Transcutaneous vagus nerve stimulation to shift approach–avoidance behavior in people with anxiety and anhedonia

Vagus Nerve Stimulation and Approach-Avoidance Behavior in Anhedonia and Anxiety

Not applicable Interventional University of Bonn · NCT07476469

This project tests whether non-invasive ear vagus nerve stimulation (tVNS), before and after a small meal, can change decision-making and foraging under threat in adults with high anxiety and/or high anhedonia and in healthy volunteers.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment104 (estimated)
Ages18 Years to 40 Years
SexAll
SponsorUniversity of Bonn Academic / other
Locations1 site (Bonn)
Trial IDNCT07476469 on ClinicalTrials.gov

What this trial studies

The work combines an online reinforcement-learning task, MRI-based phenotyping, and in-lab virtual reality to probe how anxiety and anhedonia affect learning, effort trade-offs, and foraging under threat. After online screening and diagnostic visits, participants undergo fMRI while performing an effort-based decision task, then complete two randomized VR sessions with active or sham tVNS both when hungry and after a standardized ~400 kcal milkshake. Physiological signals such as heart rate are recorded while participants freely move in VR so behavioral adaptations and recovery can be measured. Groups include healthy controls and participants with high anxiety, high anhedonia, or both, matched for age, sex, and BMI.

Who should consider this trial

Good fit: Adults aged 18–40 with BMI 18.5–30 kg/m² who can provide consent, undergo MRI and VR procedures, and have either high anxiety symptoms, high anhedonia symptoms, both, or are healthy controls are the intended participants.

Not a fit: People with severe neurological disorders, bipolar disorder, schizophrenia, recent eating disorders, certain cardiovascular or metabolic conditions, pregnancy, MRI contraindications, or impaired movement, hearing, or uncorrected vision are not eligible and unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, this could point to a non-drug way to rebalance approach and avoidance behaviors and potentially improve functioning in people with anxiety or anhedonia.

How similar studies have performed: Previous small studies have shown that tVNS can influence mood, learning, and autonomic function, but combining tVNS with VR foraging and a metabolic manipulation in anxiety/anhedonia is a relatively novel approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* BMI between 18,5 and 30,0 kg/m2,
* between 18 and 40 years of age, and
* be able and willing to provide informed consent.

Exclusion Criteria:

* have a high risk of suicide,
* have a lifetime diagnosis of severe neurological disorder (incl. ADHD), schizophrenia, bipolar disorder, or severe substance abuse, posttraumatic stress disorder, obsessive-compulsive disorder, diabetes, epilepsy, or coronary heart disease
* have fulfilled criteria for an eating disorder or somatic symptom disorder within the last 12-months,
* take medication (except psychopharmacological medication for MDD or anxiety), patients have to be on stable psychopharmacological medication for at least two months before study participation (minimizing confounding effects)
* contraindications for MRI (metal implants or claustrophobia)
* for female individuals if they are pregnant or nursing at the time,
* impaired movement ability or hearing
* impaired, uncorrected vision (need contact lenses)
* contraindications for tVNS hearing aids or diseased skin on the right ear.

Where this trial is running

Bonn

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Healthy ParticipantsAnxiety DisordersDepressive DisordersComorbid Depression and Anxiety DisorderDepressionAnhedoniaAnxietyVagusnerv-Stimulation
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.