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CompletedNCT06390267ASRUpdated Aug 1, 2025

Effect of Transcutaneous Auricular Neurostimulation on Cognitive Performance in a Laboratory Model of Acute Stress Reaction

An interventional study of Sparrow Hawk (Active) and Sparrow Hawk (Sham) in Acute Stress Reaction and Cognitive Performance, sponsored by Spark Biomedical, Inc.. Completed at 1 site in United States. Open to participants aged 18 Years to 41 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-08-01.

Sponsored by Spark Biomedical, Inc. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
43
Allocation
Randomized
Ages
18 Years to 41 Years
Sex
All
01

Study summary

The objective of this study is to test the effects of transcutaneous auricular neurostimulation (tAN) in treating or preventing performance degradation after an acute stressor.

Read the detailed description

This study is designed as a randomized, double-blind, sham-controlled trial. Sixty healthy, able-bodied participants will be randomized 1:1:2:2 into one of four experimental groups:

Group 1: Active tAN for prophylactic treatment prior to acute stress exposure (N=10)

Group 2: Sham stimulation for prophylactic treatment prior to acute stress exposure (N=10)

Group 3: Active tAN for acute treatment during acute stress exposure (N=20)

Group 4: Sham stimulation for acute treatment during acute stress exposure (N=20)

Participants will complete a baseline performance of three tasks. tAN treatment will then be administered prior to or during an acute stress test. Participants will complete the same three tasks preformed at baseline. In addition to the tAN therapy earpiece, subjects will have biosensors attached to them to collect biomarker information.

02

Conditions studied

  • Acute Stress Reaction
  • Cognitive Performance

Keywords

  • Healthy Human
  • Performance
  • Stress
  • Vagus Nerve Stimulation
  • Neurostimulation
  • Transcutaneous Auricular Neurostimulation
  • Military
03

Who can participate

Ages eligible
18 Years to 41 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Adults 18 to 41 years old
  2. Participant has the cognitive and physical abilities to carry out the study tasks
  3. Proficient in the English language
  4. Ability to understand the explanations and instructions given by the study personnel

Exclusion criteria

Exclusion Criteria:

  1. Participant presents current evidence of an uncontrolled and/or clinically significant medical condition or psychiatric condition
  2. Participant has used any psychological stress-management intervention within the last 4 weeks
  3. Participant is participating in another interventional trial within 90 days prior to or throughout duration of trial
  4. Participant has a prior diagnosis of post-traumatic stress disorder, acute stress disorder, or generalized anxiety disorder
  5. Participant is currently using anti-anxiety medications such as Xanax or beta blockers
  6. Participant has a diagnosis of attention deficit hyperactivity disorder (ADHD) and/or is currently taking medications for the treatment of ADHD.
  7. History of substance abuse or drug dependence including nicotine and alcohol in the past 3 months
  8. Participant has abnormal ear anatomy, ear infection present, or earpiercing that could interfere with stimulation
  9. Participant has a history of epileptic seizures
  10. Participant has a history of neurologic diseases or traumatic brain injury
  11. Participant wears or utilized other devices that cannot be removed during the study (e.g., pacemakers, cochlear prostheses, neurostimulators)
  12. Females who are pregnant or lactating
  13. Participant has any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants are risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
43 participants (actual)

Study arms

  • Experimental
    Active tAN for Prophylactic Treatment

    Prophylactic Active participants will undergo 20 minutes of active tAN while remaining seated and idle. After stimulation, participants will proceed into the 20-minute stressor protocol.

    Device: Sparrow Hawk (Active)

  • Sham comparator
    Sham Stimulation for Prophylactic Treatment

    Prophylactic Sham participants will undergo 20 minutes of sham stimulation while remaining seated and idle. After stimulation, participants will proceed into the 20-minute stressor protocol.

    Device: Sparrow Hawk (Sham)

  • Experimental
    Active tAN for Acute Treatment

    Acute Active participants will begin the stressor protocol immediately after baseline assessments. After a 5-min period of the stressor protocol without any intervention, active tAN treatment will be delivered concurrently for the remainder of the stressor protocol for a total of 20 minutes of stimulation and approximately 25 minutes of the stressor protocol.

