ClinicalTrials.gg
RecruitingNCT06472622Updated Sep 18, 2026

Functional Neuroimaging to Detect the Neural Signatures of the Unpleasantness of Pain and Effort

An Early Phase 1 interventional study of Thermal Pain Stimulation and Physical Effort Stimulation in Fatigue Syndrome, Chronic, sponsored by National Institute of Neurological Disorders and Stroke (NINDS). Recruiting at 1 site in United States. Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-09-18.

Sponsored by National Institute of Neurological Disorders and Stroke (NINDS) · Early Phase 1, Interventional, and Basic science

From the registry’s dates

  • Started Apr 2025; still recruiting 1 year 7 months later.

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Phase
Early Phase 1
Study type
Interventional
Enrollment
47
Allocation
Not applicable
Ages
18 Years to 50 Years
Sex
All
01

Where this study stands

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

Among 86 studies in Fatigue Syndrome, Chronic with a site in United States — 21 open to participants now, 24 under way, none of them phase 3. Fatigue Syndrome, Chronic · United States.

Planned enrollment
31st of 58
47 · median 50
Started
2025
with 2 others
Phase 1
7 of 86
2 open now
Primary completion
2034-06
later than 23 of 23 live
Registered
75th of 86
by date
Lead sponsor
2 of 86
National Institute of Neurological Disorders and Stroke (NINDS)

Among the 86 studies in Fatigue Syndrome, Chronic with a site in United States, this one is the 31st largest by planned enrollment of the 58 interventional ones that give a count, is one of 3 that started in 2025, is one of 7 in phase 1, reaches primary completion later than 23 of the 23 other live ones, and was the 75th registered.

Fatigue Syndrome, Chronic

264 studies on the registry are indexed under Fatigue Syndrome, Chronic; 62 are open to participants now.

Browse Fatigue Syndrome, Chronic studies →

Open to participants now

21 of the 86 studies in Fatigue Syndrome, Chronic with a site in United States are open now. Recruiting first, the newest first:

15 more — sign in →

All 21 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 44 Fatigue Syndrome, Chronic studies recruiting now, 18 (41%) set no upper age limit and 20 (45%) stop at 75 or younger; 5 take children under 18; 10 take healthy volunteers.

This study: 18 Years to 50 Years · all sexes · no healthy volunteers.

The full table on the hub →

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 86 studies in Fatigue Syndrome, Chronic with a site in United States, or all of them as a file.
02

Study summary

Background:

The way the brain processes rewards and punishments may play a role in some disorders of the nervous system. People with chronic overlapping pain conditions (such as myalgic encephalomyelitis/chronic fatigue syndrome [ME/CFS]) may have heightened responses to unpleasant, punishing sensations. Some of these conditions may also cause heightened responses to effort; this is an unpleasant sensation felt during physical and mental exertion.

Objective:

To learn more about how the brain processes different unpleasant sensations.

Eligibility:

People aged 18 to 50 years with ME/CFS. Healthy volunteers are also needed.

Design:

Participants will have 3 visits in 1 to 5 weeks.

Visit 1: Participants may have a neurologic exam. They will have a mock magnetic resonance imaging (MRI) scan. They will lie on a bed in a wooden tube while they practice 2 tasks:

Thermal pain rating: A device that creates mild to moderate heat will be placed on one leg.

Physical effort rating: Participants will squeeze a plastic bar with different levels of force.

Visit 2: Participants will have a real MRI scan. They will lie on a table that slides into a large tube.

Visit 3: Participants will have another MRI scan. They will repeat the thermal pain and physical effort tasks while in the scanner. Sensors will be placed on 1 arm to measure how the muscles function as they squeeze the bar.

Their heart rate will be tested: They will hold their finger against a camera lens for 1 minute. They will do 2 other tasks: 1 requires repeatedly pressing a key on a keyboard, and the other requires squeezing a bar.

Read the detailed description

Study Description:

This protocol will examine the associations between brain activation and the subjective unpleasantness associated with pain and physical effort in healthy individuals. We have developed two behavioral tasks for administration during neuroimaging: a Thermal Pain Rating task and a Physical Effort Rating task, which will allow us to identify brain regions in which activity is associated with the unpleasantness of these experiences. We hypothesize that the unpleasantness of the experiences will be associated with activity in a recently identified network of brain regions thought to be involved in computing subjective value, known as the subjective valuation network (SVN).

Objectives:

Primary Objectives:

  1. Determine which regions of the SVN are specifically involved in the subjective experience of unpleasantness associated with sensations of pain.
  2. Determine which regions of the SVN are specifically involved in the subjective experience of unpleasantness associated with sensations of physical effort.

