Feasibility Open Label Study Evaluating The Use Of Process-Instructed Self Neuro-Modulation (PRISM) For Post-Traumatic Stress Disorder

Study Overview
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Brief Summary
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This is a single-arm, open-label feasibility study. A maximum of 15 participants will be enrolled. All participants will undergo a novel neurofeedback intervention, targeting down-regulation of deep limbic structures, specifically the amygdalae. Participants will complete 12 neurofeedback sessions delivered twice weekly over 6 consecutive weeks. The intervention will be delivered via the PRISM platform.

Official Title
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Feasibility Open Label Study Evaluating The Use Of Process-Instructed Self Neuro-Modulation (PRISM) For Post-Traumatic Stress Disorder

Conditions
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Post-traumatic Stress Disorder

Intervention / Treatment
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* Device: PROCESS-INSTRUCTED SELF NEURO-MODULATION (PRISM)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults ages 18-65 years Able to provide signed informed consent Any gender Diagnosis of PTSD as established by DSM-V 1 to 15 years since index trauma Taking a stable dose of SSRI antidepressants for at least 3 months OR un-medicated for at least 2 months Normal or corrected-to-normal vision Normal or corrected-to-normal hearing No intention of changing medication or psychotherapy for the duration of the study at the time of recruitment Exclusion Criteria: Concurrent substance abuse Use of any prescribed benzodiazepine Lifetime bipolar disorder, psychotic disorder, autism, mental retardation. Comorbid mood and anxiety disorders will be permitted if they are not the primary focus of clinical attention Active suicidality within past year, or history of suicide attempt in past 2 years Any history of severe past drug dependence (i.e., a focus of clinical attention or a cause of substantial social or occupational difficulty) Any unstable medical or neurological condition Any history of brain surgery, of penetrating, neurovascular, infectious, or other major brain injury, of epilepsy, or of other major neurological abnormality (including a history of traumatic brain injury [TBI] with loss of consciousness for more than 24 hours or posttraumatic amnesia for more than 7 days) Any psychotropic medication other than a stable dose of selective serotonin reuptake inhibitors (SSRIs) Any change in accepted psychotropic medication within the past 2 months Recent initiation (within the past 3 months) of cognitive-behavioral therapy or any evidence-based PTSD psychotherapy (Cognitive Processing Therapy [CPT], Prolonged Exposure [PE], Eye Movement -Desensitization and Reprocessing [EMDR]); continuation of established maintenance supportive therapy will be permitted Significant hearing loss or severe sensory impairment Enrollment in another research study testing an experimental, clinical, or behavioral intervention intended to affect symptoms initiated within the last 2 months, or intended enrollment within the next 2.5 months

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: single-arm, open-label feasibility study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients diagnosed with PTSD<br>7-15 men and women with PTSD will be recruited from the community and from local clinical programs through a multi-modal outreach program. | Device: PROCESS-INSTRUCTED SELF NEURO-MODULATION (PRISM)<br>* Neurofeedback sessions targeting down-regulation of deep limbic structures, specifically the amygdala, delievered via PRISM: a non-significant risk device (software) intended to be used in research studies testing the clinical efficacy of an innovative paradigm for EEG-based neurofeedback. The study will include 12 EEG-NF sessions, administered twice per week for a duration of 6 active weeks in total. Twice weekly sessions will be held on non-consecutive days. Each session will last 30 minutes. EFP-EEG-NF training: Each NF training session consists of 5 consecutive sequences of NF presentations. During a watch condition (60 seconds) participants are instructed to passively view the animation, and are told that that the scenario does not influence their brain activity. In the regulate phase (60 seconds) participants are instructed to lower the room's unrest level. A rest phase (15 seconds) follows each sequence, allowing participants to relax.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in CAPS-5 score from screening to completion | The CAPS-5 is a 30-item structured interview used to: Make current (past month) diagnosis of PTSD Make lifetime diagnosis of PTSD Assess PTSD symptoms over the past week 1, 2 rule is used to determine a diagnosis: a frequency score of 1 (scale 0 = none of the time to 4 = most or all of the time) and an intensity score 2 (scale 0 = none to 4 = extreme) is required for a particular symptom to meet criterion. The assessor combines information about frequency and intensity of an item into a single severity rating. CAPS-5 total symptom severity score is calculated by summing severity scores for the 20 DSM-5 PTSD symptoms. | Screening visit (Week 0), and Post-Intervention Visit (Week 9) | 
| Change in PCL-5 score from baseline to completion | The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The self-report rating scale is 0-4 for each symptom. A total symptom severity score (range - 0-80) can be obtained by summing the scores for each of the 20 items. | Baseline visit (Week 1), and Post-Intervention Visit (Week 9) |