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Amygdala-Prefrontal in Fear Extinction

28. august 2026 oppdatert av: Washington University School of Medicine

Causal Dynamics of Human Amygdala-Prefrontal Circuits During Fear Extinction Learning

The goal of this clinical trial is to understand how brain circuits involving the amygdala and prefrontal cortex contribute to fear learning and extinction. Fear extinction is the process by which a fear response decreases when a threat is no longer present. The study will include participants with epilepsy who are undergoing stereoelectroencephalography (SEEG) monitoring as part of their clinical care. The main questions this study aims to answer are: How do the amygdala and prefrontal cortex interact during fear learning and extinction? Do different parts and hemispheres of the amygdala have different roles in fear learning and extinction? How does electrical stimulation of the amygdala affect these brain circuits and fear extinction? Participants will complete tasks involving fear learning and extinction while researchers record brain activity from clinically implanted electrodes. Researchers will also use electrical stimulation via these electrodes to study how amygdala activity affects other brain regions and fear extinction.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The ability to reduce fear responses through extinction when threats are no longer present is essential for mental health. Deficits in extinction underlie fear-related disorders such as post-traumatic stress disorder (PTSD). A critical gap remains in understanding the neural mechanisms underlying fear extinction, which poses a major barrier to developing more effective therapeutic interventions. The amygdala (AMY)-prefrontal circuits are critical in fear extinction. In animal models, the lateral nucleus of the amygdala (LA) receives sensory inputs and initiates fear learning, while the basal nucleus of the amygdala (BA) integrates regulatory inputs from the ventromedial prefrontal cortex (vmPFC) and dorsal anterior cingulate cortex (dACC) for appropriate fear response. However, due to species-specific differences between animal and human neurobiology, the nucleus-specific contributions of the amygdala and their interactions with the vmPFC and dACC in human fear extinction and regulation remain poorly understood. Clinically indicated stereoelectroencephalography (SEEG) electrodes, which allow direct recording and stimulation of amygdala-prefrontal circuits, provide a unique opportunity to address this gap. The objective of this study is to determine the causal dynamics of amygdala-prefrontal circuits involved in fear extinction learning in participants with epilepsy undergoing SEEG monitoring. The study will address three aims: (1) Determine the intrinsic and stimulation-induced dynamics of human amygdala-prefrontal circuits. The study will characterize cause pathways and circuit-level interactions in amygdala-vmPFC-dACC circuits using intracranial recordings and electrical stimulation. (2) Characterize nucleus-specific and hemispherical lateralized dynamics of amygdala-prefrontal circuits during fear extinction. The study will examine the neural dynamics of the LA, BA, and left and right amygdala-prefrontal circuits during fear extinction and regulation. (3) Determine the effects of theta-burst stimulation of amygdala nuclei on fear extinction. Theta-burst stimulation will be applied to the LA and BA during extinction learning to examine how targeted stimulation modulates fear-related neural circuits and behavior.

Studietype

Intervensjonell

Registrering (Antatt)

40

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Tao Xie, PhD
  • Telefonnummer: 314-747-1443
  • E-post: xiet@wustl.edu

Studer Kontakt Backup

Studiesteder

  • Forente stater
    • Missouri
      • St Louis, Missouri, Forente stater, 63110-1010
        • Rekruttering
        • Washington University School of Medicine
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Tao Xie, PhD

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  1. At least 18 years of age.
  2. Able to understand the nature of the task.
  3. Able to provide informed consent themselves or provide consent through their legally authorized representative.
  4. Undergoing clinically indicated intracranial electrode implantation with coverage of at least one fear-related brain region, including the amygdala, hippocampus, cingulate cortex, insula, or prefrontal cortex.

Exclusion Criteria:

  1. Under the age of 18.
  2. Unable to understand the nature of the task.
  3. Unable to provide informed consent themselves or provide consent through their legally authorized representative.
  4. No clinically indicated intracranial electrode coverage in any fear-related brain region, including the amygdala, hippocampus, cingulate cortex, insula, or prefrontal cortex

