ClinicalTrials.gg
CompletedNCT03369418Updated Aug 19, 2020Results posted

Effectiveness of CES on Emotional and Cellular Wellbeing

An interventional study of Alpha-Stim Active and Alpha-Stim Inactive in Anxiety and Depression, sponsored by University of California, Los Angeles. Completed at 1 site in United States. Open to male participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-08-19.

Primary conditionDepressionRegistry: Anxiety DisordersReclassifiedWhy we changed it
Registry
Anxiety Disorders — the first condition term the registry derived for this study.
ClinicalTrials.gg
Depression
Why
  1. The registry often attaches Anxiety Disorders to studies about something else, and this study's title and listed conditions do not name it.
  2. The study's listed conditions name Depression.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by University of California, Los Angeles · Not applicable, Interventional, and Treatment

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Phase
Not applicable
Study type
Interventional
Enrollment
44
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
Male
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 81 studies in Depression by University of California, Los Angeles — 12 open to participants now, 12 under way, none of them phase 3. Depression · University of California, Los Angeles.

Enrollment
51st of 74
44 · median 76
Started
2016
with 4 others
No phase
45 of 81
7 open now
Registered
39th of 81
by date

Among the 81 studies in Depression by University of California, Los Angeles, this one is the 51st largest by enrollment of the 74 interventional ones that give a count, is one of 5 that started in 2016, is one of 45 with no phase, and was the 39th registered.

Depression

8,582 studies on the registry are indexed under Depression; 1,723 are open to participants now.

Browse Depression studies →

Open to participants now

12 of the 81 studies in Depression by University of California, Los Angeles are open now, in 1 country. Recruiting first, the newest first:

7 more — sign in →

By country, each count listing its studies:

All 12 open studies →

Where they have run

Who these studies take

Of the 1,089 Depression studies recruiting now, 470 (43%) set no upper age limit and 519 (48%) stop at 75 or younger; 203 take children under 18; 311 take healthy volunteers.

This study: 18 Years to 40 Years · male · healthy volunteers too.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 81 studies in Depression by University of California, Los Angeles, or all of them as a file.
02

Study summary

The investigators aim to use a CES (cranial electrotherapy stimulation) intervention to improve emotional well-being by reducing symptoms of anxiety and depression and to assess for changes in markers of cellular health - specifically, telomere length and telomerase activity

Read the detailed description

This study aims to test an auricular cranial electrotherapy stimulation (CES) device, Alpha-Stim, to assess for changes in markers of cellular health and emotional well-being improvement associated with anxiety and depression.

Returning Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) Veterans have a high incidence of anxiety, depression, insomnia, post-traumatic stress disorder (PTSD) and chronic pain, leading to reductions in emotional well-being. This type of chronic emotional distress can lead to detrimental biological outcomes. We will compare as an exploratory outcome Veterans vs. non-Veterans response to Alpha-Stim treatment. At the cellular level, impairment of the telomere/telomerase system may be a result of this dysregulation, given the descriptions of shorter telomeres (a marker of cellular aging), as well as increased markers of inflammation in subjects with depression, anxiety and PTSD, compared to aged matched healthy populations. These negative cellular effects of emotional distress have not been well studied in this population and may offer significant benefit.

In one study of auricular CES using the same protocol proposed here, 115 patients with anxiety or anxiety and comorbid depression were studied over 5 weeks in a randomized, sham controlled trial, showing significant improvements in both anxiety and depression symptoms. Due to the complexity of overlapping negative affect symptoms that lead to impaired emotional well-being in Veterans, the investigators chose in this proposal to evaluate a composite measure of emotional distress (a combined anxiety and depression score) as the primary outcome. Beyond depression and anxiety, CES has been associated with reductions in insomnia and pain, both of which are also significant problems in Veterans, likely contributing to reduced emotional well-being.

Primarily all interested and appropriate study subjects will undergo a screening at the University of California, Los Angeles (UCLA) G. Oppenheimer Center for Neurobiology of Stress and Resilience (CNSR). The investigators expect to enroll and screen no less than 55 subjects in order to complete 22 evaluable subjects for analysis in each treatment group.

The Hospital Anxiety and Depression Scale (HADS) will assess symptom severity defined as normal range (0-7), mild (8-10), moderate (11-14) or severe (15-20). Subjects with impaired emotional well-being with mild to moderate anxiety and/or depression on the HADS scale will be included. Subjects with a maximum combined HADS score of 28 will be included. Subjects treated for anxiety, depression, psychiatric or mental health treatment must be on a stable regimen (pharmacological or non-pharmacological) for the past 3 months.

