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Post-Traumatic HeadacheArtTherapyNCT04776304

Art Therapy QEEG Study for Service Members with a Traumatic Brain Injury and Posttraumatic Stress Symptoms

A study testing Art Therapy in people with Post-Traumatic Headache and PTSD, run by Walter Reed National Military Medical Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Service members and/or recently separated veterans with post traumatic stress symptoms and mild traumatic brain injury may participate in 8 sessions including 2 sessions including interviews and questionnaires as well as 6 sessions of art therapy. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Post-Traumatic Headache, PTSD, TBI
What is being tested?
Art Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2 participants
Where
1 siteUnited States
Study dates
30 Oct 2021to 25 Jan 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Active duty service member or recently separated veteran (within the past 5 years)
  • DEERs eligible
  • Significant posttraumatic stress symptoms
  • History of mild traumatic brain injury
  • Aged 18-64

Who cannot join

  • Previous art therapy exposure
  • Moderate, severe, or penetrating TBI history
  • History of a psychotic disorder, bipolar disorder, or active suicidal or homicidal ideation
  • Unable to provide informed consent

Trial locations and contacts

1 site in 1 country.

United States1 site
  • National Intrepid Center of Excellence at Walter Reed National Military Medical Center

    Bethesda, Maryland, 20814

Other trials in United States

About this study

Official title: Evaluation of Quantitative EEG During Art Therapy in Service Members with Co-Morbid Traumatic Brain Injury & Posttraumatic Stress Symptoms

Service members and/or recently separated veterans with post traumatic stress symptoms and mild traumatic brain injury may participate in 8 sessions including 2 sessions including interviews and questionnaires as well as 6 sessions of art therapy. In the art therapy, participants will be provided with a blank paper mache mask template and invited to alter the mask however they wish using a variety of art materials. The therapist will use the art-making process and culminating product to aid in self-reflection, reframe negative thoughts and feelings, and work through traumatic content. Prior to the session start participants will get set up with a mobile qEEG (worn like a hat and backpack). The qEEG will measure brain activity in a non-invasive way throughout the art therapy session to improve understanding of brain activity during the art therapy process.

Read the detailed description

This is a pilot, interventional clinical trial in which all 9 service members with comorbid PTSD and mTBI participate in 8 sessions (1 baseline session of interviews and questionnaires, 6 sessions of art therapy, and 1 final session of interviews and questionnaires). Participants must have significant posttraumatic stress symptoms and a history of mild traumatic brain injury. Target enrollment is 9 active duty service members or recently separated veterans, aged 18-64 with no prior art therapy exposure, at the NICoE at Walter Reed National Military Medical Center in Bethesda, MD.

Background: Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are persistent and frequently comorbid complications of combat that remain a challenge to healthcare providers. In these complex cases, traditional treatments often fail to provide complete relief from symptoms associated with posttraumatic stress (PTS), anxiety, and depression, leading the military healthcare system to look towards complementary and integrative treatments. Art therapy is one promising intervention that helps service members (SMs) develop a "visual voice," using imagery, symbolism, and metaphor to externalize emotions and experiences that they may not be able to express in words. The standardized, integrative mental health and human services approach of the art therapy program at the NICoE utilizes a mask-making directive to explore thoughts, feelings, and experiences of combat and self-understanding. This process is especially relevant to SMs with PTS symptoms who often remember their trauma as an incoherent, fragmented memory that is often predominantly sensory in nature. NICoE researchers have provided preliminary evidence suggesting associations between recurring art themes represented within the masks and individual BH symptoms; yet, the neurobiological mechanisms underlying this therapeutic technique remain obscure. To date, there have been few studies using neuroimaging techniques to investigate brain network changes during art creation. Studies have utilized electroencephalography (EEG) and functional near infrared spectroscopy (fNIRS) during art creation but not within the context of art therapy. Mobile, quantitative EEG allows for real time data capture that could minimize interference of neuroimaging during the therapeutic process and provide insight into the neurological mechanisms underlying art therapy.