Endpoints:

Primary Endpoints:

  1. SVN regions in which activity is significantly associated with unpleasantness of pain.
  2. SVN regions in which activity is significantly associated with unpleasantness of physical effort.
03

Conditions studied

  • Fatigue Syndrome, Chronic

Keywords

  • Punishment
  • Fatigue Syndrome, Chronic
  • Pain
  • Physical Exertion
  • Effort
  • Brain
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Psychophysics
  • Reward
04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

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

Healthy Controls: In order to be eligible to participate in this study as a healthy control, an individual must meet all the following criteria:

  1. Ability of subject to understand and the willingness to sign a written document.
  2. Stated willingness to comply with all study procedures and availability for the duration of the study.
  3. Male or female, aged 18-50 (inclusive).
  4. Good general health as evidenced by medical history and/or physical examination.

ME/CFS Patients: In order to be eligible to participate in this study as an ME/CFS patient, an individual must meet all the following criteria:

  1. Ability of subject to understand and the willingness to sign a written informed consent document.
  2. Stated willingness to comply with all study procedures and availability for the duration of the study.
  3. Male or female, aged 18-50 (inclusive).
  4. Has a diagnosis of ME/CFS, meeting at least one of three ME/CFS criteria: the 1994 Fukuda Criteria, the 2003 Canadian Consensus Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, or the Institute of Medicine Diagnostic Criteria.

Exclusion criteria

EXCLUSION CRITERIA:

Healthy Controls:

  1. Any current major neurological or psychiatric disorder such as (but not limited to) stroke, Parkinson s disease, Alzheimer s disease, schizophrenia, or major depressive disorder.
  2. Any other current major medical disorder, such as a kidney disease, liver disease, cardiovascular disease, chronic pain condition, or any other disorder which, in the opinion of the PI would make participation risky for the individual or negatively affect the individual s ability to cooperate with study procedures.
  3. Current use of medications acting primarily on the central nervous system, such as antidepressants, stimulants, etc.
  4. Use of opioid medications for more than two weeks within the last two years or any use in the last month.
  5. Current or history of substance use disorder, binge drinking, illegal drug use, or excessive tobacco use (defined as more than 10 cigarettes of nicotine per week).
  6. Any more than occasional use of cannabis, defined as a score >1 (indicating use on more than one or two days in the last two weeks) on the marijuana use item of the Level 2-Substance Use-Adult questionnaire.
  7. Any use of other illicit drugs or misuse of prescription medications, defined as a score >0 on any of the other items of the DSM-5 Level 2-Substance Use-Adult questionnaire.
  8. Condition or injury affecting grip.
  9. Condition or injury affecting extremities that would alter peripheral sensitivity to painful thermal stimuli or would otherwise cause such stimuli to be .
  10. Contraindications to MRI, including ferromagnetic metal in the cranial cavity or eye, implanted neural stimulator, cochlear implant, or ocular foreign body, implanted cardiac pacemaker, auto-defibrillator, or pump, non-removable body piercing, claustrophobia, inability to lie supine for 90 minutes, known pregnancy, or plans to become pregnant during the study.
  11. Members of the NINDS BNU and their family members.
  12. Non-English speakers will be excluded from the study as several study instruments do not have validated translations.

ME/CFS Patients:

  1. Any current major neurological or psychiatric disorder, other than ME/CFS, such as (but not limited to) stroke, Parkinson s disease, Alzheimer s disease, schizophrenia, or major depressive disorder.
  2. Any other current major medical disorder, other than ME/CFS, such as a kidney disease, liver disease, cardiovascular disease, chronic pain condition, or any other disorder which, in the opinion of the PI would make participation risky for the individual or negatively

    affect the individual s ability to cooperate with study procedures.

  3. Current use of psychomotor stimulants, antipsychotics, or benzodiazepines.
  4. Use of opioid medications for more than two weeks within the last two years or any use in the last month.
  5. Current or history of substance use disorder, binge drinking, illegal drug use, or excessive tobacco use (defined as more than 10 cigarettes of nicotine per week).
  6. Any more than occasional use of cannabis, defined as a score >1 (indicating use on more than one or two days in the last two weeks) on the marijuana use item of the DSM-5 Level 2-Substance Use-Adult questionnaire.
  7. Any use of other illicit drugs or misuse of prescription medications, defined as a score >0 on any of the other items of the DSM-5 Level 2-Substance Use-Adult questionnaire.
  8. Condition or injury affecting grip.
  9. Condition or injury affecting extremities that would alter peripheral sensitivity to painful thermal stimuli or would otherwise cause such stimuli to be contraindicated.
  10. Contraindications to MRI, including ferromagnetic metal in the cranial cavity or eye, implanted neural stimulator, cochlear implant, or ocular foreign body, implanted cardiac pacemaker, auto-defibrillator, or pump, non-removable body piercing, claustrophobia, inability to lie supine for 90 minutes, known pregnancy, or plans to become pregnant during the study.
  11. Members of the NINDS BNU and their family members.
  12. Non-English speakers will be excluded from the study as several study instruments do not have validated translations.
Terms in these criteria, in plain language(3)

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.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Early Phase 1
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
47 participants (estimated)

Study arms

  • Other
    Single Arm

    This is a single-arm study. The order of intervention administration will be counterbalanced within this single arm.

