An interventional study of Approach-Avoidance Decision-Making Task in Depression - Major Depressive Disorder, sponsored by University of California, San Francisco. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-27.
Sponsored by University of California, San Francisco · Not applicable, Interventional, and Basic science
Among 64 studies in Depression by University of California, San Francisco — 8 open to participants now, 10 under way, none of them phase 3. Depression · University of California, San Francisco.
Among the 64 studies in Depression by University of California, San Francisco, this one is the 56th largest by planned enrollment of the 61 interventional ones that give a count, is the only one that started in 2026, is one of 55 with no phase, and was the 64th registered.
8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.
Browse Depression studies →8 of the 64 studies in Depression by University of California, San Francisco are open now, in 3 countries. Recruiting first, the newest first:
University of California, San Francisco · Sites in Malawi
Ages 18+
University of California, San Francisco · Sites in United States
Ages 15–24
University of California, San Francisco · Sites in United States
Ages 18+
University of California, San Francisco · Sites in United States
Ages 18–70
University of California, San Francisco · Sites in United States
Ages 18+ · Healthy volunteers
By country, each count listing its studies:
Of the 1,088 Depression studies recruiting now, 469 (43%) set no upper age limit and 519 (48%) stop at 75 or younger; 203 take children under 18; 310 take healthy volunteers.
This study: 18 Years and older · all sexes · no healthy volunteers.
The full table on the hub →This tab as a report to print or save as PDF → With an account.
64 studies; the count open now beside each. This study's row is marked.
First in 2003; this study’s year is marked. 1 started in 2026.
By drug class, each counting the studies that test any of its medicines:
This study's planned enrollment of 10 is below the median of 81 across 7,063 interventional studies indexed under Depression.
Median enrollment 70 across the 61 interventional studies, 14 across the 2 observational. Of the 53 that completed or were terminated, 14 (26%) have results posted.
This tab as a report to print or save as PDF → With an account.
University of California, San Francisco is the lead sponsor of 2,170 studies on the registry; 370 are open to participants now.
Of its 268 completed or terminated interventional studies of FDA-regulated products, 203 (76%) have results posted.
5 of the studies in Depression by University of California, San Francisco that are under way reach primary completion within a year, 0 of them phase 3. Phase 3 first, then by date:
| Study | Primary completion |
|---|---|
| NCT05865405University of California, San FranciscoA Closed Loop, Doctor to Patient, Mobile Application for Depression in People With Multiple Sclerosis | 2027-01-15 |
| NCT06659315University of California, San FranciscoPrevention of Mother-to-child Transmission (PMTCT) Among Women Experiencing Depression in Malawi | 2027-03-31 |
| NCT07896343University of California, San FranciscoUnderstanding the Neural Underpinnings of Risk-Taking Behavior in Psychiatric Disease | 2027-06 |
| NCT07064928University of California, San FranciscoIntervention to Reduce HIV Related Stigma Among Pregnant and Postpartum Women | 2027-07-31 |
| NCT04581902University of California, San FranciscoBiomarkers of Depression and Treatment Response | 2027-09 |
Add all 5 to your calendar (.ics) → With an account.
Among the 64 studies in Depression by University of California, San Francisco, from their registry updates:
This tab as a report to print or save as PDF → With an account.
The purpose of this study is to understand how the orbitofrontal cortex (OFC), a region at the front of the brain, guides decisions about whether to pursue a possible reward when doing so also carries a risk of loss, and how this process is altered in depression. People with depression are often less motivated by rewards and more sensitive to potential losses, leading them to avoid situations that others would approach. The OFC is thought to play a central role in these "approach or avoid" decisions, but how it normally does so, and what goes wrong in depression, is not well understood.
This study asks two questions: (1) How does activity in different parts of the OFC signal the decision to approach or avoid? (2) Does this activity differ in people with depression in a way that explains a bias toward avoidance? We hypothesize that the medial OFC (toward the middle of the brain) signals approach, the lateral OFC (toward the side of the brain) signals avoidance, and that in depression the medial OFC signal is weakened, tipping decisions toward avoidance.
