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Every year, millions of patients seek treatment for depression, anxiety, and other psychiatric conditions. Existing therapies work for some, but over one-third exhaust treatment option after treatment option, with little or no relief.
Lives are at stake. Globally, one in six people suffers from a mood or anxiety disorder, and roughly 75 percent do not receive treatment, with sometimes dire consequences. The World Health Organization estimates that suicide claims a life every 40 seconds, and it is believed that for every suicide, 20 more are attempted. The economic toll is also significant. In the United States alone, annual costs related to treatment of depression, depression-related illnesses, and lost workplace productivity exceed $210 billion.
New treatments to modulate brain activity are needed now. Globally, prevalence of mood disorders is increasing. In the United States, suicide rates are increasing at a time when the capacity of inpatient facilities is faltering. Finding fast-acting, effective interventions has never been more urgent.
Taking up the challenge. Psychiatrist and neurologist Dr. Nolan Williams believed that repetitive trans-cranial magnetic stimulation (rTMS) held greater potential for those who had not responded to other first-line treatments. Dr. Williams developed tools to use brain stimulation to “speak to the brain using its own language.” He developed tools to precisely target brain networks and designed brain stimulation patterns and dosing that mimics how the brain learns to rewire itself. The result is SAINT.
Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) uses electro- magnetic pulses to mimic the language of the brain. Matched with state-of-the-art imaging techniques to uncover each individual patient’s unique brain networks, SAINT targets specific brain circuits and retrains the brain through a series of magnetic pulses that induce brain activity. The protocol uses higher doses than standard rTMS in shorter intervals. It also uses patterns of stimulation that provide time for the brain to build proteins needed for the brain to rewire itself, resulting in sustained changes in neural circuits. By speaking to the brain in its own language, the time commitment from the patient has been reduced from 6 weeks to 5 days and the effectiveness of TMS treatment is dramatically improved.
The results have been astonishing. A pilot study in treatment-resistant depression yielded tremendously exciting results. Analysis shows that 90 percent of the 31 patients enrolled in the study met remission criteria, using established depression scales. Not only did patients’ symptoms improve, but they improved to the point that they are indistinguishable from individuals who have never suffered from depression. The risk of suicide in these patients all but vanished. Perhaps most intriguing, this patient group included those who had sought ECT and traditional TMS without relief. Encouragingly, the therapeutic effects for most of the patients continued weeks and even months after treatment ended. Some patients have remained well for over a year. A re-treatment protocol was offered to study participants if needed to sustain results.
Maintaining momentum is critical. New studies and trials are underway.
Enabling hope around the world. When patients have tried everything medicine has to offer to no avail, they suffer and wait for something new to give them hope. SAINT is that something new. The culminating steps in fully realizing the potential of SAINT are a combination of donor and federally funded large multisite clinical trials. SAINT will then be disseminated to other medical centers, enabling countless people around the globe to benefit from research taking place here at Stanford. Additionally, the SAINT platform will inform other efforts to develop new, alternative neuromodulation therapies at Stanford and beyond its walls.