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Grunnvitenskap
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Amygdala-prefrontal in Fear Extinction
Participants will undergo direct intracranial electrical stimulation and complete a Pavlovian fear conditioning and extinction task while neural activity is recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes. Electrical stimulation, including single-pulse and/or high-frequency stimulation, will be delivered through the intracranial electrodes to investigate amygdala-prefrontal circuit dynamics. Participants may also receive theta-burst stimulation of the amygdala during extinction learning.
Annen: Direct intracranial electrical stimulation
During a resting state and extinction learning phase, participants will receive electrical stimulation (single-pulse and/or high-frequency stimulation) through the intracranial electrodes while recording local field potentials from the neural networks. Direct electrical stimulation will be accomplished using FDA-approved equipment and stimulation protocols that are consistent with those used routinely for clinical purposes.
Atferdsmessig: Fear conditioning
Participants will be involved in a Pavlovian fear conditioning/extinction experiment while recording local field potential signals from the neural networks. During the experiment, neutral stimuli will be paired with an aversive but not painful electric shock (via the surface skin of the hand/foot) or screeching sound.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Broadband high-frequency power (70-170 Hz) in amygdala-prefrontal circuits
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Broadband high-frequency power (70-170 Hz) will be quantified from local field potentials recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes in the amygdala and prefrontal cortex. Broadband high-frequency power will be assessed during fear processing and during intracranial electrical stimulation to characterize local neural activity within amygdala-prefrontal circuits. For stimulation recordings, stimulation artifacts will be removed using appropriate artifact-removal methods, for example, MPARRM (matching pursuit-based artifact reconstruction and removal method) for single-pulse stimulation and LIBRA (linear baseline-integrated removal of artifacts) for high-frequency stimulation.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Oscillatory power at the stimulation frequency during intracranial electrical stimulation
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Oscillatory power at the stimulation frequency will be quantified from local field potentials recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes in the amygdala and prefrontal cortex. Power at the stimulation frequency will be assessed during intracranial electrical stimulation to quantify stimulation-induced oscillatory entrainment within amygdala-prefrontal circuits. For theta-burst stimulation, theta-band activity (4-8 Hz) will be assessed.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Amplitude of cortico-cortical evoked potentials in amygdala-prefrontal circuits
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Cortico-cortical evoked potential (CCEP) amplitude will be quantified from local field potentials recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes following single-pulse intracranial electrical stimulation. CCEP amplitude will be used to assess effective connectivity between the amygdala and prefrontal cortex.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Theta/gamma band power in amygdala-prefrontal circuits
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Theta (4-8 Hz) and gamma (30-50 Hz) band power will be quantified from local field potentials recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes in the amygdala and prefrontal cortex. Theta/gamma-band power will be assessed during fear conditioning and extinction to characterize oscillatory neural activity within amygdala-prefrontal circuits.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Cross-frequency coupling in amygdala-prefrontal circuits
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Cross-frequency coupling will be quantified from local field potentials recorded through clinically implanted stereoelectroencephalography (SEEG) electrodes in the amygdala and prefrontal cortex. Coupling between neural activity across different frequency bands, including phase-amplitude coupling between lower-frequency oscillations and high-frequency activity, will be assessed during resting state and fear processing to characterize cross-frequency neural interactions within amygdala-prefrontal circuits.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Skin conductance response amplitude during fear conditioning and extinction
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Skin conductance response (SCR) amplitude will be quantified during fear conditioning and extinction to assess autonomic responses to conditioned stimuli.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Pupil diameter during fear conditioning and extinction
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Pupil diameter will be quantified from eye-tracking recordings during fear conditioning and extinction to assess autonomic responses to conditioned stimuli.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Button press reaction time during fear conditioning and extinction
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Button press reaction time will be quantified during fear conditioning and extinction to assess behavioral responses to conditioned stimuli.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Subjective unpleasantness rating during fear conditioning and extinction
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Participants will rate the unpleasantness of the conditioned stimuli during fear conditioning and extinction. Ratings will be used to quantify subjective emotional responses to the conditioned stimuli.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Heart rate during fear conditioning and extinction
Tidsramme: During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.
Heart rate will be quantified during fear conditioning and extinction to assess autonomic responses to conditioned stimuli.
During research sessions, up to 2 hours per day for up to 4 days during the participant's hospital stay.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Washington University School of Medicine

Samarbeidspartnere

National Institute of Mental Health (NIMH)

Etterforskere

  • Hovedetterforsker: Tao Xie, PhD, Washington University School of Medicine

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

15. september 2026

Primær fullføring (Antatt)

31. juli 2031

Studiet fullført (Antatt)

31. juli 2032

Datoer for studieregistrering

Først innsendt

18. august 2026

Først innsendt som oppfylte QC-kriteriene

28. august 2026

Først lagt ut (Faktiske)

2. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Andre studie-ID-numre

  • 202507143
  • K99MH144521 (U.S. NIH-stipend/kontrakt)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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