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NCT03372460: TAVRE

tDCS Plus Virtual Reality for PTSD

Completed NA Results posted Last updated 13 August 2024
What this trial tests

NA trial testing Active stimulation in Post-Traumatic Stress Disorder in 65 participants. Completed in 1 August 2023.

Timeline
2 April 2018
Primary endpoint
1 August 2023
1 August 2023

Quick facts

Lead sponsorVA Office of Research and Development
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment65
Start date2 April 2018
Primary completion1 August 2023
Estimated completion1 August 2023
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

VA Office of Research and Development — full company profile →

Who can join

Adults 18 to 70, any sex, with Post-Traumatic Stress Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5) Total Score Primary · Baseline, Midpoint (1 week after VR session 3), Endpoint (2 weeks after VR session 6), 1 Month Follow-up, 3 Month Follow-Up

The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. Items are rated on how much the symptom bothered the respondent in the past month (0 = "not at all bothered by" to 4 = "extremely bothered "). A total symptom severity score (range: 0-80) can be obtained by summing the scores for each of the 20 items, with higher scores indicating more severe PTSD symptoms. PCL-5 scores at 1 month was the primary symptom outcome measure for this study.

Baseline
GroupValue95% CI
Active Stimulation48.6± 12.1
Sham Stimulation45.0± 11.9
Midpoint
GroupValue95% CI
Active Stimulation38.5± 14.4
Sham Stimulation41.3± 15.1
Endpoint
GroupValue95% CI
Active Stimulation36.0± 15.4
Sham Stimulation38.9± 15.1
1 Month Follow-Up
GroupValue95% CI
Active Stimulation31.4± 17.8
Sham Stimulation37.9± 16.6
3 Month Follow-Up
GroupValue95% CI
Active Stimulation21.2± 12.6
Sham Stimulation32.3± 17.1
Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ) Primary · Baseline, Endpoint (2 weeks after VR session 6), 1 Month Follow-Up, 3 Month Follow-Up

The 16-item QLESQ (short form) evaluates quality of life and other areas of change related to functioning outside of symptom domains (e.g., physical health, mood, leisure time activities, social relationships, etc.). Items are rated on how satisfied the respondent has been in the past week (1 = "very poor" to 5 = "very good "). A total raw score (range: 16-80). Higher outcomes indicate better quality of life, greater enjoyment, and satisfaction.

Baseline
GroupValue95% CI
Active Stimulation35.9± 8.9
Sham Stimulation39.2± 9.8
Endpoint
GroupValue95% CI
Active Stimulation39.2± 10.2
Sham Stimulation41.6± 9.2
1 month follow-up
GroupValue95% CI
Active Stimulation40.7± 10.3
Sham Stimulation41.0± 8.5
3-month follow-up
GroupValue95% CI
Active Stimulation44.3± 9.6
Sham Stimulation47.1± 10.1
Psychophysiology (Skin Conductance Reactivity; SCR) Primary · Measured during each tDCS+VR session, each session up to 1 hour

Psychophysiology will include skin conductance reactivity to specific trauma context virtual reality (VR) cues presented in the VR scenario. SCR to VR events will be measured by the phasic responses that occur after the presentation of discreet VR events. SCR will be compared from baseline to end of tDCS+VR, to correlate these measures and evaluate changes attributable to active tDCS+VR compared to sham.

VR Session 1
GroupValue95% CI
Active Stimulation0.742± 0.093
Sham Stimulation0.64± 0.093
VR Session 2
GroupValue95% CI
Active Stimulation0.596± 0.095
Sham Stimulation0.503± 0.092
VR Session 3
GroupValue95% CI
Active Stimulation0.48± 0.095
Sham Stimulation0.539± 0.093
VR Session 4
GroupValue95% CI
Active Stimulation0.458± 0.096
Sham Stimulation0.475± 0.093
VR Session 5
GroupValue95% CI
Active Stimulation0.295± 0.095
Sham Stimulation0.492± 0.094
VR Session 6
GroupValue95% CI
Active Stimulation0.441± 0.096
Sham Stimulation0.492± 0.094
Inventory of Depressive Symptomatology Self-Report (IDSSR) Secondary · Baseline, Midpoint (1 week after VR session 3), Endpoint (2 weeks after VR session 6), 1 Month Follow-up, 3 Month Follow-Up

The 28-item IDSSR is a self-report measure of depressive symptom severity. Each item is rated on a scale of 0 to 3 by the participant for a total minimum score of 0 and a maximum score of 84. A higher score on the IDSSR indicates increased depressive symptom severity.

Baseline
GroupValue95% CI
Active Stimulation41.6± 12.0
Sham Stimulation38.6± 13.0
Midpoint
GroupValue95% CI
Active Stimulation35.5± 10.7
Sham Stimulation35.3± 13.4
Endpoint
GroupValue95% CI
Active Stimulation34.2± 15.1
Sham Stimulation34.8± 14.5
1 Month Follow-Up
GroupValue95% CI
Active Stimulation30.5± 16.2
Sham Stimulation32.3± 15.5
3 Month Follow-Up
GroupValue95% CI
Active Stimulation23.4± 12.7
Sham Stimulation27.1± 14.8
Social and Occupational Function Scale (SOFAS) Secondary · Baseline, Endpoint (2 weeks after VR session 6), 1 Month Follow-Up, 3 Month Follow-Up

The SOFAS is a scale that focuses on the individual's level of social and occupational functioning and is not directly influenced by the overall severity of the individual's psychological symptoms. Any impairment in social and occupational functioning that is due to general medical conditions is considered in making the SOFAS rating. The SOFAS is usually used to rate functioning for the current period (i.e., the level of functioning at the time of the evaluation). Scores range from 0 to 100, with higher scores indicating better social and occupational functioning.

