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Posttraumatic Stress SymptomsSANI-TNCT07868055

Self-administered Neurostimulation Intervention for Firefighter Traumatic Stress to Reduce Alcohol Use: Pilot Study

A study testing Transcutaneous auricular neurostimulation (tAN) in people with Posttraumatic Stress Symptoms and Heavy Alcoholic Consumption, run by University of Cincinnati.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to evaluate the feasibility, acceptability, and appropriateness of a transcutaneous auricular neurostimulation (tAN) protocol in firefighters who engage in heavy drinking, have at least a mild alcohol use disorder, and report above-average posttraumatic stress symptoms (PTS). Read more about this study

Who is it for?
Ages 18 to 64 years
What is being tested?
Transcutaneous auricular neurostimulation (tAN)
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
No sites listed yet
Study dates
1 Sep 2027to 30 Jun 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Active-duty firefighter aged 18 to 64 years old.
  • Endorse at least one heavy drinking event within the past month based on sex-assigned-at-birth thresholds (males: 5+ standard drinks on a single day and/or 15+ over 7 days; females: 4+ standard drinks on a single day and/or 8+ over 7 days).
  • Meet DSM-5 criteria for mild, moderate, or severe alcohol use disorder. Report at least moderate posttraumatic stress (PTS) symptoms, defined as a PTSD Checklist for DSM-5 (PCL-5) score of 20 or greater.
  • Willing to attend research visits, complete EMA measurements, use the study device, and provide informed consent in English.

Who cannot join

  • Currently engaged in evidence-based PTSD psychotherapy or AUD-focused counseling at the time of randomization, or has experienced a past-month change in PTSD- or AUD-relevant medication.
  • High risk for moderate to severe alcohol withdrawal syndrome, indicated by a Prediction of Alcohol Withdrawal Severity Scale (PAWSS) score of 4 or greater.
  • Unmedicated psychotic disorder or unmedicated bipolar disorder with a manic episode in the past month.
  • History of epileptic seizures, neurological diseases, or traumatic brain injury with lasting effects.
  • Current evidence of an uncontrolled and/or clinically significant medical or psychiatric condition precluding device-related research participation.
  • Suicide attempt in the past month leading to hospital admission, or expressed suicidal ideation with intent and plan in the past month.
Show all 9Show fewer
  • Presence of devices such as pacemakers, cochlear prostheses, or neurostimulators.
  • Current ear infection or abnormal ear anatomy that would prevent therapeutic earpiece contact to at least one ear.
  • Pregnant, lactating, or a person of childbearing potential not using adequate contraception.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Principal Investigator contact

513-287-9517

ucptsdstudy@gmail.com

About this study

Official title: Developing and Evaluating a Firefighter Self-administered Neurostimulation Intervention for Traumatic Stress to Reduce Alcohol Use

The goal of this clinical trial is to evaluate the feasibility, acceptability, and appropriateness of a transcutaneous auricular neurostimulation (tAN) protocol in firefighters who engage in heavy drinking, have at least a mild alcohol use disorder, and report above-average posttraumatic stress symptoms (PTS).

The main questions it aims to answer are:

Read more
  • How feasible do firefighter participants rate the study procedures on the Feasibility of Intervention Measure?
  • How do firefighter participants rate the acceptability of the study procedures (Acceptability of Intervention Measure) and the appropriateness of the tAN device (Intervention Appropriateness Measure)?

Researchers will compare an active tAN condition (receiving therapeutic stimulation from the Sparrow device) to an active sham condition (receiving stimulation below a therapeutic level) to see if the intervention reduces PTS symptom severity and heavy drinking events, and to evaluate the clinical effects on insomnia, mental health symptoms, and quality of life.

Participants will:

  • Use the Sparrow device for at least 1 hour/day for 5 days/week throughout a 4-week treatment phase.
  • Complete daily measures of traumatic event exposure, PTS symptom severity, alcohol use, and trauma-related drinking motivations.
  • Complete audio journals capturing their experience with symptoms and the device.
  • Wear sensors to record heart rate, heart rate variability, and sleep data throughout the intervention phase.

Complete assessments immediately following treatment (Week 4) and one month later (Week 8).

