In a new study, researchers found that a new form of magnetic brain stimulation rapidly relieved symptoms of severe depression in 90% of participants.
The researchers are conducting a larger, double-blinded trial in which half the participants are receiving fake treatment.
The researchers are optimistic the second trial will prove to be similarly effective in treating people whose condition hasn’t improved with medication, talk therapy or other forms of electromagnetic stimulation.
The research was conducted by a team at the Stanford University School of Medicine.
The treatment is called Stanford Accelerated Intelligent Neuromodulation Therapy, or SAINT.
It is a form of transcranial magnetic stimulation, which is approved by the Food and Drug Administration for the treatment of depression.
The researchers reported that the therapy improves on current FDA-approved protocols by increasing the number of magnetic pulses, speeding up the pace of the treatment and targeting the pulses according to each individual’s neurocircuitry.
Before undergoing the therapy, all 21 study participants were severely depressed, according to several diagnostic tests for depression. Afterward, 19 of them scored within the nondepressed range.
Although all of the participants had suicidal thoughts before the therapy, none of them reported having suicidal thoughts after treatment.
All 21 participants had previously not experienced improvements with medications, FDA-approved transcranial magnetic stimulation or electroconvulsive therapy.
The only side effects of the new therapy were fatigue and some discomfort during treatment, the study reported.
The team says there’s never been a therapy for treatment-resistant depression that’s broken 55% remission rates in open-label testing.
Electroconvulsive therapy is thought to be the gold standard, but it has only an average 48% remission rate in treatment-resistant depression. No one expected these kinds of results.
In transcranial magnetic stimulation, electric currents from a magnetic coil placed on the scalp excite a region of the brain implicated in depression.
The treatment, as approved by the FDA, requires six weeks of once-daily sessions. Only about half of patients who undergo this treatment improve, and only about a third experience remission from depression.
Stanford researchers hypothesized that some modifications to transcranial magnetic stimulation could improve its effectiveness.
Studies had suggested that a stronger dose, of 1,800 pulses per session instead of 600, would be more effective.
The researchers were cautiously optimistic of the safety of the treatment, as that dose of stimulation had been used without harm in other forms of brain stimulation for neurological disorders, such as Parkinson’s disease.
Other studies suggested that accelerating the treatment would help relieve patients’ depression more rapidly.
With SAINT, study participants underwent 10 sessions per day of 10-minute treatments, with 50-minute breaks in between.
After a day of therapy, Lehman’s mood score indicated she was no longer depressed; it took up to five days for other participants.
On average, three days of the therapy were enough for participants to have relief from depression.
The researchers also conjectured that targeting the stimulation more precisely would improve the treatment’s effectiveness.
In transcranial magnetic stimulation, the treatment is aimed at the location where most people’s dorsolateral prefrontal cortex lies.
This region regulates executive functions, such as selecting appropriate memories and inhibiting inappropriate responses.
For SAINT, the researchers used magnetic-resonance imaging of brain activity to locate not only the dorsolateral prefrontal cortex, but a particular subregion within it.
They pinpointed the subregion in each participant that has a relationship with the subgenual cingulate, a part of brain that is overactive in people experiencing depression.
The researchers plan to study the effectiveness of SAINT on other conditions, such as obsessive-compulsive disorder, addiction and autism spectrum disorders.
The study is published in the American Journal of Psychiatry.
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