Choking During Sex for Brain Function

Overseen By Keisuke Kawata, PhD

Age: 18 - 65

Sex: Female

Trial Phase: Academic

Sponsor: Indiana University

Must not be taking: Antipsychotics

Disqualifiers: Pregnancy, TBI, Concussion, Neurological, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

25 Participants Needed

Trial Summary

Do I have to stop taking my current medications for the trial?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are currently taking antipsychotic medication.

What data supports the idea that Choking During Sex for Brain Function is an effective treatment?

The available research does not provide evidence that choking during sex is an effective treatment for brain function. Instead, studies focus on the prevalence and neurological effects of this behavior. For example, one study found different brain activation patterns in women who frequently experienced choking during sex, but it did not show improved brain function. Another study noted changes in brain connectivity, but again, it did not demonstrate any therapeutic benefits. Overall, the research highlights potential neurological changes but does not support the idea of choking during sex as an effective treatment. ^{1 2 3 4 5}

What safety data exists for choking during sex as a treatment?

The existing research on choking during sex primarily focuses on its neurological and physiological effects rather than safety data. Studies have shown that frequent sexual choking is associated with different neural activation patterns and structural brain changes, such as inter-hemispheric imbalance and hyperconnectivity in certain brain regions. Additionally, surveys indicate that while many participants report pleasurable sensations, some experience negative physical responses like neck bruising and loss of consciousness. There is a lack of comprehensive safety data, and further investigation into the neurologic and health effects of this behavior is warranted. ^{1 2 3 4 5}

Is choking during sex a promising treatment for brain function?

Choking during sex is not a promising treatment for brain function. While it is a common behavior among young adults, studies show it changes brain activity patterns, but there's no evidence it improves brain function. ^{1 2 3 4 5}

What is the purpose of this trial?

The purpose of this study is to examine the acute effect of being choked during partnered sex on neurological measures. The study is designed to identify the effects being choked during partnered sex on the brain through the use of neural-injury blood biomarkers, functional, diffusion, and perfusion MRI, and ocular-motor function across 3 time points (baseline, post-choking, post-non-choking). The central hypothesis is that acute neuronal structural, physiological, and functional alterations will be amplified after an incidence of choking-involved sex. The neural-injury blood biomarkers neurofilament light (NfL), glial fibrillary acidic protein (GFAP), Ubiquitin C-Terminal Hydrolase L1 (UCH-L1), and Tau will be measured in plasma, with the hypothesis that having choking involved sex will result in a increased heightened response compared to baseline and post non-choking involved sex timepoints. An additional panel of inflammatory cytokines may be considered if/when brain injury biomarkers show changes. It is also hypothesized that engaging in choking-involved sex will be associated with changes in fMRI activation patterns. White matter microstructure will be measured by diffusion imaging metrics, with the hypothesis that engaging in choking-involved sex will significantly disrupt microstructure at a post-choking involved sex time point, compared to baseline, but not at the post non-choking involved sex timepoint. The study will also assess oculomotor function as measured by near-point-of-convergence (NPC) in response to engaging in choking involved sex. The hypothesis is that NPC performance will be significantly impaired at the post choking-involved sex timepoint in comparison to both baseline and non-choking involved sex timepoints.

Eligibility Criteria

This trial is for individuals who engage in partnered sexual activity, both with and without the practice of choking. Participants must be healthy enough to undergo MRI scans and blood tests. Those with conditions affecting brain function or injury risk, such as a history of brain hypoxia or respiratory issues, may not qualify.

Inclusion Criteria

I am female.

Proficient in English

Reports engaging in sex involving being choked at least 2 times in the past month

Exclusion Criteria

I have only engaged in sexual activities involving choking in the past month.

Traumatic brain injury within past year

I have a neurological condition like epilepsy or a brain tumor.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Baseline Data Collection

Baseline data collection including blood biomarkers, MRI, and ocular-motor function assessments

2 hours

1 visit (in-person)

Post Choking-Involved Sex Data Collection

Data collection including blood biomarkers, MRI, and ocular-motor function assessments within 24 hours after engaging in choking-involved sex

2 hours

1 visit (in-person)

Post Non-Choking-Involved Sex Data Collection

Data collection including blood biomarkers, MRI, and ocular-motor function assessments within 24 hours after engaging in non-choking-involved sex

2 hours

1 visit (in-person)

Follow-up

Participants are monitored for any delayed effects or safety concerns after the main data collection phases

4 weeks

1 visit (in-person)

Treatment Details

Interventions

• Choking during Partnered Sex

Trial Overview The study investigates how being choked during sex affects the brain by comparing it to non-choking sexual activity. It measures changes in blood biomarkers for neural injury, brain imaging results from MRIs, and eye movement functions before and after each type of sexual encounter.