Read the detailed description

The investigators' goal is to evaluate the feasibility, acceptability, and appropriateness of a transcutaneous auricular neurostimulation (tAN) protocol for firefighters with alcohol use disorder (AUD) and co-occurring posttraumatic stress (PTS) symptoms. Firefighters are repeatedly exposed to potentially traumatic events, and many experience PTS symptoms as a result. Over 50% of firefighters report past-month heavy alcohol use, and many use alcohol to "self-medicate" symptoms of hyperarousal, intense negative affect, and insomnia that follow traumatic events. tAN, a patient-administered intervention that delivers electrical stimulation to branches of the vagus and trigeminal nerves, has shown promise for alleviating symptoms of PTS and opioid withdrawal. However, its effects have yet to be tested in a sample of firefighters with AUD and co-occurring PTS symptoms. Within this highly impacted population, providing a culturally informed tAN intervention promises to reduce the PTS symptoms driving heavy alcohol use. Study results, utilizing the ear-worn Sparrow device, will inform a revised trial protocol and an FDA pre-submission to support a PTS/AUD indication. In summary, the investigators will examine whether the study protocol is feasible and whether active tAN provides preliminary evidence of reducing PTS symptoms and heavy drinking events compared to an active sham.

Design: The investigators will randomize 20 active-duty firefighters who engage in heavy drinking and report at least moderate PTS symptoms to receive: 1) active tAN or 2) active sham tAN. tAN is administered via the Sparrow device for at least 1 hour per day, 5 days per week, throughout a 4-week treatment phase. Assessments will be collected at Baseline (Week 0), Interim (Week 2), Post-treatment (Week 4), and 1-month follow-up (Week 8), alongside daily ecological momentary assessments and audio journals. The primary outcome will be posttreatment ratings on the Feasibility of Intervention Measure (FIM). Secondary outcomes include ratings of protocol acceptability (Acceptability of Intervention Measure; AIM) and device appropriateness (Intervention Appropriateness Measure; IAM). Exploratory clinical outcomes include the PTSD Checklist for DSM-5 (PCL-5) and heavy drinking events. Biomarker and ecological momentary assessment (EMA) analysis will examine the dynamic relationships between neurostimulation, autonomic arousal (heart rate, heart rate variability), sleep, trauma exposure, and alcohol motives.

Aim (1): Evaluate the feasibility, acceptability, and appropriateness of the study protocol and Sparrow intervention for a firefighter population with AUD and co-occurring PTS symptoms.

Hypothesis 1a: The protocol and intervention will be feasible, acceptable, and appropriate, as indicated by mean scores of 4 or greater on the FIM, AIM, and IAM.

Hypothesis 1b: The trial will meet feasibility benchmarks, including a dropout rate ≤30%, ≥80% device adherence, >50% EMA completion, and ≥80% blinding effectiveness.

Exploratory Aim (1): Assess whether the results provide preliminary support for the efficacy of the active tAN device in reducing PTS symptoms and heavy drinking events compared to sham tAN.

Exploratory Hypothesis (1): Active tAN will result in larger mean pre-post reductions and a higher percentage of clinically meaningful change in PCL-5 total scores and heavy drinking events compared to active sham tAN.

Exploratory Aim (2): Develop longitudinal data analysis strategies to examine dynamic relationships between participants' duty status, ongoing trauma exposure, PTS symptoms, alcohol use/motives, autonomic arousal, sleep patterns, and device usage.

The long-term objective of this feasibility pilot is to use the data to validate the FDA clearance strategy, inform revisions to the study protocol, and support an R01 application for a fully powered Phase II RCT.

Being tested
Transcutaneous auricular neurostimulation (tAN), Active Sham
Keywords
posttraumatic stress symptoms, transcutaneous auricular neurostimulation, vagus nerve stimulation, trigeminal nerve stimulation, alcohol use disorder, firefighter
Medical subject headings
Alcoholism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transcutaneous auricular neurostimulation (tAN)Device

    Also called Sparrow Link

    The research version of Spark's Sparrow Ascent for vagus and trigeminal nerve stimulation provided through a disposable earpiece that attaches to the ear. The device allows the participant to self-administer stimulation when they choose.

  • Active ShamDevice

    Also called Sparrow Link

    Same research device as the active tAN condition, but programmed with active sham parameters such that the stimulation is sufficient to be felt on the skin, but subtherapeutic.

