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Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression

By Eleanor J. Cole, Ph.D., Katy H. Stimpson, B.S., Brandon S. Bentzley, M.D., Ph.D., Merve Gulser, B.S., Kirsten Cherian, Ph.D., Claudia Tischler, B.S., Romina Nejad, M.S., Heather Pankow, B.S., Elizabeth Choi, B.S., Haley Aaron, B.S., Flint M. Espil, Ph.D., Jaspreet Pannu, B.S., Xiaoqian Xiao, Ph.D., Dalton Duvio, B.S., Hugh B. Solvason, M.D., Jessica Hawkins, B.A., Austin Guerra, B.A., Booil Jo, Ph.D., Kristin S. Raj, M.D., Angela L. Phillips, Ph.D., Fahim Barmak, M.D., James H. Bishop, Ph.D., John P. Coetzee, Ph.D., Charles DeBattista, M.D., Jennifer Keller, Ph.D., Alan F. Schatzberg, M.D., Keith D. Sudheimer, Ph.D., Nolan R. Williams, M.D

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New antidepressant treatments are needed that are effective, rapid acting, safe, and tolerable. Intermittent theta-burst stimulation (iTBS) is a noninvasive brain stimulation treatment that has been approved by the U.S. Food and Drug Administration for treatment-resistant depression.

Recent methodological advances suggest that the current iTBS protocol might be improved through1) treating patients with multiple sessions per day at optimally spaced intervals, 2) applying a higher overall pulse dose of stimulation, and 3) precision targeting of the left dorsolateral prefrontal cortex (DLPFC) to subgenual anterior cingulate cortex (sgACC) circuit.

The authors examined the feasibility, tolerability, and preliminary efficacy of Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an accelerated, high-dose resting-state functional connectivity MRI (fcMRI)–guided iTBS protocol for treatment-resistant depression.

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