    Device: Sparrow Hawk (Active)

  • Sham comparator
    Sham Stimulation for Acute Treatment

    Acute Sham participants will begin the stressor protocol immediately after baseline assessments. After a 5-min period of the stressor protocol without any intervention, sham stimulation will be delivered concurrently for the remainder of the stressor protocol for a total of 20 minutes of stimulation and approximately 25 minutes of the stressor protocol.

    Device: Sparrow Hawk (Sham)

Interventions

  • DeviceSparrow Hawk (Active)

    Wearable, battery-operated, device designed to transcutaneously stimulate nerves on and/or around the auricle. The device will be used to deliver tAN sessions of active (prophylactic or acute) therapy according to the participant's randomization group.

  • DeviceSparrow Hawk (Sham)

    Wearable, battery-operated, device designed to transcutaneously stimulate nerves on and/or around the auricle. The device will be used to deliver tAN sessions of sham (prophylactic or acute) therapy according to the participant's randomization group.

05

What researchers measure

Primary outcomes

  1. Match-to-Sample Task (MST)

    Mean change in performance on the MST (in combination with the Psychomotor Vigilance Task (PVT) and Perdue Pegboard Task (PPT)) in the active tAN acute treatment group (Group 3) compared to sham acute treatment group (Group 4). The MST assesses short-term spatial memory (working memory) and pattern recognition skills. An 8 × 8 matrix of a red and green checkerboard pattern will be presented for 10 seconds, then removed, and then followed by a variable delay of 8 or 16 seconds. Two matrices will then be presented: the original matrix and a matrix with the color of 2 squares reversed. The subjects will attempt to select the original matrix. The task consists of 30 trials, ≈15 for each delay. A response (left or right arrow key) is required within 10 s, or a time-out error will be recorded. Correct matches were recorded, as was reaction time. This test takes less than 5 minutes to complete.

    Time frame: From baseline to post-stressor (up to 3 hours)

  2. Psychomotor Vigilance Task (PVT)

    Mean change in performance on the PVT (in combination with the MST and PPT) in the active tAN acute treatment group (Group 3) compared to sham acute treatment group (Group 4). The PVT is a test of visual reaction time. A series of stimuli are presented at random intervals on a screen, and the subject responds as rapidly as possible when a stimulus appears. Response time, false alarms, and the number of lapses (long duration responses) will be recorded. Performance lapses refer to the instances when a subject failed to respond in \<500 ms. This test will be administered on a computer monitor or tablet.

    Time frame: From baseline to post-stressor (up to 3 hours)

  3. Perdue Pegboard Task (PPT)

    Mean change in performance on the PTT (in combination with the PVT and MST) in the active tAN acute treatment group (Group 3) compared to sham acute treatment group (Group 4). The PPT is a psychomotor test of manual dexterity and bimanual coordination. A pegboard consisting of two parallel sets of twenty-five holes arranged vertically is presented to the participant, and they are asked to remove pegs from concave cups at the top of the board and place them in the holes sequentially as rapidly as possible. The number of pegs placed successfully in thirty seconds is scored. Each participant is tested three times using both hands.

    Time frame: From baseline to post-stressor (up to 3 hours)

  4. Maastricht Acute Stress Test (MAST)

    The MAST is a safe, non-invasive, and expedited method to create a stress response in human subjects under laboratory conditions. The test combines two well-validated laboratory stress paradigms, the Trier Social Stress Test (TSST) and the Cold Pressor Test (CPT) into a single protocol. The MAST is effective in increasing salivary cortisol, increasing blood pressure, salivary alpha-amylase, and eliciting subjective stress reactions. Participants will be videotaped and monitored to analyze their facial expressions. They will undergo multiple hand immersion trials (HIT) in which they have to immerse their hand in ice-cold (2 °C) water. They will engage in mental arithmetic trials (MAT), counting backwards starting at 2043 in steps of 17 as fast and accurate as possible. For each mistake made, the experimenter will provide negative feedback and instruct them to start over at 2043.

