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| Name | Class |
|---|---|
| Tiny Blue Dot Foundation | OTHER |
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This open-label, randomized crossover study in healthy adults tests two propofol protocols to produce distinct experiential states. One induces brief loss of responsiveness with spontaneous emergence, intended to elicit dream reports; the other maintains light sedation without loss of responsiveness, intended to elicit non-dream experiences while participants remain responsive. The main goals are to (a) measure the protocol-concordant experiential report rate (how often each method produces its intended experience), (b) explore EEG correlates of these experiences in the two states, and (c) describe their phenomenology (what they are like). We will also examine short-term changes in well-being and sleep related to these experiences. Participants complete four sessions (two of each method) with EEG and routine monitoring, immediate post-session interviews, and brief questionnaires and daily sleep/dream logs before and after anesthesia sessions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Emergence-from-LOR Protocol | Experimental | Participants receive propofol titrated to loss of responsiveness (LOR) followed by maintenance and spontaneous emergence. This protocol is designed to elicit dream reports upon emergence (i.e., reports of subjective experiences occurring during the unresponsiveness period) |
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| No-LOR Light Sedation Protocol | Experimental | Participants receive propofol titrated stepwise to light sedation without LOR, maintaining responsiveness. This protocol is designed to elicit non-dream experiential reports while responsive (e.g., simple imagery, sounds, thoughts, bodily sensations, hypnagogic-like experiences). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Propofol - Emergence-from-LOR Protocol | Drug | Intravenous propofol infusion that meets the criteria: (1) maintenance of spontaneous ventilation, (2) sedation level corresponding to a Patient State Index (PSI) no lower than 25; and (3) loss of responsiveness (LOR) defined by the Richmond Agitation Sedation Scale (RASS) = -5 [unarousable]. Anesthesia is then maintained at that level for 30 minutes, followed by spontaneous emergence. |
| Measure | Description | Time Frame |
|---|---|---|
| Protocol-concordant experiential report | Presence vs absence of an experiential report elicited via a structured interview (modified Brice). "Protocol-concordant" is defined as: LOR protocol-success = any dream report upon emergence; Light-sedation (no-LOR) protocol-success = any experiential report that is not a dream (e.g., imagery, sounds, thoughts, bodily sensations, hypnagogic-like experiences) while the participant remained behaviorally responsive. | Assessed within 5 minutes of return of responsiveness (LOR protocol) or within 5 minutes of session end (light-sedation protocol). |
| Measure | Description | Time Frame |
|---|---|---|
| EEG correlates of protocol-concordant experiential outcome | EEG correlates of the two protocols/states, examining spectral band powers, band ratios, and other features during the matched windows and their association with protocol-concordant experiential outcomes. | Matched-duration EEG windows during the 30-minute maintenance period: pre-emergence window prior to return of responsiveness in the LOR protocol, and a time-matched window during maintenance in the no-LOR protocol. |
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Inclusion Criteria:
Exclusion Criteria:
Female of childbearing potential who is not willing to use one of the specified forms of birth control during the study.
Female that is pregnant or breastfeeding.
Female with a positive pregnancy test at screening or baseline.
Current diagnosis of a Substance Use Disorder (SUD; Abuse or Dependence, as defined by DSM-V) rated "moderate" or "severe", or Alcohol Use Disorder rated "moderate" or "severe". The following categories of SUD will NOT be excluded: nicotine dependence; alcohol or substance use disorder rated "mild"; alcohol or substance use disorder of any severity in remission, either early (3-12 months) or sustained (>12 months) time frames.
Current diagnosis of Axis I disorders other than Dysthymic Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder, Panic Disorder, Agoraphobia, Specific Phobia, or Bipolar II Disorder
History of schizophrenia or schizoaffective disorders, or any history of psychotic symptoms
History of anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, within five years of screening.
In the judgment of the investigator, the subject is at significant risk for suicidal behavior during the course of his/her participation in the study.
A neurological disorder including:
A cardiovascular disorder including:
A pulmonary/respiratory disorder including:
Clinically significant liver disease, determined by LFTs within the past 6 months.
Clinically significant kidney disease determined by creatinine / GFR within the past 6 months.
Symptomatic gastroesophageal reflux disease, hiatal hernia, or other gastrointestinal disorder placing patient at risk for aspiration or that would merit categorization of patient as ASA Class 3 or higher
Any endocrine disorder including:
Patients taking any of the following daily medications:
Any other clinically significant abnormal laboratory result at the time of the screening exam.
Has a clinically significant abnormality on the screening physical examination that might affect safety, study participation or confound interpretation of study results, including any condition that would merit categorization of patient as ASA Class 3 or higher.
Participation in any clinical trial with an investigational drug or device that conflicts with this trial, within the past month or concurrent to study participation.
