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Eleanor J. Cole, Angela Phillips, Brandon S. Bentzley, Katy H. Stimpson, Romina Nejad, Fahim Barmak, Clive Veerapal, Naushaba Khan, Kirsten N. Cherian, Emily Felber and 20 more
OBJECTIVE: Depression is the leading cause of disability worldwide, and half of patients with depression have treatment-resistant depression. Intermittent theta-burst stimulation (iTBS) is approved by the U.S. Food and Drug Administration for the treatment of treatment-resistant depression but is limited by suboptimal efficacy and a 6-week duration. The authors addressed these limitations by developing a neuroscience-informed accelerated iTBS protocol, Stanford neuromodulation therapy (SNT; previously referred to as Stanford accelerated intelligent neuromodulation therapy, or SAINT). This protocol was associated with a remission rate of ∼90% after 5 days of open-label treatment. Here, the authors report the results of a sham-controlled double-blind trial of SNT for treatment-resistant depression. METHODS: Participants with treatment-resistant depression currently experiencing moderate to severe depressive episodes were randomly assigned to receive active or sham SNT. Resting-state functional MRI was used to individually target the region of the left dorsolateral prefrontal cortex most functionally anticorrelated with the subgenual anterior cingulate cortex. The primary outcome was score on the Montgomery-Åsberg Depression Rating Scale (MADRS) 4 weeks after treatment. RESULTS: At the planned interim analysis, 32 participants with treatment-resistant depression had been enrolled, and 29 participants who continued to meet inclusion criteria received either active (N=14) or sham (N=15) SNT. The mean percent reduction from baseline in MADRS score 4 weeks after treatment was 52.5% in the active treatment group and 11.1% in the sham treatment group. CONCLUSIONS: SNT, a high-dose iTBS protocol with functional-connectivity-guided targeting, was more effective than sham stimulation for treatment-resistant depression. Further trials are needed to determine SNT's durability and to compare it with other treatments.
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Cole, E. J., Phillips, A., Bentzley, B. S., Stimpson, K. H., Nejad, R., Barmak, F., Veerapal, C., Khan, N., Cherian, K. N., Felber, E., Brown, R. E., Choi, E., King, S., Pankow, H., Bishop, J. H., Azeez, A., Coetzee, J. P., Rapier, R., Odenwald, N., … Williams, N. (2021). Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. American Journal of Psychiatry, 179(2), 132–141. https://doi.org/10.1176/appi.ajp.2021.20101429
Cole, Eleanor J., et al. "Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial." American Journal of Psychiatry, vol. 179, no. 2, 2021, pp. 132–141, https://doi.org/10.1176/appi.ajp.2021.20101429.
Cole, Eleanor J., Angela Phillips, Brandon S. Bentzley, Katy H. Stimpson, Romina Nejad, Fahim Barmak, Clive Veerapal, et al. "Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial." American Journal of Psychiatry 179, no. 2 (2021): 132–141. https://doi.org/10.1176/appi.ajp.2021.20101429.
Cole E. J., Phillips A., Bentzley B. S. [и др.] Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial // American Journal of Psychiatry. — 2021. — Vol. 179, № 2. — P. 132–141. — URL: https://doi.org/10.1176/appi.ajp.2021.20101429
@article{cole2021stanford,
title = {{Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial}},
author = {Eleanor J. Cole and Angela Phillips and Brandon S. Bentzley and Katy H. Stimpson and Romina Nejad and Fahim Barmak and Clive Veerapal and Naushaba Khan and Kirsten N. Cherian and Emily Felber and Randi E. Brown and Elizabeth Choi and Sinéad King and Heather Pankow and James H. Bishop and Azeezat Azeez and John P. Coetzee and Rachel Rapier and Nicole Odenwald and David M. Carreon and Jessica Hawkins and Maureen Chang and Jennifer Keller and Kristin Sharmila Raj and Charles DeBattista and Booil Jo and Flint M. Espil and Alan F. Schatzberg and Keith D. Sudheimer and Nolan Williams},
journal = {American Journal of Psychiatry},
year = {2021},
volume = {179},
number = {2},
pages = {132--141},
doi = {10.1176/appi.ajp.2021.20101429},
url = {https://doi.org/10.1176/appi.ajp.2021.20101429}
}TY - JOUR AU - Cole, Eleanor J. AU - Phillips, Angela AU - Bentzley, Brandon S. AU - Stimpson, Katy H. AU - Nejad, Romina AU - Barmak, Fahim AU - Veerapal, Clive AU - Khan, Naushaba AU - Cherian, Kirsten N. AU - Felber, Emily AU - Brown, Randi E. AU - Choi, Elizabeth AU - King, Sinéad AU - Pankow, Heather AU - Bishop, James H. AU - Azeez, Azeezat AU - Coetzee, John P. AU - Rapier, Rachel AU - Odenwald, Nicole AU - Carreon, David M. AU - Hawkins, Jessica AU - Chang, Maureen AU - Keller, Jennifer AU - Raj, Kristin Sharmila AU - DeBattista, Charles AU - Jo, Booil AU - Espil, Flint M. AU - Schatzberg, Alan F. AU - Sudheimer, Keith D. AU - Williams, Nolan TI - Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial JO - American Journal of Psychiatry VL - 179 IS - 2 SP - 132 EP - 141 PY - 2021 DA - 2021/10/29 DO - 10.1176/appi.ajp.2021.20101429 UR - https://doi.org/10.1176/appi.ajp.2021.20101429 ER -
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