An interventional study of ATTN201 head-worn focused ultrasound in Depression, Anxiety and Obsessive Compulsive Disorder (OCD), sponsored by Attune Neurosciences Inc. Not yet recruiting at 1 site in United States. Open to participants aged 22 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-10-01.
Sponsored by Attune Neurosciences Inc · Not applicable, Interventional, and Treatment
This is a double-blind, within-participant crossover, multi-site dose-finding study evaluating the safety, feasibility, and preliminary efficacy of repeated low-intensity focused ultrasound (LIFU) stimulation using the ATTN201 device across seven candidate deep-brain targets in adults with subsyndromal-to-moderate depression, anxiety, or obsessive-compulsive disorder. Every session delivers active ATTN201 stimulation; there is no sham or placebo condition. Participants and the on-site study staff who deliver stimulation and administer the clinical scales are blinded to the brain target and to the stimulation parameters assigned for each session by a constrained Bayesian optimization algorithm.
Following a remote pre-screen and an in-person screening/baseline visit (Visit 0), at which informed consent is obtained, eligibility is confirmed, baseline clinical scales are administered, optional biospecimens are collected from participants who consent to them, a multi-sequence brain MRI is acquired for targeting, and monitoring devices are fitted, each participant receives between 3 and 10 ATTN201 stimulation sessions spaced approximately 7 days apart. Each stimulation visit serves as the pre-stimulation baseline for that session, the 1-week post-stimulation measurement for the prior session, and the 2-week post-stimulation measurement for the session before that. A platform-administered scale battery at day 7 after the last stimulation captures the 1-week measurement for the final session; a remote final treatment-period follow-up approximately 2 weeks after the last stimulation captures the 2-week measurement. A remote 3-month post-treatment check-in captures durability and any delayed adverse events.
The trial uses a two-stage architecture. In Stage 1, visits are allocated across all seven candidate targets. After approximately 300 visits, the Sponsor and ARPA-H convene a joint review and select 3-5 targets for continued Bayesian optimization in Stage 2.
Monitoring during enrollment includes validated clinical scales (PHQ-9, GAD-7, OCI-R) at baseline, before each stimulation visit, at the final treatment-period follow-up, and at the 3-month follow-up; transdiagnostic visual analog scales, a morning sleep diary, and brief voice recordings prompted through the Attune platform during monitoring blocks; optional nightly ambulatory EEG; and a smart watch worn from Visit 0 through device return. All scheduled platform prompts are voluntary at the individual-prompt level.
Blinding: A single on-site research associate positions the device, runs the stimulation session, and administers participant-facing assessments, and is blinded to the brain target and parameter combination; this individual occupies both the care provider and the outcomes assessor role. The stimulation condition is selected by the Bayesian optimization algorithm and pushed to the device as a sealed session. The Lead Principal Investigator and the optimization team are unblinded as required to operate the adaptive design and do not deliver stimulation or administer participant-facing assessments. The independent Medical Monitors and the Data Safety and Monitoring Board receive unblinded safety data.
8,055 studies on the registry are indexed under Depression; 1,643 are open to participants now.
This study's planned enrollment of 300 is above the median of 84 across 6,718 interventional studies indexed under Depression.
Browse Depression studies →This is the only study on the registry with Attune Neurosciences Inc as lead sponsor.
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Exclusion Criteria:
ATTN201 head-worn low-intensity focused ultrasound delivered to the basolateral amygdala (BLA). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the dorsal anterior cingulate cortex (dACC). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the anterior limb of the internal capsule (ALIC). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the centromedian nucleus of the thalamus (CMN). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the rostral zona incerta (rZi). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the subthalamic nucleus (STN). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn low-intensity focused ultrasound delivered to the anterior nucleus of the thalamus (ANT). Sessions at which the constrained Bayesian optimization algorithm assigns this target; stimulation parameters (pulse repetition frequency, duty cycle, target pressure) vary within the ITRUSST-bounded search space. Participants may cross over to other target arms at subsequent sessions.
Device: ATTN201 head-worn focused ultrasound
ATTN201 head-worn focused ultrasound
Patient-specific transdiagnostic score (TDx) at 1 week after stimulation
TDx measured 1 week after each stimulation session. The TDx is a severity-weighted composite of normalized improvement on PHQ-9, GAD-7, and OCI-R; higher TDx indicates greater improvement.
Time frame: 1 week after each stimulation session
Patient-specific transdiagnostic score (TDx) at 2 weeks after stimulation
TDx measured 2 weeks after each stimulation session. The TDx is a severity-weighted composite of normalized improvement on PHQ-9, GAD-7, and OCI-R; higher TDx indicates greater improvement.