    Device: Thermal Pain Stimulation · Device: Physical Effort Stimulation

Interventions

  • DeviceThermal Pain Stimulation

    Thermal pain will be administered during fMRI neuroimaging via a thermal stimulation device (Medoc Ltd., Advanced Medical System, Israel; 510K: K052357; K041908; K922052) to examine brain activity corresponding to the experience of this stimulus. This device and associated system carries an FDA 510 (K) clearance.

  • DevicePhysical Effort Stimulation

    Physical effort will be administered during fMRI neuroimaging via a hand dynamometer attachment for a physiological monitoring system (BIOPAC Systems, Inc., Goleta, CA, USA) to examine brain activity corresponding to the experience of this stimulus. This device has not received pre-marked approval or 510 (K) clearance by the FDA.

06

What researchers measure

Primary outcomes

  1. Determine which regions of the SVN are specifically involved in the subjective experience of unpleasantness associated with sensations of pain.

    SVN regions in which activity is significantly associated with unpleasantness of pain.

    Time frame: The measurement will be assessed concurrently with thermal pain stimulus administration during the fMRI procedure associated with one of the study visits, 1-31 days following the visit for the first session.

  2. Determine which regions of the SVN are specifically involved in the subjective experience of unpleasantness associated with sensations of physical effort.

    The SVN has been hypothesized to play a role in producing the unpleasantness of negative experiences including effort.

    Time frame: The measurement will be assessed concurrently with physical effort stimulus administration during the fMRI associated with one of the study visits, 1-31 days following the visit for the first session.

07

Study locations

1 of 1 sites recruiting
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
    Recruiting
08

References and documents

Publications

  • Zald DH, Treadway MT. Reward Processing, Neuroeconomics, and Psychopathology. Annu Rev Clin Psychol. 2017 May 8;13:471-495. doi: 10.1146/annurev-clinpsy-032816-044957. Epub 2017 Mar 15. PubMed 28301764 ↗
  • Chong TT, Bonnelle V, Manohar S, Veromann KR, Muhammed K, Tofaris GK, Hu M, Husain M. Dopamine enhances willingness to exert effort for reward in Parkinson's disease. Cortex. 2015 Aug;69:40-6. doi: 10.1016/j.cortex.2015.04.003. Epub 2015 Apr 20. PubMed 25967086 ↗
  • Peters J, Buchel C. Overlapping and distinct neural systems code for subjective value during intertemporal and risky decision making. J Neurosci. 2009 Dec 16;29(50):15727-34. doi: 10.1523/JNEUROSCI.3489-09.2009. PubMed 20016088 ↗
  • Levy DJ, Glimcher PW. The root of all value: a neural common currency for choice. Curr Opin Neurobiol. 2012 Dec;22(6):1027-38. doi: 10.1016/j.conb.2012.06.001. Epub 2012 Jul 3. PubMed 22766486 ↗
  • Basten U, Biele G, Heekeren HR, Fiebach CJ. How the brain integrates costs and benefits during decision making. Proc Natl Acad Sci U S A. 2010 Dec 14;107(50):21767-72. doi: 10.1073/pnas.0908104107. Epub 2010 Nov 30. PubMed 21118983 ↗

Individual participant data

Plan to share: Undecided — It has not been determined if data analysis based on IPD is beneficial or feasible. This will be evaluated at a later time.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Apr 2025 (actual). Primary completion is estimated for Jun 2034, 110 months after the start.

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

Registered
Jun 22, 2024
First posted
Jun 25, 2024
StartActual
Apr 9, 2025
Primary completionEst.
Jun 30, 2034
CompletionEst.
Jun 30, 2034
Last update
Sep 18, 2026
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 Sep 18, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06472622
Responsible party
Sponsor
First posted
Jun 25, 2024
Start date
Apr 9, 2025
Primary completion
Jun 30, 2034 (estimated)
Completion
Jun 30, 2034 (estimated)
Last update
Sep 18, 2026

Study contacts

Nicholas J Madian, Ph.D.
Contact
nicholas.madian@nih.gov
(301) 480-9787
Eric M Wassermann, M.D.
Contact
wassermanne@nih.gov
(301) 496-0151
Eric M Wassermann, M.D.
principal investigator · National Institute of Neurological Disorders and Stroke (NINDS)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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