Accelerated Smart Neuromodulation Therapy: What It Is And How It Is Used

The World Health Organization (WHO) has estimated that the depression it is the leading cause of disability worldwide. Health systems, in the absence of mental health personnel, often resort to the prescription of antidepressants to treat depression and, to a lesser extent, given to therapy patients psychological.

A recently emerged alternative is accelerated smart neuromodulation therapy, developed by a group of scientists from Stanford University, which promises results hopeful in those cases in which the depression does not remit after having used the treatments usual.

Accelerated intelligent neuromodulation therapy has been developed by a group of scientists from the prestigious Stanford University with in order to be able to provide an alternative treatment in those cases in which depression has resisted conventional treatments (p. g., psychoactive drugs and psychological therapy), promising positive results.

In this article we will explain how this innovative treatment for depression is applied and what were the results obtained by this group of researchers.

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What is accelerated smart neuromodulation therapy?

This therapy arose from the current situation in which there has been a considerable increase in cases of depression, so new treatments are needed to combat depression that are fast acting and that also offer a high degree of effectiveness, being also safe and tolerable for patients.

Stanford University School of Medicine's “Accelerated Intelligent Neuromodulation Therapy” (“Stanford Accelerated Intelligent Neuromodulation Therapy ”- SAINT) is a therapeutic alternative to antidepressants and therapy psychological that has been developed recently for those cases of persistent depression, having given positive results in more than 80% of the study participants, although it should be noted that the The sample was small, so it is necessary to know the results by doing it with a larger sample to see if it is a therapy reliable.

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How is it used?

Accelerated Smart Neuromodulation Therapy applied through intermittent theta-burst stimulation (iTBS), which is a type of non-invasive brain stimulation treatment for the treatment of persistent depression that has resisted 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 a day, with an optimal interval between sessions and for several days in a row.
• Apply a dose of general pulse stimulation that is higher than usual (1,800 instead of 600).
• Focus precisely on the left dorsolateral prefrontal cortex and the anterior cingulate cortex.

For its application, 50 sessions of 10 minutes are administered for 5 days in a row (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, the Stanford researchers evaluated the tolerability, feasibility, and efficacy preliminarily over drug therapy. accelerated smart neuromodulation so that patients are safe and do not suffer any adverse effects when receiving the treatment.

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Experimental study on accelerated smart neuromodulation therapy

All those who came forward to participate in the study were prescribed through the Stanford University Depression Research Clinic.

To carry out the study on accelerated intelligent neuromodulation therapy, of all the volunteers who came forward to participate, 22 subjects were chosen with ages between 19 and 78 years (13 women and 9 men) who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from a non-psychotic major depressive episode or type II bipolar disorder and not having responded correctly to antidepressant medication to treat their mental disorder, which is why they had suffered from symptoms of depression for several years.

In addition, these participants were assessed with the Hamilton Depression Scale (Hamilton Depression Rating Scale), having to score at least 20 points, which indicates that they suffer from severe depression On the other hand, they had a drug test and the women also had to take a pregnancy test, having to give negative in both tests to be able to participate in the study with the new therapy for depression.

The patients who had come forward to participate in the study and were excluded, it was because had a history of seizures, cardiac pacemakers, or some type of neurological disorder, including others. There was also one participant who had been selected to participate in the study but had to drop out on the first day of stimulation. after suffering high levels of anxiety, so that the study concluded with 21 subjects, instead of 22, as was the case. provided.

Methods for applying accelerated smart neuromodulation therapy

Before starting the stimulation within the accelerated intelligent neuromodulation therapy, a previous examination of the resting brain of all participants through functional magnetic resonance imaging and magnetic resonance imaging structural.

They then proceeded with accelerated smart neuromodulation therapy consisting of 10 sessions each day (1,800 pulses per session) lasting 5 consecutive days, so each patient received 90,000 total pulses.

In addition, before and after accelerated smart neuromodulation therapy, they conducted a series of evaluations to all participants to find out if they had ideas. suicide, using the Columbia Suicide Severity Rating Scale and on the state of their depression through the Beck Depression Inventory and the Hamilton Scale on the Depression.

They also had to perform neurological tests to detect any neurological disturbances that the treatment could cause, through Hopkins Verbal Learning Test, Wechsler Adult Intelligence Scale, and Delas Executive Function Test Series Kaplan.

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Results of its effectiveness

The highlight of this study is that 19 of the 22 participants met all the criteria for depression remission, which It is an 86.4% success rate, since the depression scale answered at the end of the treatment showed a score lower than 11 points. In addition, a reduction in suicidal ideation was found in these patients with persistent depression.

In addition, except for one patient who had to drop out the first day due to symptoms of anxiety, the rest did not suffer serious adverse effects and were able to complete all sessions of the treatment.

The only side effects reported by some of the treatment participants were the sensation of fatigue, some discomfort in the facial muscles and headache, but without becoming excessively annoying. In addition, Neither negative effects were found in the pneumological tests after having concluded the treatment..

This study was also able to show that spaced sessions (with 50 minutes of rest between each session in this case) produced a accumulation of advances, such that improvements were shown by 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 to take into account when applying treatments of this type.

Conclusions.

The results obtained through the study carried out with this innovative therapy for depression that have been detailed above have been very positive, which is encouraging in the face of the future. However, it has been done with a very small sample, so there is still a long way to go and it has to be approved by the different federations and drug agencies to be able to be administered more widely in hospitals around the world. world.

However, in this small sample fewer side effects have been seen than in a treatment that has been approved by the US drug regulatory body (FDA), which is "transcranial magnetic stimulation" which is applied daily for a period of 6 weeks and offers a success rate of approximately 50%, so it would be interesting to be able to see more studies on accelerated smart neuromodulation therapy to see if it is a better alternative to magnetic stimulation transcranial.