Baseline
GroupValue95% CI
Active Stimulation40.5± 9.7
Sham Stimulation43.0± 11.2
Endpoint
GroupValue95% CI
Active Stimulation47.2± 14.7
Sham Stimulation48.0± 12.2
1 Month Follow-Up
GroupValue95% CI
Active Stimulation53.1± 13.8
Sham Stimulation54.1± 15.4
3 Month Follow-Up
GroupValue95% CI
Active Stimulation67.2± 8.3
Sham Stimulation62.2± 15.3
Clinician Administered PTSD Scale for the DSM-5 (CAPS-5) Secondary · Baseline, Endpoint (2 weeks after VR session 6), 1 Month Follow-Up, 3 Month Follow-Up

The CAPS-5 is the gold standard in clinician-assessed PTSD symptoms. The CAPS-5 is a 30-item structured interview that can be used to make current (past month) diagnosis of PTSD, make lifetime diagnosis of PTSD, and assess PTSD symptoms over the past week. In addition to assessing the 20 DSM-5 PTSD symptoms, questions target the onset and duration of symptoms, subjective distress, impact of symptoms on social and occupational functioning, improvement in symptoms since a previous CAPS administration, overall response validity, overall PTSD severity, and specifications for the dissociative subty

Baseline
GroupValue95% CI
Active Stimulation44.8± 8.2
Sham Stimulation40.5± 8.1
Endpoint
GroupValue95% CI
Active Stimulation40.4± 11.2
Sham Stimulation37.1± 9.2
1 Month Follow-Up
GroupValue95% CI
Active Stimulation34.1± 14.7
Sham Stimulation36.1± 12.6
3 Month Follow-Up
GroupValue95% CI
Active Stimulation22.7± 13.9
Sham Stimulation31± 11.9

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to three months. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Active Stimulation
Serious: 2/26 (8%)
Deaths: 0/26
Sham Stimulation
Serious: 2/28 (7%)
Deaths: 0/28

Serious adverse events (3 terms)

ReactionSystemActive StimulationSham Stimulation
Exacerbation of chronic gastrointestinal illnessGastrointestinal disorders
Syncopal episodeGeneral disorders
Treatment-emergent suicidal ideationPsychiatric disorders
Other adverse events (16 terms — click to expand)

ReactionSystemActive StimulationSham Stimulation
TinglingGeneral disorders
Change in moodPsychiatric disorders
ItchingSkin and subcutaneous tissue disorders
RednessSkin and subcutaneous tissue disorders
BurningSkin and subcutaneous tissue disorders
Sleepy, drowsy, or fatigueGeneral disorders
Changes in concentrationGeneral disorders
HeadacheNervous system disorders
NauseaGeneral disorders
Ringing or buzzing in earsGeneral disorders
Dizziness or lightheadednessGeneral disorders
Blurry visionGeneral disorders
Neck painGeneral disorders
Scalp painGeneral disorders
Head painGeneral disorders
Flickering lightsGeneral disorders

Most-reported serious reactions: Exacerbation of chronic gastrointestinal illness, Syncopal episode, Treatment-emergent suicidal ideation.

Data from ClinicalTrials.gov NCT03372460 adverse events section.

Sponsor's own description

This study tests the efficacy of combining non-invasive brain stimulation, called transcranial direct current stimulation (tDCS), with virtual reality exposure as a treatment for Veterans with chronic posttraumatic stress disorder (PTSD). Investigators tested whether this intervention improves PTSD symptoms and improves quality of life. Results from this study may be used to develop a new non-medication approach to treating chronic PTSD.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Virtual Reality and Transcranial Direct Current Stimulation for Posttraumatic Stress Disorder: A Randomized Clinical Trial.
    van 't Wout-Frank M, Arulpragasam AR, Faucher C, Aiken E, et al · · 2024 · cited 23× · PMID 38446471 · DOI 10.1001/jamapsychiatry.2023.5661
  2. Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure.
    van 't Wout-Frank M, Philip NS. · · 2021 · cited 5× · PMID 33522512 · DOI 10.3791/61795
  3. One year clinical outcomes after transcranial direct current stimulation and virtual reality for posttraumatic stress disorder.
    Philip NS, Brettler K, Greenberg BD, Arulpragasam AR, et al · · 2024 · cited 2× · PMID 39069125 · DOI 10.1016/j.brs.2024.07.016
  4. ACNP 59<sup>th</sup> Annual Meeting: Poster Session III.
    · 2020 · cited 1× · PMID 33279936 · DOI 10.1038/s41386-020-00892-5
  5. Mechanisms and clinical potential of combined tDCS and virtual reality in psychiatric disorders: a systematic review.
    Guo X, Jiang H, Zheng Z, Zhang J, et al · · 2026 · PMID 41691330 · DOI 10.1186/s12991-025-00621-6
  6. ACNP 63rd Annual Meeting: Poster Abstracts P609-P914
    · 2024
  7. Pathway to response: Associations between individual electrical fields and psychophysiological habituation to predict clinical outcomes to transcranial direct current stimulation combined with virtual reality for PTSD.
    van 't Wout-Frank M, Sorensen DO, Parra LC, Huang Y, et al · · 2025 · PMID 40216306 · DOI 10.1016/j.brs.2025.04.001
  8. ACNP 62nd Annual Meeting: Poster Abstracts P1 – P250
    · 2023

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Trials by the same sponsor.

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