Cognitive Tasks for Post-Traumatic Stress Disorder

Overseen By Estrella V Thomas, MA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Must not be taking: Psychotropic medications

Disqualifiers: Significant suicidality, Psychosis, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

Duration: 1 week

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how a special task involving visual and spatial skills, known as the Visuospatial Task (VST), might help reduce PTSD symptoms. It examines how this task can alter memory and feelings related to past trauma. Participants will be divided into groups, with some performing the visuospatial task and others engaging in different activities. Suitable candidates for this trial are adults who have experienced trauma from events like car accidents, assaults, or combat and have access to a computer with internet. As an unphased trial, this study offers a unique opportunity to contribute to innovative PTSD research.

Do I need to stop my current medications for the trial?

The trial does not specify if you need to stop your current medications, but it does mention that you should not have had changes in psychotropic medication (medications affecting the mind) in the last 8 weeks.

What prior data suggests that this visuospatial task is safe for trauma-exposed individuals?

Research has shown that tasks involving visual and spatial activities, like the one in this study, are generally safe. These tasks have been examined for their ability to lessen the intensity and emotional impact of traumatic memories. One study found that a specific task called dynamic visual noise made memories feel less vivid and emotional. Importantly, these studies reported no major safety issues, suggesting participants handle these tasks well.

While these tasks might not always significantly reduce symptoms compared to doing nothing or other treatments, they have not been shown to cause harm. This is reassuring for anyone considering joining a study involving these tasks. The absence of negative effects in past research suggests these tasks are a low-risk option for those dealing with trauma-related symptoms. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Visuospatial Task (VST) for treating Post-Traumatic Stress Disorder (PTSD) because it's a novel approach that leverages cognitive exercises rather than traditional pharmacotherapy or talk therapy. Most treatments for PTSD, like SSRIs or cognitive-behavioral therapy, focus on either chemical imbalances or psychological patterns. However, VST is unique because it engages the brain in specific spatial and visual tasks, which may help in rerouting attention and reducing trauma-related symptoms. This non-invasive method could offer a new way to help patients who don't respond well to existing treatments.

What evidence suggests that the Visuospatial Task is effective for PTSD?

Research has shown that activities like playing Tetris can reduce the vividness and emotional impact of traumatic memories. One study found that these activities change how memories are processed, making them less distressing. Another study discovered that engaging in visual activities lessens the intensity of emotional memories, offering promise for people with PTSD. In this trial, participants will engage in a Visuospatial Task (VST), which uses the brain's visual and spatial systems to potentially alter how traumatic memories are stored and recalled. This method relies on the idea that focusing on visual tasks can disrupt how memories are "reconsolidated" or rewritten in the mind, potentially easing trauma symptoms. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for adults aged 18-65 who speak and write English fluently, have internet access, a computer with video/audio recording, and have experienced trauma from a vehicle accident, sexual or physical assault, or combat.

Inclusion Criteria

You have experienced a serious accident, sexual assault, physical assault, or combat.

You can use the internet.

You can read and speak English fluently.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a trauma memory reactivation procedure followed by a visuospatial task, word association task, or no treatment control condition

1 week

1 visit (in-person)

Follow-up

Participants are monitored for changes in trauma-related symptoms and memory reconsolidation effects

2 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Visuospatial Task (VST)

Trial Overview The study examines how doing a visuospatial task (like puzzles) affects the way people remember traumatic events and their symptoms of trauma. Participants will first be reminded of their trauma before trying the tasks.

How Is the Trial Designed?

Group I: Visuospatial Task (VST) Experimental Treatment 1 Intervention

Group II: No Game Play (NT-CTRL) Active Control 1 Intervention

Group III: Word Association Task (WAT) Placebo Group 1 Intervention

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Published Research Related to This Trial

In a study involving 16 participants (8 PTSD patients with substance abuse histories and 8 normal subjects), PTSD-SA patients performed worse on attentional tasks, making more errors than the control group.

PET scans revealed decreased blood flow in the parietal cortex of PTSD-SA patients during attentional tasks, suggesting that this reduced brain activity may contribute to their attentional difficulties and overall PTSD symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attention and regional cerebral blood flow in posttraumatic stress disorder patients with substance abuse histories. Semple, WE., Goyer, PF., McCormick, R., et al.[2019]

In a study of 109 female U.S. veterans, those with PTSD showed significantly lower neurocognitive performance across various domains, including verbal learning and executive functioning, compared to those without PTSD.