If eligible the study coordinator will contact them to schedule a screening visit at UCLA. During this visit, the research team will conduct baseline measurements via study questionnaires, history and physical exam, and a standardized psychiatric evaluation (MINI). Subjects meeting the inclusion criteria will have training in use of the Alpha-Stim device and will have their first 1 hour treatment. Subjects who tolerate the CES treatment will have blood drawn for biological measures and will take the device home to use daily for 8 weeks. Mid-study the subjects will come back to UCLA to complete questionnaires and have vital signs and weight measured. At the end of the 8 weeks, subjects will return to UCLA, return the device, have vital signs and weight measured, have the final blood draw, and complete a final set of questionnaires.

All in all, to complete the study, subjects will have an initial screening, mid and final study visit, pre, mid, and final study questionnaires, and blood drawn in the first and final visit.

03

Conditions studied

  • Anxiety
  • Depression

Browse trials for

04

In context

Depression Reclassified

8,582 studies on the registry are indexed under Depression; 1,723 are open to participants now.

This study's enrollment of 44 is below the median of 81 across 7,066 interventional studies indexed under Depression.

Browse Depression studies →

Lead sponsor

University of California, Los Angeles is the lead sponsor of 1,170 studies on the registry; 195 are open to participants now.

Of its 95 completed or terminated interventional studies of FDA-regulated products, 70 (74%) have results posted.

Compared within Depression, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Anxiety Disorders. The counts are of registry records indexed under each term, refreshed daily. How we classify →

05

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male
  2. Within the age range of 18-40 years old
  3. Score 8-14 on either the anxiety or depression HADS scale as defined as mild (8-10) to moderate (11-14)
  4. Subjects who receive anxiety, depression, psychiatric or mental health treatment (pharmacological or non-pharmacological) must be on a stable regimen for the past 3 months
  5. No active suicidal ideation or psychosis (including schizophrenia and bipolar disorder)
  6. No uncontrolled or progressive severe medical illness (e.g., cancer, uncontrolled diabetes mellitus, active cardiac disease)
  7. No use of a pacemaker or any other implanted electrical device
  8. No alcohol consumption greater than 2 units daily
  9. Ability to independently complete the in-person study questionnaires and sign form (ICF) without assistance
  10. Willing to comply with all study procedures and be available for the duration of the study
  11. No participation in another clinical trial study

Exclusion criteria

Exclusion Criteria:

  1. Not a male
  2. Younger than 18 years old or older than 40 years old
  3. Score ≥15 on either the anxiety or depression HADS scale as defined as severe (15-20)
  4. Subject who receive anxiety, depression, psychiatric or mental health treatment (pharmacological or non-pharmacological) who have not been on a stable regimen for the past 3 months
  5. Active suicidal ideation or psychosis (including schizophrenia and bipolar disorder)
  6. History of inpatient treatment or suicidal ideation within the last year
  7. Use of a pacemaker or any other implanted electrical device
  8. Unable to independently complete the in-person study questionnaires and sign ICF due to impaired cognitive function
  9. Unwilling to comply with all study procedures
  10. Unavailable for the duration of the study
  11. Current participation in another clinical trial study
  12. Any other condition that the investigator believes would jeopardize the safety or rights of the subject or would render the subject unable to comply with the study protocol or make use of acquired data non-analyzable
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

06

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
44 participants (actual)

Study arms

  • Active comparator
    Active

    Subjects will be given an Alpha-Stim active device for daily treatment. The electrodes attached to the device will be active. The device frequency is preset to 0.5 Hz and 100 microampere and treatment is one hour daily. The subjects will be instructed that the device is set to a low level so that the current is not detectable but should still be effective. The current will not be detectable in both active and sham devices in order for adequate blinding to occur.

    Device: Alpha-Stim Active

  • Sham comparator
    Inactive

    Subjects will be given an Alpha-Stim inactive device for daily treatment. The electrodes attached to the device will be inactive. The device will not transmit anything when turned on because the electrodes are inactive. The frequency on the device will state 0.5 Hz and 100 microampere but it will not actually emit anything. Subjects in this group will receive "treatment" one hour daily. The subjects will be instructed that the device is set to a low level so that the current is not detectable but should still be effective. The current will not be detectable in both active and sham devices in order for adequate blinding to occur.

    Device: Alpha-Stim Inactive

Interventions

  • DeviceAlpha-Stim Active

    The study device is a safe, commercially available take-home cranial electrotherapy stimulation device that applies an electrical current to a subject's head to treat anxiety, depression or insomnia

  • DeviceAlpha-Stim Inactive

    The study device given to the inactive group will be identical to the active except the electrodes attached to the device will be inactive. The device will not transmit anything when turned on because the electrodes are inactive.

