Effective, fast-acting therapies for psychiatric disorders have been far too elusive. We are radically changing this dynamic.
The mission of the Brain Stimulation Lab (BSL) is to invent, develop, and refine neuromodulatory techniques and use them to probe the underlying neural networks of neuropsychiatric disease. We aim to use innovative technologies both to identify biomarkers of pathological states underlying brain disease and to elucidate mechanisms of treatment response, with the ultimate goal of creating personalized, rapidly effective, and safe treatments.
Towards these ends, we employ a variety of standard and modified neuromodulatory techniques, both non-invasive and invasive, such as transcranial magnetic stimulation (TMS), focused ultrasound, electroconvulsive therapy, vagus nerve stimulation, and deep brain stimulation. To study brain networks we combine neuromodulation with electrophysiology and structural and functional MRI. We strive to use these technologies to build a bridge between the structurally ambiguous neural networks of psychiatric illnesses and the more readily observed neuroanatomical pathology associated with more traditional neurological illness.
Questions we routinely ask in our studies include which brain networks are of interest to a particular psychiatric condition, how can we functionally visualize these brain regions, and what type of neuromodulation might be used to treat the dysfunction and thereby restore an individual’s health? Disorders of interest to our lab include treatment-resistant depression (unipolar and bipolar), obsessive-compulsive disorder, suicide, mania, addiction, chronic pain, borderline personality disorder, depression associated with Parkinson’s disease, and persistent tic disorders.
Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT)
One example of this approach is our recently developed personalized, accelerated TMS protocol known as Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT). SAINT merges advanced imaging technologies with targeted, higher-dosed, and spatially optimized intermittent theta-burst stimulation (a more efficient form of traditional transcranial magnetic stimulation) to treat severe, treatment-resistant depression. The results of the pilot trial showed that SAINT is safe and well tolerated. 90 percent of the 31 patients went into remission from depression based on widely accepted clinical research criteria. In addition to being life-changing, SAINT may also have been lifesaving for some of these patients: within two weeks, thoughts of suicide improved dramatically in all groups. Importantly, these improvements were associated with changes in specific functional brain networks targeted by the treatment. Positive results from a follow-up, sham-controlled study will be published shortly. We view the success of SAINT as validation of our scientific approach, and it further motivates us to continue to improve these methodologies and apply them more broadly.