    Time frame: After baseline tasks, approximately 35 minutes

Secondary outcomes

  1. Mean change in performance on the MST in the active tAN groups (Groups 1 and 3) compared to sham groups (Groups 2 and 4).

    Mean change in performance on the MST in combination with PVT and PPT

    Time frame: From baseline to post-stressor (up to 3 hours)

  2. Mean change in performance on the PVT in the active tAN groups (Groups 1 and 3) compared to sham groups (Groups 2 and 4).

    Mean change in performance on the PVT in combination with MST and PPT

    Time frame: From baseline to post-stressor (up to 3 hours)

  3. Mean change in performance on the PPT in the active tAN groups (Groups 1 and 3) compared to sham groups (Groups 2 and 4).

    Mean change in performance on the PPT in combination with MST and PVT

    Time frame: From baseline to post-stressor (up to 3 hours)

  4. Mean change in performance on the MTS in the prophylactic active tAN group (Group 1) compared to the acute active tAN group (Group 3).

    Mean change in performance on the MST in combination with PVT and PPT

    Time frame: From baseline to post-stressor (up to 3 hours)

  5. Mean change in performance on the PVT in the prophylactic active tAN group (Group 1) compared to the acute active tAN group (Group 3).

    Mean change in performance on the PVT in combination with MST and PPT

    Time frame: From baseline to post-stressor (up to 3 hours)

  6. Mean change in performance on the PPT in the prophylactic active tAN group (Group 1) compared to the acute active tAN group (Group 3).

    Mean change in performance on the PPT in combination with MST and PVT

    Time frame: From baseline to post-stressor (up to 3 hours)

  7. Change in working memory as measured by performance on the MST

    Time frame: From baseline to post-stressor (up to 3 hours)

  8. Change in reaction time as measured by performance on the PVT

    Time frame: From baseline to post-stressor (up to 3 hours)

  9. Change in dexterity as measured by performance on the PPT

    Time frame: From baseline to post-stressor (up to 3 hours)

Other outcomes

  1. Change in heart rate variability in milliseconds (ms) across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  2. Change in heart rate in beats per minute (bpm) across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  3. Change in electrodermal activity across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  4. Change in cortisol levels across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  5. Change in Interleukin-6 (IL-6) levels across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  6. Change in melatonin levels across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  7. Change in Tumor Necrosis Factor Alpha (TNF-α) levels across groups

    Biomarker data will be collected throughout the study using wearable sensors, including the off-the-shelf Empatica E4 smart watch and the Corti SweatSensor.

    Time frame: From baseline, during the stressor, and post-stressor (up to 3 hours)

  8. Change in self-reported stress across groups using the Stress Monitoring and Response Tool (SMART)

    The SMART tool is a patient-reported assessment of acute stress. The questionnaire contains questions asking the participant to rate their severity of stress related symptoms on a scale of 0 ("none") to 10 ("severe"). Symptoms include feeling worthless, sad, distant, irritable, headaches, dizziness, fatigue, nausea, difficulty concentrating, pain, etc. This study will ask participants 23 questions on the SMART tool based on their recent experiences.

    Time frame: Before baseline to after post-stressor tasks (up to 3 hours; assessment valid up to 24 hours after event))

  9. Mean therapeutic stimulation intensity

    amplitude in milliamperes (mA)

    Time frame: From start to end of tAN (30 minutes)

06

Study locations

1 site
  • Battelle Memorial Institute
    Columbus, Ohio 43201, United States
07

Registry details

Key details

Study ID
NCT06390267
Lead sponsor
Spark Biomedical, Inc.
Collaborators
Battelle Memorial Institute, United States Department of Defense
Responsible party
Sponsor
First posted
Apr 30, 2024
Start date
Nov 26, 2024
Primary completion
Jun 18, 2025
Completion
Jun 18, 2025
Last update
Aug 1, 2025

Study contacts

Philip Putnam, PhD
principal investigator · Battelle Memorial Institute
Navid Khodaparast, PhD
principal investigator · Spark Biomedical, Inc.

Oversight

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

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