Study groups in NCT07868055
Study groupRoleWhat they receive
Active tANExperimentalTranscutaneous auricular neurostimulation (tAN) applied for at least 1 hour per day, for at least 5 days per week, for at 4 week treatment phase. Frequency: 25 Hz on ABVN region, 100Hz on ATN region; pulse width: 250 µs; duty cycle: 5 minutes on, 10 seconds off.
Receives: Device: Transcutaneous auricular neurostimulation (tAN)
Active ShamSham comparatorSame research device as the Active tAN condition, but programmed to deliver perceptible but subtherapeutic stimulation. Frequency: 1 Hz on outer region (ATN), Pulse width: up to 250 µs, Duty cycle: 1 minute on, 5 minutes off.
Receives: Device: Active Sham

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Protocol Feasibility as Assessed by the Feasibility of Intervention Measure (FIM)

    The FIM is a 4-item self-report questionnaire assessing the extent to which participants agree that the study protocol is feasible to implement. Items are rated on a 5-point Likert scale ranging from 1 ("Completely disagree") to 5 ("Completely agree"). Scores are calculated as an average across items (ranging from 1 to 5), with higher scores indicating greater feasibility. Feasibility success is predefined as a mean score of at least 4.

    Measured: Post-treatment (Week 4) and 1-month follow-up (Week 8)

Secondary outcomes (6)
  1. Protocol Acceptability as Assessed by the Acceptability of Intervention Measure (AIM)

    The AIM is a 4-item self-report questionnaire evaluating the degree to which participants perceive the study protocol to be acceptable. Items are rated on a 5-point Likert scale from 1 ("Completely disagree") to 5 ("Completely agree"). Scores are averaged across items (range: 1 to 5), where higher scores indicate greater acceptability (benchmark: mean at least 4).

    Measured: Post-treatment (Week 4) and 1-month follow-up (Week 8)

  2. Device Appropriateness as Assessed by the Intervention Appropriateness Measure (IAM)

    The IAM is a 4-item self-report questionnaire assessing the perceived fit, relevance, and suitability of the Sparrow device for this population. Items are rated on a 5-point Likert scale from 1 ("Completely disagree") to 5 ("Completely agree"). Scores are averaged across items (range: 1 to 5), with higher scores reflecting greater appropriateness (benchmark: mean at least 4).

    Measured: Post-treatment (Week 4) and 1-month follow-up (Week 8)

  3. Protocol Feasibility: Participant Retention Rate

    Calculated as the percentage of randomized participants who complete the study through the Week 4 assessment. A study dropout rate > 30% will indicate the need for protocol modification.

    Measured: Baseline (Week 0) through Week 4

  4. Protocol Feasibility: Sparrow Device Adherence Rate

    Calculated as the percentage of participants who adhere to the minimum required stimulation dosage (at least 1 hour/day, 5 days/week) for at least 75% of the 4-week active treatment period, measured via automated device usage logs. The feasibility benchmark is achieved if at least 80% of participants meet this threshold.

    Measured: Daily throughout the 4-week treatment phase (Weeks 1-4)

  5. Protocol Feasibility: Ecological Momentary Assessment (EMA) Completion Rate

    Calculated as the percentage of prompted daily EMA surveys successfully completed by participants across the 4-week active phase. An overall completion rate of 50% or below will indicate the need for protocol modification.

    Measured: Daily throughout the 4-week treatment phase (Weeks 1 through 4)

  6. Blinding Effectiveness Assessment

    Assessed by asking participants to guess their condition assignment (Active tAN vs. Active Sham) and their confidence in that guess. Effective blinding is operationalized as at least 80% of participants remaining blind to condition.

    Measured: Post-treatment (Week 4)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Oct 2026
  2. Study start1 Sep 2027 (estimated)
  3. Primary completion1 May 2028 (estimated)
  4. Study completion30 Jun 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Firefighters are randomly assigned to receive active tAN or active Sham for the treatment phase (4 weeks).
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07868055
Sponsor's protocol ID
R34AA032824
Other IDs
R34AA032824
Acronym
SANI-T
Status last verified
Oct 2026
First submitted
1 Oct 2026
Last updated
9 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: All de-identified human subjects data will be submitted to the NIAAADA. Proprietary Spark Biomedical, Inc. tAN protocols will not be shared. We will share non-proprietary syntax and software solutions created to publish findings from this project. We will upload supporting documents (e.g., study protocols, assessment schedules, data dictionaries, and analytic algorithms used for publications) to the NDA to facilitate reuse.

Questions about this trial

What is this clinical trial studying?

A study testing Transcutaneous auricular neurostimulation (tAN) in people with Posttraumatic Stress Symptoms and Heavy Alcoholic Consumption, run by University of Cincinnati.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 9 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Principal Investigator (513-287-9517, ucptsdstudy@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Protocol Feasibility as Assessed by the Feasibility of Intervention Measure (FIM) (time frame: Post-treatment (Week 4) and 1-month follow-up (Week 8)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Oct 2026.

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