07

What researchers measure

Primary outcomes

  1. HADS Questionnaire Combined Score

    The Hospital anxiety and depression scale (HADS) evaluates symptoms of anxiety and depression, minimum 0 and maximum 52 with higher scores indicating more symptoms. A combined score it utilized as the primary outcome measure, summing the scores for anxiety and depression.

    Time frame: After completion of the study (1 year)

Secondary outcomes

  1. Telomere Length

    Telomere length will be determined using real time quantitative polymerase chain reaction (qPCR) methodology as described previously with minor modifications.30,31 Peripheral blood mononuclear cells (PBMC) are isolated and genomic DNA extracted. Using the standard curve method, cycle threshold (CT) values are plotted on a standard curve of human genomic DNA to estimate an ng/microliter concentration value. Telomere length values are expressed as the ratio of the estimated concentration generated by PCR of the telomere gene (T) divided by the hemoglobin single (S) copy gene = (T/S).

    Time frame: After completion of the study (1 year)

08

Results

Posted Aug 19, 2020
Limitations and caveats
This was a feasibility study that failed to meet its recruitment goals. The results should be viewed with some caution given that the study did not reach its calculated goal sample size.

Participant flow

Subjects were recruited by flyers from the WLA VA Integrative Medicine Clinics and on the UCLA campus between April 2016 and August 2018.

Participant flow — Overall Study
MilestoneActiveInactive
Started1614
Completed1311
Not completed33
Withdrew: Withdrawal by subject33

Outcome measures

PrimaryHADS Questionnaire Combined Score

The Hospital anxiety and depression scale (HADS) evaluates symptoms of anxiety and depression, minimum 0 and maximum 52 with higher scores indicating more symptoms. A combined score it utilized as the primary outcome measure, summing the scores for anxiety and depression.

Time frame:
After completion of the study (1 year)
Reported as:
Least squares mean · score on a scale
HADS Questionnaire Combined Score
score on a scaleActiveInactive
Baseline estimated means20.3077 ± 1.6519.909 ± 1.79
Post treatment estimated mean11.1538 ± 1.6515.4545 ± 1.79
Statistical analysis
  • Active vs Inactive · t-test, 1 sided · p = .013 (A priori threshold for statistical significance was p\<.05.)
SecondaryTelomere Length

Telomere length will be determined using real time quantitative polymerase chain reaction (qPCR) methodology as described previously with minor modifications.30,31 Peripheral blood mononuclear cells (PBMC) are isolated and genomic DNA extracted. Using the standard curve method, cycle threshold (CT) values are plotted on a standard curve of human genomic DNA to estimate an ng/microliter concentration value. Telomere length values are expressed as the ratio of the estimated concentration generated by PCR of the telomere gene (T) divided by the hemoglobin single (S) copy gene = (T/S).

Time frame:
After completion of the study (1 year)
Reported as:
Mean · T/S
Telomere Length
T/SActiveInactive
Telomere Length.6945 ± .03231.7841 ± .03487
Statistical analysis
  • Active vs Inactive · t-test, 1 sided · p = .33

Adverse events

Collected over Adverse events were collected during the study period (10 weeks).. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Active0/13 (0%)0/13 (0%)2/13 (15.4%)
Inactive0/11 (0%)0/11 (0%)6/11 (54.5%)
Most frequent other events
Most frequent other events
EventActiveInactive
increased irritabilityPsychiatric disorders0/131/11
upper respiratory tract infectionRespiratory, thoracic and mediastinal disorders0/131/11
vitamin d deficiencyEndocrine disorders0/131/11
headahceNervous system disorders0/131/11
panic attackPsychiatric disorders0/131/11
insomniaGeneral disorders0/131/11
fatigueGeneral disorders1/130/11
ear infectionEar and labyrinth disorders1/130/11

Baseline characteristics

Age, Continuous
Age, Continuous(years)ActiveInactiveTotal
Mean28.62 ± 7.2927.09 ± 5.7227.92 ± 6.52
Sex: Female, Male
Sex: Female, Male(Participants)ActiveInactiveTotal
Female000
Male131124
Race (NIH/OMB)
Race (NIH/OMB)(Participants)ActiveInactiveTotal
American Indian or Alaska Native000
Asian112
Native Hawaiian or Other Pacific Islander000
Black or African American303
White7512
More than one race022
Unknown or Not Reported235
09