Study design and procedures: Participants will be provided with a blank paper mache mask template and invited to alter the mask however they wish using a variety of art materials. The therapist will use the art-making process and culminating product to aid in self-reflection, reframe negative thoughts and feelings, and work through traumatic content. Prior to the session start participants will get set up with the mobile qEEG. The qEEG will be segmented into a pre-art therapy session resting state, prompt-specific tasks during the art therapy session, and a post-art therapy session resting state.

Being tested
Art Therapy
Medical subject headings
Post-Traumatic Headache, Stress Disorders, Post-Traumatic, Brain Injuries, Traumatic, Brain Concussion, Parasomnias, Headache, Feeding and Eating Disorders, Combat Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Art TherapyBehavioural

    This is a pilot study in which every participant receives the art therapy intervention arm. There are no waitlist or control arms. Art therapy is one promising intervention that helps service members (SMs) develop a "visual voice," using imagery, symbolism, and metaphor to externalize emotions and experiences that they may not be able to express in words. The standardized, integrative mental health and human services approach of the art therapy program at the NICoE utilizes a mask-making directive to explore thoughts, feelings, and experiences of combat and self-understanding. This process is especially relevant to SMs with PTS symptoms who often remember their trauma as an incoherent, fragmented memory that is often predominantly sensory in nature. NICoE researchers have provided preliminary evidence suggesting associations between recurring art themes represented within the masks and individual BH symptoms.

Study groups in NCT04776304
Study groupRoleWhat they receive
qEEG Art TherapyOtherParticipants will receive art therapy while a noninvasive, mobile qEEG measures brain activity. There is no comparison as this is an exploratory pilot study.
Receives: Behavioral: Art Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations. Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 1 (Week 2)

  2. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations. Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 2 (Week 3)

  3. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations.Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 3 (Week 4)

  4. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations. Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 4 (Week 5)

  5. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations. Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 5 (Week 6)

  6. The primary outcome measure is an analysis of qEEG session data.

    The primary outcome measure is an analysis of qEEG session data, which will include regional and global power across the following frequency bands: delta (1-4 Hz), theta (4-7 Hz), alpha (8-13 Hz), beta (13- 30 Hz), and gamma (>30 Hz); global interhemispheric coherence; and regional coherence between pairs of sensor locations. Global/regional power (units: micro-Volts-squared per Hz (uV2/Hz) Interhemispheric coherence (units coherence) Regional coherence (units coherence)

    Measured: during the intervention Session 6 (Week 7)

Secondary outcomes (10)
  1. CAPS-5

    Clinician-Administered PTSD Scale for DSM-5

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  2. TAS-20

    The Toronto Alexithymia Scale

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  3. AIQ

    Aspects of Identity Questionnaire

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  4. PCL-5

    Post Traumatic Stress Symptom Questionnaire

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  5. GAD-7

    General Anxiety Disorder Questionnaire

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  6. PHQ-9

    Patient Health Questionnaire for depression symptoms

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  7. PHQ-15

    Patient Health Questionnaire for somatic symptoms

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  8. NSI

    Neurological Symptom Inventory

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  9. PGIC

    General Impression of Change

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

  10. SUD Scores

    Subjective Units of Distress

    Measured: baseline (pre-intervention) and immediately after the intervention; within a period of 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Mar 2021
  2. Study start30 Oct 2021
  3. Primary completion25 Jan 2024
  4. Study completion25 Jan 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is both interventional, meaning SMs receive art therapy, and analytical, to understand qEEG outcomes.
Masking
None (open label)
Enrolment
2 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04776304
Sponsor's protocol ID
WRNMMC-2020-0279
Acronym
ArtTherapy
Status last verified
Nov 2024
First submitted
8 Apr 2020
Last updated
6 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Art Therapy in people with Post-Traumatic Headache and PTSD, run by Walter Reed National Military Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The primary outcome measure is an analysis of qEEG session data. (time frame: during the intervention Session 1 (Week 2)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Nov 2024.

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