Virtual Contexts for Affective Modulation

NCT06986122 | Recruiting

• 1 other identifier: STUDY00033386
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates how spatial context and perceived controllability modulate pain, affective states such as anxiety, and motivated behavior. The study examines how control over pain and threat-related environments influences pain perception, state anxiety, associated autonomic responses, and behavior. The main questions it aims to answer are: Does having control over pain within specific contexts alter how much pain people feel-even when the stimulus intensity remains constant? How do different types of environments (safe, controllable, or uncontrollable) shape pain-related brain activity, subjective anxiety, and physiological arousal? How do people perform cognitively demanding or distracting tasks (and retain their memory) when under threat versus when in control? Lastly, how do these learned associations with spatial contexts persist or adapt when environmental contingencies are explicitly changed? Taken together, exploration of these factors may lay the groundwork for understanding how placebo-related mechanisms-including perceived control, contextual learning, emotional engagement, and distraction-interact to shape pain and anxiety in complex environments.

Conditions

Pain Control; Anxiety; Memory

Keywords

Place conditioning; controllability of pain

Outcome Measures

Primary Outcomes (2)

• Pain Intensity Ratings

  Self-reported pain level following each thermal stimulus, measured on a visual analog scale. 0-100 scale with 0 indicating no pain and higher values indicating more pain.

  3-10 sec post-stimulus throughout testing sessions, on average complete within 1 month

• Self-Reported Anxiety Ratings

  Participants rate their current level of anxiety using a 0-100 visual analogue Subjective Units of Distress Scale (SUDS). 0 indicates no anxiety and higher values indicating more anxiety.

  Every 45-60 sec throughout testing sessions, on average complete within 1 month

Study Arms (1)

Contextual learning

EXPERIMENTAL

All participants complete trials in three virtual contexts (safe, controllable threat, uncontrollable threat), with pain controllability and task performance assessed across all conditions in a randomized within-subject design.

Behavioral: Pain Threat Manipulation; Behavioral: Pain Controllability Manipulation

Interventions

Pain Threat Manipulation BEHAVIORAL

Participants receive brief thermal pain stimuli in certain virtual environments to examine how threat influences perception and physiological responses.

Contextual learning

Pain Controllability Manipulation BEHAVIORAL

In some contexts, participants can reduce or avoid pain using a button; in others, no action changes the outcome. This manipulation is used to study the effects of perceived control over pain.

Contextual learning

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

* No self-reported current or history of depression, bipolar disorder, or other psychiatric diagnosis * No self-reported current seizure disorder (i.e., seizure within past 10 years), or history of stroke or other major neurological diagnosis * No self-reported current chronic pain, or acute pain within three months of the study period * No current migraine disorder (i.e., 15 headache days or more in 1 month) * No use of central nervous system-effective medication or other medication for neurological/psychiatric treatment * No self-reported substance abuse within the last six months * No contraindication to MRI (e.g., pregnancy, claustrophobia, pacemakers, ear/cochlear implants, shrapnel injuries, clips, or other ferromagnetic/electrical objects/devices, diagnosed brain abnormality such as tumor, or skin lesions on the scalp.) * No contraindications for induced pain (e.g., no heart disease, high blood pressure, heart surgery, heart problems of any kind, severe asthma, respiratory problems of any kind, fibromyalgia, Raynaud's Syndrome or Disease, chronic pain, diabetes) * Participants must be capable of performing experimental tasks (e.g., are able to read), are fluent or native speakers of English * Participants must be able to tolerate the maximum level of thermal pain stimuli (for thermal stimuli)

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Trustees of Dartmouth College: lead

Study Sites (1)

Dartmouth College

Hanover, New Hampshire, 03755, United States

RECRUITING

Related Publications (7)

• Tzschentke TM. Measuring reward with the conditioned place preference paradigm: a comprehensive review of drug effects, recent progress and new issues. Prog Neurobiol. 1998 Dec;56(6):613-72. doi: 10.1016/s0301-0082(98)00060-4.

  PMID: 9871940 BACKGROUND

• Salomons TV, Nusslock R, Detloff A, Johnstone T, Davidson RJ. Neural emotion regulation circuitry underlying anxiolytic effects of perceived control over pain. J Cogn Neurosci. 2015 Feb;27(2):222-33. doi: 10.1162/jocn_a_00702.

  PMID: 25208742 BACKGROUND

• Salomons TV, Johnstone T, Backonja MM, Davidson RJ. Perceived controllability modulates the neural response to pain. J Neurosci. 2004 Aug 11;24(32):7199-203. doi: 10.1523/JNEUROSCI.1315-04.2004.

  PMID: 15306654 BACKGROUND

• Kragel PA, Kano M, Van Oudenhove L, Ly HG, Dupont P, Rubio A, Delon-Martin C, Bonaz BL, Manuck SB, Gianaros PJ, Ceko M, Reynolds Losin EA, Woo CW, Nichols TE, Wager TD. Generalizable representations of pain, cognitive control, and negative emotion in medial frontal cortex. Nat Neurosci. 2018 Feb;21(2):283-289. doi: 10.1038/s41593-017-0051-7. Epub 2018 Jan 1.

  PMID: 29292378 BACKGROUND

• Atlas LY, Bolger N, Lindquist MA, Wager TD. Brain mediators of predictive cue effects on perceived pain. J Neurosci. 2010 Sep 29;30(39):12964-77. doi: 10.1523/JNEUROSCI.0057-10.2010.

  PMID: 20881115 BACKGROUND

• Amat J, Baratta MV, Paul E, Bland ST, Watkins LR, Maier SF. Medial prefrontal cortex determines how stressor controllability affects behavior and dorsal raphe nucleus. Nat Neurosci. 2005 Mar;8(3):365-71. doi: 10.1038/nn1399. Epub 2005 Feb 6.

  PMID: 15696163 BACKGROUND

• Alvarez RP, Biggs A, Chen G, Pine DS, Grillon C. Contextual fear conditioning in humans: cortical-hippocampal and amygdala contributions. J Neurosci. 2008 Jun 11;28(24):6211-9. doi: 10.1523/JNEUROSCI.1246-08.2008.

  PMID: 18550763 BACKGROUND

MeSH Terms

Conditions

Agnosia; Anxiety Disorders

Condition Hierarchy (Ancestors)

Perceptual Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders

Central Study Contacts

Tor D Wager, PhD

CONTACT

3038958739; tor.d.wager@dartmouth.edu

Vivek Sagar, PhD

CONTACT

vivek.sagar@dartmouth.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Diana L. Taylor Distinguished Professor in Neuroscience

Study Record Dates

• First Submitted: May 8, 2025
• First Posted: May 22, 2025
• Study Start: October 28, 2025
• Primary Completion (Estimated): June 15, 2027
• Study Completion (Estimated): June 15, 2029
• Last Updated: October 31, 2025

Record last verified: 2025-10

Locations

US (1)