in Escape/ Avoidance Electroencephalography
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Electroencephalography (EEG) is measured during an experimental task in which participants prepare to avoid, escape, or simply be exposed to aversive pictures. An event-related potential, the stimulus-preceding negativity, will be derived from the EEG to index action preparation processing.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Approach/ Avoidance Conflict Electroencephalography
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Electroencephalography (EEG) is measured during an experimental task in which participants can win money but also must evade a slow, moderate, or fast virtual predator. A frequency signature, power in the theta frequency band, will be derived from the EEG to index cognitive control processes.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Task-Related Heart Rate Changes
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Heart rate is measured during experimental tasks in which: 1) participants prepare to avoid, escape, or simply be exposed to aversive pictures; 2) participants can win money but also must evade a slow, moderate, or fast virtual predator. Heart rate slowing measures task-related engagement of attention, while heart rate increase indicates defensive activation.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Task-Related Skin Conductance Responding
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Skin conductance is measured during experimental tasks in which: 1) participants prepare to avoid, escape, or simply be exposed to aversive pictures; 2) participants can win money but also must evade a slow, moderate, or fast virtual predator. Skin conductance increases indicate task-related sympathetic arousal.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Task-Related Perceived Control
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Perceived control over aversive stimuli is queried after an experimental task in which participants prepare to avoid, escape, or simply be exposed to aversive pictures. Perceived control for each condition is queried using self-report Likert-type scales for each condition.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in Difficulty of Avoiding Task-Based Aversive Exposure
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Difficulty of avoiding exposure to aversive stimulation is queried after each trial during a task in which participants can win money but also must evade a slow, moderate, or fast virtual predator. Avoidance difficulty is queried using a Likert-type scale delivered after each trial. The scale ranges from 1 to 5, with higher scores indicating greater perceived difficulty of avoiding capture by the virtual predator.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)
Change in State Anxiety During Session
Periodo de tiempo: Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

State-level anxiety is measured throughout the experimental session using the State-Trait Anxiety Inventory - State Form. The State-Trait Anxiety Inventory - State Form uses 20 items querying anxiety symptom experience in the present moment to measure how anxiety fluctuates across the experimental session. The scale ranges from 20 to 80, with higher scores indicating higher state anxiety.

Immediately Pre-Stimulation and Immediately Post-Stimulation (Approx. 30 minutes between assessments)

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Task-Related Brain Activation
Periodo de tiempo: During Session (Approx. 45 minutes)

Blood flow in the brain will be measured during completion of two experimental tasks using functional magnetic resonance imaging (fMRI). Blood flow in the brain can be used to measure what brain areas are being activated during the performance of a task.

During Session (Approx. 45 minutes)

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

26 de junio de 2021

Finalización primaria (Actual)

31 de agosto de 2026

Finalización del estudio (Estimado)

30 de diciembre de 2026

Fechas de registro del estudio

Enviado por primera vez

24 de marzo de 2021

Primero enviado que cumplió con los criterios de control de calidad

26 de marzo de 2021

Publicado por primera vez (Actual)

1 de abril de 2021

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

5 de noviembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

2 de noviembre de 2026

Última verificación

1 de noviembre de 2026

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • 00106843
  • 1K23MH123931-01A1 (Subvención/contrato del NIH de EE. UU.)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Descripción del plan IPD

Objective data will be archived in raw format on the NITRIC Data Repository. Sufficient description of tasks and event markers will be included to allow reprocessing and replication by trained researchers. Original, albeit cleaned and de-identified, self-report data will also be included. Cleaning will entail the most basic review of each variable to assure correct coding, and, in justified cases, invert variable scores to make variables easier to interpret. Inversions will always be noted.

DATA FORMAT: Objective data will be delivered to NITRIC in NIFTII format for fMRI data and tab-delimited text files for EEG and physiology data. Self-report data will be delivered in SPSS .sav format. No identifying information will be included.

VARIABLE CREATION: All variable computation, weighting, and imputation syntax will be in SPSS format and delivered in .txt file. A variable definition list / codebook will also be delivered.

Marco de tiempo para compartir IPD

Immediately following publication of primary project manuscript, or by 6 months after study completion, whichever is earlier.

Criterios de acceso compartido de IPD

De-identified data will be made available through upload to the NITRIC Data Repository. As such, de-identified data will be publically available.

Tipo de información de apoyo para compartir IPD

  • PROTOCOLO DE ESTUDIO
  • SAVIA

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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