Participants are adults who are hospitalized with stereo-EEG (sEEG) electrodes already placed in the brain by their medical team, either to locate the source of seizures in epilepsy or as part of a separate clinical trial for treatment-resistant depression. The electrodes are placed for clinical reasons only, not for this study. During their hospital stay, participants complete a short, game-like computer task (about 20 minutes per session) in which they repeatedly choose whether to approach or avoid options that offer different chances of reward and loss. Their choices and reaction times are recorded along with brain activity from the existing electrodes, and participants rate their mood before each session.
The researchers will compare OFC activity during approach versus avoid decisions, use mathematical models of decision-making to measure how strongly each participant weighs rewards and losses, and compare participants with and without depression. No drugs, devices, or brain stimulation are given as part of this study. The findings are intended to guide the development of more targeted brain-stimulation treatments for treatment-resistant depression.
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.
All participants:
Depressed cohort:
Control (non-depressed) cohort:
Exclusion Criteria:
All participants:
Control (non-depressed) cohort only:
* Epileptiform abnormalities involving the OFC, OFC dysplasia, or prior OFC resection, as determined by clinical evaluation and imaging
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.
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.
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.
Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Relapsed and refractory
Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Adults undergoing inpatient stereo-EEG (sEEG) monitoring with electrodes in the orbitofrontal cortex (OFC). The primary cohort consists of patients with treatment-resistant depression enrolled under the parent IRB protocol of a deep brain stimulation trial for refractory depression (PRESIDIO; NCT04004169), who undergo sEEG with bilateral OFC electrodes during that trial's inpatient phase. The control cohort consists of non-depressed patients undergoing sEEG monitoring for other clinical indications, such as seizure localization in refractory epilepsy. All participants complete the same computerized approach-avoidance decision-making task (\~20 minutes per session), choosing on each trial to approach or avoid offers of probabilistic reward and punishment, while neural activity is recorded from the implanted electrodes. No drug, device, or stimulation is administered as part of this study; implantation and any stimulation occur solely under clinical care or the parent trial.
Behavioral: Approach-Avoidance Decision-Making Task
A computerized, gamified approach-avoidance decision-making task built in the Unity game engine and presented on a laptop at the bedside during inpatient sEEG monitoring. On each trial, the participant views a virtual corridor containing a reward offer (0-7 treasure chests) and a punishment offer (0-4 bombs) and indicates by button press whether to approach the corridor, with probabilistic gain and loss outcomes, or avoid it, with a neutral outcome. Reward and punishment magnitudes are varied in pseudorandomized order across 220 trials per session (\~20 minutes). Choices and reaction times are recorded and synchronized with intracranial neural recordings at millisecond precision. The task serves as an experimental probe of the neural and behavioral mechanisms of approach-avoidance decision-making; it is not a treatment, and no therapeutic effect is expected. Task code is openly available (github.com/cstarkweather).
Difference in Orbitofrontal Cortex High-Frequency Activity (70-150 Hz) Between Approach and Avoidance Decisions
High-frequency activity (HFA; 70-150 Hz band-limited power) is extracted from sEEG electrodes in the orbitofrontal cortex (OFC) and normalized to each channel's baseline. Mean HFA is computed in a pre-specified decision epoch (300 ms preceding the button press). The outcome is the difference in mean HFA between approach and avoidance trials (HFA on approach trials minus HFA on avoidance trials), computed per electrode and reported separately for medial and lateral OFC electrodes. Analyzed in the non-depressed cohort (Aim 1). Unit of measure: percent of baseline HFA.
Time frame: During task session(s) completed during inpatient sEEG monitoring, from enrollment up to 3 weeks
Plan to share: Yes — De-identified electrophysiological and behavioral data will be made available via data repository.
No publications or documents are linked to this record.
Start is estimated for Oct 2026; primary completion for Jun 2027, 8 months later.
Of 3,468 non-industry interventional studies with no phase under Depression, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 41. This study's planned 8 months is below that.
Counting every sponsor, half of 3,566 studies reached it within 21 months; a quarter within 9 and three quarters within 41.
How these figures are worked out, and which studies are left out of them.
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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