The World Health Organization (WHO) has estimated that depression is the leading cause of disability worldwide. Health systems, faced with a shortage of mental health personnel, often resort to the prescription of antidepressants to treat cases of depression and, to a lesser extent, are provided to patients for psychological therapy.
A recently emerging alternative is accelerated intelligent neuromodulation therapy, developed by a group of scientists at Stanford University, which promises promising results in cases where depression does not go away after using usual treatments.
Accelerated Intelligent Neuromodulation Therapy was developed by a group of scientists at prestigious Stanford University to provide alternative treatment in cases where depression has resisted conventional treatments (eg, mind-altering drugs and psychological therapy), promising positive results.
In this article, we will explain how this innovative treatment for depression is applied and what the results were obtained by this group of researchers.
What is Intelligent Accelerated Neuromodulation Therapy?
This therapy arose in the face of the current situation in which there has been a dramatic increase in cases of depression., new treatments are therefore needed to combat depression, which act quickly and also offer a high degree of effectiveness, while being safe and tolerable for patients.
Stanford Intelligent Accelerated Neuromodulation Therapy (SAINT) from Stanford University School of Medicine is a therapeutic alternative to antidepressants and psychological therapy. was recently developed for cases of persistent depression, having given positive results in more than 80% of the study participants, although it should be noted that the sample was small, so it is necessary to know the results by doing it with a larger sample to see s ‘this is a reliable therapy.
How is it used?
Accelerated intelligent neuromodulation therapy is applied by intermittent theta-burst stimulation (iTBS), which is a type of non-invasive brain stimulation treatment for the treatment of persistent depression that has been resistant to other treatments such as psychotherapy and antidepressants.
This therapy suggests that the Intermittent Theta-Burst Stimulation (iTBS) protocol has been improved by following the following premises:
- Perform several sessions per day, with an optimal interval between sessions and for several days in a row.
- Apply a higher than usual dose of general pulse stimulation (1800 instead of 600).
- Focus precisely on the left dorsolateral prefrontal cortex and the anterior cingulate cortex.
To apply it, 50 sessions of 10 minutes are administered for 5 consecutive days (10 sessions / day) at 90% of the motor threshold at rest., receiving 1,800 pulses per session, with a 50-minute break between sessions. Prior to its application, Stanford researchers evaluated the safety, viability and efficacy on a preliminary basis of the accelerated intelligent neuromodulation therapy to ensure that patients are safe and do not experience any adverse effects upon receipt. processing.
Accelerated Intelligent Neuromodulation Therapy Experimental Study
Everyone who applied to participate in the study was prescribed by the University of Standford’s Depression Research Clinic.
To complete the Intelligent Accelerated Neuromodulation Therapy study, among all the volunteers who came forward to participate, 22 subjects aged between 19 and 78 years were chosen (13 women and 9 men) who met the criteria of the Diagnostic Manual. and statistics of Mental Disorders (DSM-5) of a major non-psychotic depressive episode or type II bipolar disorder and did not respond well to antidepressant medications to treat their mental disorder, so they had suffered symptoms of depression for years.
In addition, these participants were assessed with the Hamilton Depression Rating Scale, which was expected to score at least 20 points, indicating that they were suffering from severe depression. On another side, they were tested for drugs and the women also had to take a pregnancy test, who must give a negative result on both tests in order to participate in the study with the new therapy for depression.
The patients who came forward to participate in the study and were excluded were due to a history of seizures, pacemakers, or some type of neurological disorder, among others. There was also one participant who had been selected to participate in the study but the first day of stimulation had to leave after suffering from high levels of anxiety, so the study ended with 21 subjects, instead of 22, as expected.
Methods for the application of accelerated intelligent neuromodulation therapy
Prior to initiating stimulation as part of accelerated intelligent neuromodulation therapy, a pre-examination of the resting brain of all participants was performed by functional MRI and structural MRI.
Then they proceeded to the intelligent accelerated neuromodulation therapy which consisted of 10 sessions per day (1,800 pulses per session) lasting 5 consecutive days, so each patient received 90,000 pulses in full.
Additionally, before and after the Accelerated Intelligent Neuromodulation Therapy, a series of assessments were performed on all participants to determine if they were having thoughts of suicide, using the Severity Rating Scale. of Columbia’s suicide and their state of depression. Depression scale.
They also had to perform neurological tests to detect any neurological disorder that could lead to treatment, via the Hopkins verbal learning test, the Wechsler adult intelligence scale and a series of executive function tests from Delas Kaplan. .
Results of its effectiveness
The highlight of this study was that 19 of the 22 participants met all criteria for remission from depression, or 86.4% success, because the depression scale that was responded to at the end of treatment showed a score less than 11 points. Also, a reduction in suicidal ideation was found in these patients with persistent depression.
In addition, with the exception of one patient who had to leave on the first day due to symptoms of anxiety, the others did not experience any serious side effects and were able to complete all treatment sessions.
The only side effects reported by some of the treatment participants were feeling tired, some discomfort in the facial muscles, and headaches, but not overly bothersome. Also, pneumological tests did not show any negative effects after the end of treatment.
This study was also able to show that spaced sessions (with 50 minutes of rest between each session in this case) produced an accumulation of progress, so that improvements were shown for the remission of clinical symptoms, so it is likely that the Duration of the intervals between each of the treatment sessions is an important factor that must be taken into account when applying such treatments.
The results obtained from the study carried out with this innovative therapy for depression which have been detailed above have been very positive, which gives hope for the future. However, this was done with a very small sample so there is still a long way to go and it needs to be approved by the various drug federations and agencies in order to be administered more widely in hospitals around the world.
However, in this small sample There were fewer side effects than in a treatment approved by the US Drug Administration (FDA), which is “transcranial magnetic stimulation”. which is applied daily for a period of 6 weeks and has a success rate of around 50%, so it would be interesting to see more studies on accelerated intelligent neuromodulation therapy to see if it is a better alternative than the transcranial magnetic stimulation.