Time frame: 2 weeks after each stimulation session
Posterior mean transdiagnostic score (TDx) at the best stimulation parameter set for each brain target
Posterior mean TDx, from a Gaussian process model fit for each brain target, at the stimulation parameter set that maximizes it. TDx is a severity-weighted composite of normalized improvement on PHQ-9, GAD-7, and OCI-R; higher TDx indicates greater improvement.
Time frame: At study completion, up to 19 months
Change from pre-stimulation baseline in PHQ-9 total score
Change from the local pre-stimulation baseline in Patient Health Questionnaire-9 (PHQ-9) total score. The PHQ-9 is a 9-item self-report measure of depression severity over the preceding 2 weeks. Total score range is 0 to 27; higher scores indicate greater depression severity. A negative change score indicates improvement.
Time frame: Pre-stimulation baseline, 1 week after stimulation, and 2 weeks after stimulation
Change from pre-stimulation baseline in GAD-7 total score
Change from the local pre-stimulation baseline in Generalized Anxiety Disorder-7 (GAD-7) total score. The GAD-7 is a 7-item self-report measure of anxiety severity over the preceding 2 weeks. Total score range is 0 to 21; higher scores indicate greater anxiety severity. A negative change score indicates improvement.
Time frame: Pre-stimulation baseline, 1 week after stimulation, and 2 weeks after stimulation
Change from pre-stimulation baseline in OCI-R total score
Change from the local pre-stimulation baseline in Obsessive-Compulsive Inventory-Revised (OCI-R) total score. The OCI-R is an 18-item self-report measure of distress associated with obsessive-compulsive symptoms. Total score range is 0 to 72; higher scores indicate greater symptom severity. A negative change score indicates improvement.
Time frame: Pre-stimulation baseline, 1 week after stimulation, and 2 weeks after stimulation
Mood visual analog scale (VAS) score
Self-rated mood on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate better mood.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Arousal visual analog scale (VAS) score
Self-rated arousal on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate greater arousal.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Sleepiness visual analog scale (VAS) score
Self-rated sleepiness on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate greater sleepiness.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Anxiety symptom visual analog scale (VAS) score
Self-rated current anxiety symptoms on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate greater anxiety.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Obsessive-compulsive symptom visual analog scale (VAS) score
Self-rated current obsessive-compulsive symptoms on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate greater symptom severity.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Depression symptom visual analog scale (VAS) score
Self-rated current depression symptoms on a 0-100 continuous VAS administered through the Attune platform; higher scores indicate greater symptom severity.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Prefrontal EEG delta band spectral power
Absolute spectral power in the delta band from nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Prefrontal EEG theta band spectral power
Absolute spectral power in the theta band from nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Prefrontal EEG alpha band spectral power
Absolute spectral power in the alpha band from nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Prefrontal EEG beta band spectral power
Absolute spectral power in the beta band from nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Prefrontal EEG gamma band spectral power
Absolute spectral power in the gamma band from nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
EEG-derived sleep efficiency
Sleep efficiency (percentage of time in bed spent asleep) derived by automated sleep staging of nightly two-channel prefrontal ambulatory EEG recordings, among participants who elect optional EEG monitoring.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Smart-watch-derived heart rate variability
Daily heart rate variability (milliseconds) recorded by the study smart watch.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Smart-watch-derived daily step count
Daily step count (actigraphy) recorded by the study smart watch.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Smart-watch-derived sleep duration
Nightly total sleep duration (minutes) recorded by the study smart watch.
Time frame: Nightly from Day 1 through Day 7 after each stimulation session
Life-space mobility
Daily life-space mobility (maximum distance from home, kilometers) derived from de-identified GPS collected by the optional Beiwe research application on the participant's smartphone.
Time frame: Daily from Day 1 through Day 7 after each stimulation session
Patient-specific transdiagnostic score (TDx) at 1 week after stimulation, by primary indication
TDx measured 1 week after each stimulation session, summarized separately for participants whose primary indication is depression, anxiety, obsessive-compulsive disorder, or comorbid. TDx is a severity-weighted composite of normalized improvement on PHQ-9, GAD-7, and OCI-R; higher TDx indicates greater improvement.
Time frame: 1 week after each stimulation session
Plan to share: Yes — De-identified individual participant data will be deposited into the ARPA-H designated data repository as required by the funded ARPA-H EVIDENT program. Deposited data include clinical outcome measures (PHQ-9, GAD-7, OCI-R, PROMIS Sleep Disturbance 8a, PROMIS Sleep-Related Impairment 8a, DASS-8, Brief Resilience Scale, Flourishing Scale, and transdiagnostic visual analog scales), delivered stimulation parameters, EEG-derived and wearable-derived biomarker measures, platform-derived measures, relevant metadata, and optional baseline dried blood spot and saliva biospecimens where collected. Participant identifiers are not included in deposited datasets.
Supporting information: Study protocol, Sap
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