Executive functioning was found to significantly influence verbal learning in veterans with PTSD, indicating that cognitive deficits in PTSD may be linked to difficulties in managing and processing information.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The neurocognitive performance of female veterans with posttraumatic stress disorder. Stricker, NH., Keller, JE., Castillo, DT., et al.[2019]

In a study of 15 women with PTSD, trauma-focused treatment led to medium-sized improvements in executive function, particularly in cognitive flexibility and planning skills, assessed before and about 3 months after treatment.

These results suggest that effective treatment for PTSD may help alleviate cognitive impairments, potentially reducing the risk of negative outcomes, although further research with larger samples is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

More than symptom reduction: changes in executive function over the course of PTSD treatment. Walter, KH., Palmieri, PA., Gunstad, J.[2022]

Individuals with PTSD exhibit altered cognitive processing, particularly when exposed to trauma-related material, which can enhance their focus on such information while impairing their ability to process unrelated emotional content.

The review identifies two key brain networks affected in PTSD: a trauma-disrupted network that alters emotional and cognitive processing, and a limbic corticostriatal loop involved in fear processing, suggesting potential targets for new therapies to improve treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural systems for cognitive and emotional processing in posttraumatic stress disorder. Brown, VM., Morey, RA.[2021]

In a study of 243 military veterans with PTSD, impaired verbal memory was specifically linked to reexperiencing symptoms, indicating that these memory deficits are closely tied to certain PTSD symptoms rather than other cognitive issues or brain injuries.

The research suggests that slowed response times during word encoding may contribute to the relationship between reexperiencing symptoms and memory performance, highlighting the importance of attentional control in addressing verbal memory deficits in PTSD treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inefficient Attentional Control Explains Verbal-Memory Deficits Among Military Veterans With Posttraumatic Reexperiencing Symptoms. Marquardt, CA., Pokorny, VJ., Disner, SG., et al.[2023]

Individuals with acute PTSD showed significant neurocognitive impairments in memory, attention, executive function, and working memory compared to those without PTSD and individuals never exposed to trauma, based on a study involving 54 participants.

These findings suggest that acute PTSD may disrupt fronto-temporal brain function, highlighting the importance of early clinical intervention for affected individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Memory and executive dysfunctions associated with acute posttraumatic stress disorder. Lagarde, G., Doyon, J., Brunet, A.[2022]

In a study of 39 male combat veterans, those with more severe PTSD symptoms showed less activity in the medial prefrontal cortex (PFC) and anterior cingulate cortex (ACC) during cognitive tasks, indicating difficulties in cognitive inhibition.

The research also found that worse neuropsychological performance was linked to reduced functional connectivity between the medial PFC/ACC and other brain regions, suggesting that PTSD may disrupt the brain networks responsible for executive functioning and emotional regulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity. Clausen, AN., Francisco, AJ., Thelen, J., et al.[2020]

In a study of 32 Vietnam combat veterans, those with PTSD showed significant impairments in memory and attention compared to those without PTSD, indicating that these cognitive functions are particularly affected by the disorder.

Memory functioning is a key neurocognitive area that can help differentiate between veterans with and without PTSD, suggesting that it plays a specific role in the development of PTSD beyond general cognitive impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multivariate assessment of explicit memory function in combat veterans with posttraumatic stress disorder. Gilbertson, MW., Gurvits, TV., Lasko, NB., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11028024/

The effect of a visuospatial interference intervention on ... This study aims to test the effect of a visuospatial Tetris-based intervention versus a verbal condition (Wiki) and a never-targeted control (no intervention) ...

2. researchgate.net researchgate.net/publication/303546283_Effects_of_visuospatial_tasks_on_desensitization_to_emotive_memories

Effects of visuospatial tasks on desensitization to emotive ... Experimental analogues of post-traumatic stress disorder have shown that dynamic visual noise can successfully reduce the vividness and ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0887618525000830

Review PTSD and cognition in older adults: A systematic ... PTSD was associated with significant accelerated general cognitive decline and possible accelerated decline in attention and memory over time.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9942044/

Posttraumatic stress, visual working memory, and visual ... Two studies were conducted to examine the relevance of military-related PTSD to two cognitive functions – visual working memory and visual imagery.

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1002/jts.23012

State of the science: Eye movement desensitization and ... EMDR was found to be highly effective in reducing posttraumatic stress, depressive, and anxiety symptoms, and results were maintained at 6-month ...

6. bmjopen.bmj.com bmjopen.bmj.com/content/11/2/e041469

Experiences with traumatic events, consequences and ... Having a visual impairment may affect traumatic events and post-traumatic stress reactions, particularly by contributing to low self-esteem, problems in social ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3871398/

Atypical visual processing in posttraumatic stress disorder In this fMRI study we asked PTSD patients and trauma-exposed healthy controls to view pictures with varying emotional contents and found substantial reductions ...