Study locations

1 site
  • University of California, Los Angeles (UCLA)
    Los Angeles, California 90025, United States
10

References and documents

Publications

  • Verhoeven JE, Revesz D, Wolkowitz OM, Penninx BW. Cellular aging in depression: Permanent imprint or reversible process?: An overview of the current evidence, mechanistic pathways, and targets for interventions. Bioessays. 2014 Oct;36(10):968-78. doi: 10.1002/bies.201400068. Epub 2014 Aug 20. PubMed 25143317 ↗
  • Simon NM, Smoller JW, McNamara KL, Maser RS, Zalta AK, Pollack MH, Nierenberg AA, Fava M, Wong KK. Telomere shortening and mood disorders: preliminary support for a chronic stress model of accelerated aging. Biol Psychiatry. 2006 Sep 1;60(5):432-5. doi: 10.1016/j.biopsych.2006.02.004. Epub 2006 Apr 11. PubMed 16581033 ↗
  • van Ockenburg SL, de Jonge P, van der Harst P, Ormel J, Rosmalen JG. Does neuroticism make you old? Prospective associations between neuroticism and leukocyte telomere length. Psychol Med. 2014 Mar;44(4):723-9. doi: 10.1017/S0033291713001657. Epub 2013 Jul 9. PubMed 23834823 ↗
  • Teyssier JR, Chauvet-Gelinier JC, Ragot S, Bonin B. Up-regulation of leucocytes genes implicated in telomere dysfunction and cellular senescence correlates with depression and anxiety severity scores. PLoS One. 2012;7(11):e49677. doi: 10.1371/journal.pone.0049677. Epub 2012 Nov 21. PubMed 23185405 ↗
  • Jergovic M, Tomicevic M, Vidovic A, Bendelja K, Savic A, Vojvoda V, Rac D, Lovric-Cavar D, Rabatic S, Jovanovic T, Sabioncello A. Telomere shortening and immune activity in war veterans with posttraumatic stress disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2014 Oct 3;54:275-83. doi: 10.1016/j.pnpbp.2014.06.010. Epub 2014 Jun 28. PubMed 24977331 ↗
  • Barclay TH, Barclay RD. A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression. J Affect Disord. 2014 Aug;164:171-7. doi: 10.1016/j.jad.2014.04.029. Epub 2014 Apr 21. PubMed 24856571 ↗
  • Kirsch DL, Nichols F. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia. Psychiatr Clin North Am. 2013 Mar;36(1):169-76. doi: 10.1016/j.psc.2013.01.006. PubMed 23538086 ↗
  • Lande RG, Gragnani C. Efficacy of cranial electric stimulation for the treatment of insomnia: a randomized pilot study. Complement Ther Med. 2013 Feb;21(1):8-13. doi: 10.1016/j.ctim.2012.11.007. Epub 2012 Dec 21. PubMed 23374200 ↗
  • Taylor AG, Anderson JG, Riedel SL, Lewis JE, Kinser PA, Bourguignon C. Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia. Pain Manag Nurs. 2013 Dec;14(4):327-335. doi: 10.1016/j.pmn.2011.07.002. Epub 2011 Oct 6. PubMed 24315255 ↗
  • Lee SH, Kim WY, Lee CH, Min TJ, Lee YS, Kim JH, Park YC. Effects of cranial electrotherapy stimulation on preoperative anxiety, pain and endocrine response. J Int Med Res. 2013 Dec;41(6):1788-95. doi: 10.1177/0300060513500749. PubMed 24265330 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

11

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Mar 2016, a primary completion of Oct 2018 and a completion of Oct 2018. It does not say whether these dates are actual or estimated.

Results were first posted in Aug 2020, 1 year 9 months after primary completion. A results delay was requested in Oct 2019.

How these figures are worked out, and which studies are left out of them.

Registered
May 19, 2016
First posted
Dec 12, 2017
Start
Mar 2016
Primary completionActual
Oct 20, 2018
CompletionActual
Oct 20, 2018
Results delay requested
Oct 17, 2019
Results first posted
Aug 19, 2020
Last update
Aug 19, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 19, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
12

Registry details

Key details

Study ID
NCT03369418
Responsible party
Kirsten Tillisch, MD (MD, University of California, Los Angeles) — Principal investigator
First posted
Dec 12, 2017
Start date
Mar 2016
Primary completion
Oct 20, 2018
Completion
Oct 20, 2018
Results posted
Aug 19, 2020
Last update
Aug 19, 2020

Study contacts

Kirsten Tillisch, MD
principal investigator · University of California, Los Angeles

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2020. You cannot join it, but the record below documents what was studied.

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