Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial.
By E. Cole, A. Phillips, B. Bentzley, K. Stimpson, R. Nejad, Fahim Barmak, Clive Veerapal, Naushaba Khan, K. Cherian, Emily Felber and 20 more. American Journal of Psychiatry, 2021
609 citations recorded by the source corpus.
OBJECTIVE Depression is the leading cause of disability worldwide, and half of patients with depression have treatment-resistant depression. Intermittent theta-burst stimulation (iTBS) is approved by the U.S. Food and Drug Administration for the treatment of treatment-resistant depression but is limited by suboptimal efficacy and a 6-week duration. The authors addressed these limitations by developing a neuroscience-informed accelerated iTBS protocol, Stanford neuromodulation therapy (SNT; previously referred to as Stanford accelerated intelligent neuromodulation therapy, or SAINT). This protocol was associated with a remission rate of ∼90% after 5 days of open-label treatment. Here, the authors report the results of a sham-controlled double-blind trial of SNT for treatment-resistant depression. METHODS Participants with treatment-resistant depression currently experiencing moderate to severe depressive episodes were randomly assigned to receive active or sham SNT. Resting-state functional MRI was used to individually target the region of the left dorsolateral prefrontal cortex most functionally anticorrelated with the subgenual anterior cingulate cortex. The primary outcome was score on the Montgomery-Åsberg Depression Rating Scale (MADRS) 4 weeks after treatment. RESULTS At the planned interim analysis, 32 participants with treatment-resistant depression had been enrolled, and 29 participants who continued to meet inclusion criteria received either active (N=14) or sham (N=15) SNT. The mean percent reduction from baseline in MADRS score 4 weeks after treatment was 52.5% in the active treatment group and 11.1% in the sham treatment group. CONCLUSIONS SNT, a high-dose iTBS protocol with functional-connectivity-guided targeting, was more effective than sham stimulation for treatment-resistant depression. Further trials are needed to determine SNT's durability and to compare it with other treatments.
Subfields: Neurology
View Paper: https://www.semanticscholar.org/paper/e244e400ad19605c257a4623dc09a7d4fa31baed
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Citations in the corpus
- Theta-burst direct electrical stimulation remodels human brain networks (2024, unknown): “It clearly adds to the understanding of the effects, underlying mechanisms and factors that impact on TBS.”
- Closing the loop between brain and electrical stimulation: towards precision neuromodulation treatments (2023, background): “A recently cleared TMS protocol suggests fMRI as a new gold standard for individualized TMS that may play an important role in future clinical trials [169].”