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| Name | Affiliation | Role |
|---|---|---|
| Dr. Boris D Heifets, MD, PhD | Stanford University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Stanford University | Stanford | California | 94305 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35952341 | Background | Chow HS, Hack LM, Kawai M, Heifets BD. Anesthetic-Induced Intraoperative Dream Associated With Remission of a Psychiatric Disorder: A Case Report. A A Pract. 2022 Aug 10;16(8):e01613. doi: 10.1213/XAA.0000000000001613. eCollection 2022 Aug 1. | |
| 38476046 | Background | Hack LM, Sikka P, Zhou K, Kawai M, Chow HS, Heifets B. Reduction in Trauma-Related Symptoms After Anesthetic-Induced Intra-Operative Dreaming. Am J Psychiatry. 2024 Jun 1;181(6):563-564. doi: 10.1176/appi.ajp.20230698. Epub 2024 Mar 13. No abstract available. |
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Identifiers might be removed from identifiable private information and/or identifiable specimens and, after such removal, the information and/or specimens could be used for future research studies or distributed to another investigator for future research studies without additional informed consent from the participant.
The results of this research study may be presented at scientific or medical meetings or published in scientific journals without disclosing the identify of the participants (unless there is a separate consent from participants to reveal their identity).
After the completion of the study and upon publishing the results
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| Propofol - Light Sedation Protocol | Drug | Intravenous propofol infusion titrated stepwise to reach a state where participants are sedated but have behavioral responsiveness. Sedation is maintained at this level for 30 minutes. |
|
| Phenomenology of anesthesia experiences (analysis of narrative reports) | Transcriptions of audio-interviews and analysis of these using (i) codebook-based content analysis, (ii) phenomenological thematic/structural coding, and (iii) NLP-derived text features. | Interview immediately post-session |
| Phenomenology of anesthesia experiences (self-ratings) | Participants' own ratings of their anesthesia experiences: complexity, vividness, affect (valence/intensity), meaningfulness, dynamism/movement, bizarreness, perceived duration, the degree of mystical experiences (Mystical Experience Questionnaire; Barrett et al., 2015) and challenging experiences (Challenging Experience Questionnaire; Strickland et al., 2024). | Interview immediately post-session |
| Dream vs dream-like experiences (within-anesthesia) - phenomenological differences | Comparison of phenomenology between anesthesia dreams (LOR protocol) and dream-like experiences (light sedation no-LOR protocol) based on the analysis of narrative reports and self-ratings of the experiences | Interview immediately post-session |
| Home dreams vs anesthesia dreams - phenomenological differences | Differences in phenomenology of home dreams vs anesthesia dreams based on the analysis of narrative reports and self-ratings of these experiences | Home dream logs (2 weeks pre-session and 2 weeks post-session) vs anesthesia interview (immediate post-session). |
| Safety outcomes | Incidence of adverse events during anesthesia or recovery (e.g., PONV; hypoxemia; hypotension; airway intervention) and any serious adverse events per FDA criteria. | From pre-anesthesia baseline to post-anesthesia discharge |
| Changes in daily mood | As measured with the following mood scales: PANAS (Watson et al., 1988) and items from the 12-point Affect Circumplex (Yik et al., 2011) | Baseline (2-week pre-session average) to follow-up (2-week post-session average) |
| Change in well-being: life satisfaction | As measured with The Satisfaction With Life Scale (Diener et al., 1985) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in well-being: peace of mind | As measured with The Peace of Mind Scale (Lee et al., 2013) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in sleep quality | Change in sleep quality as measured using the Pittsburgh Sleep Quality Inventory (PSQI; Buysse et al., 1989) and daily sleep and dream diaries | Baseline (2-week pre-session) to follow-up (2-week post-session) |
| Change in dream outcomes | Change in dream recall frequency, occurrence of nightmares, nightmare distress as measured using the Mannheim Dream Questionnaire (MADRE; Schredl et al., 2014) and daily dream diaries | Baseline (2-week pre-session) to follow-up (2-week post-session). |
| Change in well-being: harmony in life | As measured with the Harmony in Life Scale (Kjell et al., 2016) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in well-being: psychological (eudaimonic) well-being | As measured with the Psychological Well-Being Scale (Ryff, 1989) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in alexithymia score | As measured with the Perth Alexithymia Questionnaire Short Form (Preece et al., 2023) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in emotion regulation | As measured with the Emotion Regulation Questionnaire (Gross & John, 2003) and the Perth Emotion Regulation Competency Index (Preece et al., 2018) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in symptoms of depression | As measured with the depression module of the Patient Health Questionnaire (PHQ9; Spitzer et al., 1999) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in symptoms of anxiety | As measured with the The Generalized Anxiety Disorder Scale (GAD-9; Spitzer et al., 2006) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |
| Change in perceived loneliness | As measured the 3-item UCLA Loneliness Scale (Hughes et al., 2004) | Baseline (2-weeks pre-anesthesia) to follow-up (2-weeks post-anesthesia) |