Participant Groups

Group I: Path 2 (non-choking involved sex prior to choking involved sex) Experimental Treatment 2 Interventions

Path 2 will involve 3 data collection time points including baseline data collection, post non-choking involved sex time point, and post choking involved sex time point, in that order. After enrollment, subjects will be sent a brief Qualtrics survey link once a day to determine when they are eligible for data collection based on their sexual activity within the last 24 hours. Subjects placed in the group following Path 2 will first come in for a baseline data collection which will occur after a 48 hour washout period of not engaging in partnered sex. Next, subjects will be asked to come in for an experimental data collection visit within the 24 hours after engaging in sex that did not involve any choking. Last, subjects will be asked to come in for an experimental data collection visit within 24 hours of engaging in choking involved sex.

Group II: Path 1 (choking involved sex prior to non-choking involved sex) Experimental Treatment 2 Interventions

Path 1 will involve 3 data collection time points including baseline data collection, post choking involved sex data collection time point, and post non-choking involved sex time point, in that order. After enrollment, subjects will be sent a brief Qualtrics survey link once a day to determine when they are eligible for data collection based on their sexual activity within the last 24 hours. Subjects placed in the group following Path 1 will first come in for a baseline data collection which will occur after a 48 hour washout period of not engaging in partnered sex. Next, subjects will be asked to come in for an experimental data collection visit within the 24 hours post engaging in choking involved sex. Last, subjects will be asked to come in for an experimental data collection visit within 24 hours of engaging in sex that did not involve any choking.

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

Findings from Research

The study analyzed 15 cases of erotic asphyxiation, revealing that defendants in these cases often avoided prison time if the victim had a documented history of paraphilic tendencies and the defendant was not under the influence of drugs during the incident.

In contrast, in non-sexual homicide cases, defendants under the influence of alcohol were more likely to face severe penalties, highlighting the legal complexities surrounding strangulation in both erotic and non-erotic contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lethal asphyxiation due to sadomasochistic sex training - How some sex partners avoid criminal responsibility even though their actions lead to someone's death. Sendler, DJ.[2018]

A study involving 40 young adult women (20 who experienced frequent choking during sex and 20 who had never experienced it) found that those who were choked showed different brain activation patterns during working memory tasks, indicating potential neurological changes due to this behavior.

Despite no significant differences in task performance between the two groups, the choking group exhibited increased brain activation in areas associated with cognitive load, suggesting that repeated exposure to choking may alter how the brain allocates resources during complex tasks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks. Huibregtse, ME., Alexander, IL., Klemsz, LM., et al.[2022]

In a study of 41 young adult women, those who experienced frequent sexual choking showed significant increases in cortical thickness in several brain regions compared to those who had not experienced choking.

The choking group also exhibited widespread reductions in gyrification, suggesting that sexual choking may be linked to neuroanatomical changes, warranting further longitudinal research to explore these effects over time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. Hou, J., Huibregtse, ME., Alexander, IL., et al.[2023]

Women who experienced choking during sex showed significant differences in brain activity compared to those who had not, with lower activation in certain left cortical regions and higher activation in right cortical regions, indicating an inter-hemispheric imbalance in neural functioning.

The choking group exhibited hyperconnectivity between the angular gyrus and motor control areas of the brain, suggesting that frequent experiences of sexual choking may impact emotional and motor processing, warranting further longitudinal studies to explore the long-term effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Association of Frequent Sexual Choking/Strangulation With Neurophysiological Responses: A Pilot Resting-State fMRI Study. Hou, J., Huibregtse, ME., Alexander, IL., et al.[2023]

A survey of 4254 students revealed that choking during sex is common, with a mean age of first experience around 19, and women and transgender/gender non-binary individuals reporting higher rates of being choked than men.

Responses to being choked varied widely, with 81.7% reporting pleasurable sensations, but also significant risks such as neck bruising (15%) and loss of consciousness (3%), indicating potential health risks associated with this practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. Herbenick, D., Fu, TC., Eastman-Mueller, H., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Lethal asphyxiation due to sadomasochistic sex training - How some sex partners avoid criminal responsibility even though their actions lead to someone's death. [2018]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Association of Frequent Sexual Choking/Strangulation With Neurophysiological Responses: A Pilot Resting-State fMRI Study. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. [2023]