Post Traumatic Stress Disorder Clinical Trial
Official title:
Reduction of Trauma-induced Intrusions and Amygdala Hyperreactivity Via Non-invasive Brain Stimulation
The study will focus on the modulation of intrusive memories via functional magnetic resonance imaging (fMRI)-guided repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex (dlPFC) directly after exposure to a traumatic video.
Traumatic experiences can lead to posttraumatic stress disorder (PTSD) with clinical
manifestations including intrusions, avoidance behavior, and hyperarousal. Unlike most other
psychological disorders, a PTSD diagnosis requires a clearly identifiable inciting event. As
such, preventive interventions in recently traumatized individuals seem promising.
In this randomized, placebo-controlled study the investigators explore the potential of
individualized transcranial magnetic stimulation (TMS) to reduce trauma-induced intrusive
thoughts by altering functional connectivity between the dorsolateral prefrontal cortex
(dlPFC) and amygdala. Subjects will undergo a functional magnetic resonance imaging (fMRI)
session consisting of a resting state scan, an emotion recognition task and an anatomical
scan at the beginning of the study (day 1). Resting state data will be used to determine
individualized TMS targets for every subject, depending on functional connectivity between
the dlPFC and amygdala. Subsequently, the analogue trauma model will be used to induce
intrusions in healthy subjects. Subjects will be confronted with a video clip from the movie
"Irreversible" and they will complete online questionnaires in the following three days to
measure intrusive thoughts, trauma disclosure (i.e. duration of conversations about the
aversive movie) and sleeping quality. Intermittent theta-burst stimulation (iTBS) will be
administered directly after the video clip and on the following two days (day 2-4). Cognitive
tasks will be applied before and after iTBS sessions to examine short-term effects of iTBS on
a behavioral level. Finally, subjects will undergo a second fMRI session similar to the first
one, to probe iTBS-induced changes in functional connectivity and emotional processing (day
5).
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