Mental Imagery and Targeted Memory Reactivation in PTSD

NCT05933109 | Completed

• 1 other identifier: 2019-02270_TR
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

With this protocol, investigators examine whether targeted memory reactivation (TMR), a technique used to strengthen memories, can accelerate remission of traumatic nightmares and post-traumatic stress disorder (PTSD) symptomatology. This protocol uses TMR during REM sleep to strengthen positive memories generated by Imagery Rehearsal Therapy (IRT), a recommended treatment of nightmares. Patients with PTSD are asked to perform 3 weekly IRT sessions and, while they generate a positive outcome of their recurrent nightmare, half of the patients are exposed to a sound S1 (TMR group), while the other half is not exposed to this sound (control group). All patients will perform IRT every evening at home and will be exposed to the sound S1 during REM sleep with a wireless headband, which automatically detects sleep stages. Clinical evaluation of the severity of PTSD and nightmares before and after (1-month follow-up and 3-months follow-up) this intervention takes place using the validated Clinically Administered PTSD Scale for DSM-5 (CAPS-5, primary outcome measure). The investigators hypothesize that patients treated with IRT and who are exposed, during REM sleep to a sound that had previously been associated with the new positive dream scenario of IRT (TMR group), will have more reduced frequency of PTSD severity and nightmares compared to participants with stimulation of the same, but non-associated, sound during REM sleep (control group).

Conditions

PTSD; Nightmares, REM-Sleep Type

Outcome Measures

Primary Outcomes (2)

• Clinician-Administered PTSD Scale for DSM-5

  Validated questionnaire that assesses PTSD symptoms, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

  1 month

• Clinician-Administered PTSD Scale for DSM-5

  Validated questionnaire that assesses PTSD symptoms, the score ranges from 0-80, zero indicating no symptom severity and 80 indicating the higher symptom severity.

  3 months

Secondary Outcomes (12)

• Nightmare Frequency

  1 month

• Nightmare Frequency

  3 months

• Nightmare Distress Questionnaire

  1 month

• Nightmare Distress Questionnaire

  3 months

• Positive emotions in dreams

  1 month

Other Outcomes (3)

• Sleep efficiency

  1 month

• REM arousal index

  1 month

• Arousal index

  1 month

Study Arms (2)

TMR group

EXPERIMENTAL

Patients will receive a sound S1 while they generate a positive outcome of imagery rehearsal therapy (IRT). They will also receive the sound S1 during REM sleep.

Behavioral: Imagery Rehearsal Therapy and Targeted memory reactivation during REM sleep

Control group

ACTIVE COMPARATOR

Patients will not receive the sound S1 while they generate a positive outcome of imagery rehearsal therapy (IRT). During REM sleep, they will receive the same sound as the experimental group (S1) under the same conditions.

Behavioral: Imagery Rehearsal Therapy

Interventions

Imagery Rehearsal Therapy BEHAVIORAL

These patients will receive the classic treatment of Imagery Rehearsal Therapy (IRT) for nightmares without association with the sound S1.

Control group

Imagery Rehearsal Therapy and Targeted memory reactivation during REM sleep BEHAVIORAL

Emerging evidence shows that REM sleep plays a causal role in extinction learning, emotion regulation and consolidation of emotionally positive memories. By using targeted memory reactivation (TMR), a known method where a sound S1 is associated with a waking experience (i.e., a positive outcome of imagery rehearsal therapy in this study) and strengthening it during REM sleep, the investigators want to accelerate the remission of traumatic nightmares and PTSD symptomatology.

TMR group

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• with untreated persistent PTSD according to DSM-5 (\> 1 month), suffering from chronic nightmares
• with no active specific treatment for PTSD

You may not qualify if:

• patients with active specific treatment for PTSD
• patients with neurological disorders

Sponsors & Collaborators

• University Hospital, Geneva: lead

Study Sites (1)

Center for Sleep Medicine

Geneva, Switzerland

Location

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Attending Physician

Study Record Dates

• First Submitted: June 20, 2023
• First Posted: July 6, 2023
• Study Start: March 1, 2023
• Primary Completion: July 27, 2025
• Study Completion: October 27, 2025
• Last Updated: March 4, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)