Recruiting

Decoded Neuro-reinforcement

Sponsor:

UCLA

Code:

NCT06420557

Conditions

Phobia

Eligibility Criteria

Sex: All

Age: 18 - 65

Healthy Volunteers: Not accepted

Interventions

Unconscious Neuro-reinforcement

Unconscious Neuro-reinforcement

Unconscious Neuro-reinforcement

Study Details

Brief summary:

This application investigates the efficacy of a novel method of neuro-reinforcement based on decoded fMRI activity to reduce fear responses in individuals with phobias (e.g., spiders, snakes). This method works unconsciously in the brain, without the need for participants to endure repeated conscious exposures to their feared stimuli. Fear-related disorders such as specific phobia, post-traumatic stress disorder (PTSD), and other anxiety disorders present a major challenge, as effective treatment options usually involve repeated exposures to feared stimuli, leading to high levels of distress, fear, and panic that can motivate premature treatment termination. Consequently, there is an unmet need for treatment that minimizes subjective discomfort and attrition in order to maximize efficacy. Recent developments in computational neuroimaging have enabled a method that can deliver unconscious exposure to feared stimuli, resulting in effective fear reduction while bypassing a primary cause of treatment attrition. Because this treatment method happens unconsciously in the brain, changes in behavior outcomes are potentially more likely to generalize to different contexts, thereby overcoming a limitation of traditional treatments.

Conditions

Phobia

Study ID

NCT06420557

Start date

Sep 9, 2024

Status verified date

Sep, 2025

Completion date

Sep 30, 2026

Anticipated

Primary completion date

Sep 30, 2026

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 65

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Individual has normal or corrected to normal vision
2. Individual has normal or corrected to normal hearing
3. Individual is competent to understand informed consent
4. Individual must meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for specific phobias, animal subtype

Exclusion Criteria:

1. Individual is unable to fill in consent form correctly
2. Individual is unable to respond adequately to screening questions
3. Individual is unable to maintain focus or to sit during assessment
4. Individual has history of: neurological disease or defect (e.g., stroke, traumatic brain injury, schizophrenia or other psychological disorders, or seizures) Individual has vision problems (including cataracts, amblyopia, or glaucoma) Individual presents with: Obsessive Compulsive Disorder, Substance Use Disorder, Bipolar Disorder, Psychosis, neurologic diagnoses or unstable serious medical conditions
5. Participant receives an elevated score on the PHQ-9
6. Individual does not present with more than one object of specific phobia
7. Individual can touch the phobic object category during the pre-treatment Behavioral Approach Test without presenting significant distress
8. Individual is currently prescribed psychotropic medication

Study Design

Enrollment

60 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: 1 Session

1 neuro-reinforcement session

experimental: 3 Sessions

3 neuro-reinforcement sessions

experimental: 5 sessions

5 neuro-reinforcement sessions

Interventions

Unconscious Neuro-reinforcement

Individuals will complete an implicit fmri neuro-reinforcement task where real-time brain activity is matched to a desired activation. Individuals will also receive financial reward for activating the desired activation. Visual feedback will be presented to indicate how well individuals' brain activity matches the desired activation. Individuals will complete 1 session of neuro-reinforcement.

Unconscious Neuro-reinforcement

Individuals will complete an implicit fmri neuro-reinforcement task where real-time brain activity is matched to a desired activation. Individuals will also receive financial reward for activating the desired activation. Visual feedback will be presented to indicate how well individuals' brain activity matches the desired activation. Individuals will complete 3 sessions of neuro-reinforcement.

Unconscious Neuro-reinforcement

Individuals will complete an implicit fmri neuro-reinforcement task where real-time brain activity is matched to a desired activation. Individuals will also receive financial reward for activating the desired activation. Visual feedback will be presented to indicate how well individuals' brain activity matches the desired activation. Individuals will complete 5 sessions of neuro-reinforcement.

Primary outcome measure

  • Change in Amygdala Reactivity [ Time Frame: 14 days (measured at pre-treatment and 2 weeks) ]
  • Subjective Fear Post-treatment Minus Pre-treatment [ Time Frame: 14 days (measured at pre-treatment and 2 weeks) ]

Central Contacts and Locations

Central contacts

Gabriel J Fiol, B.A.

7252228834gfiol@psych.ucla.edu

Kainoa R MacDonald, B.A.

macdonald@psych.ucla.edu

Locations

University of California, Los Angeles

Recruiting

Los Angeles, California, United States, 90095

Contacts

Michelle G Craske, PhD

310-206-9191MCraske@mednet.ucla.edu

Principal Investigator:

Michelle G. Craske, Ph.D

More Information

Sponsor

University of California, Los Angeles

Last update posted

Oct 2, 2025

Last verified

Sep, 2025

Keywords

  • unconscious fear extinction
  • anxiety disorders
  • decoded neuro-reinforcement

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by University of California, Los Angeles on 2025-10-02.