Accelerated intelligent neuromodulation therapy: what is it and how is it used?

This is accelerated intelligent neuromodulation therapy applied to depression.

The World Health Organization (WHO) has estimated that depression is the leading cause of disability worldwide. Health systems, faced with a lack of mental health personnel, often resort to prescribing antidepressants to treat cases of depression and, to a lesser extent, provide patients with psychological therapy.

A recently emerged alternative is the accelerated intelligent neuromodulation therapydeveloped by a group of scientists at Stanford University, which promises promising results in cases where depression does not remit after the usual treatments have been used.

Accelerated intelligent neuromodulation therapy has been developed by a group of scientists at the prestigious Stanford University in order to provide an alternative treatment in cases where depression has resisted conventional treatments (e.g., psychotropic 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.

What is accelerated intelligent neuromodulation therapy?

This therapy arose in the face of the current situation in which there has been a considerable increase in the number of cases of depression.Therefore, there is a need for new treatments for depression that are fast-acting and offer a high degree of efficacy, while also being safe and tolerable for patients.

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

How is it used?

The accelerated intelligent neuromodulation therapy is delivered through intermittent theta-burst stimulation (iTBS)which is a type of non-invasive brain stimulation therapy 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 could be improved by following the following premises:

• Perform several sessions per day, with an optimal interval between sessions and for several days in a row.
• Apply a higher than usual dose of general pulse stimulation (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 consecutive days (10 sessions/day) at 90% of the resting motor threshold.The patients received 1,800 pulses per session, with a 50-minute break between sessions. Prior to its application, the Stanford researchers assessed tolerability, feasibility and efficacy in a preliminary manner on accelerated intelligent neuromodulation therapy so that patients are safe and do not suffer any adverse effects when receiving the treatment.

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Experimental study on accelerated intelligent neuromodulation therapy.

All those who applied to participate in the study were prescribed through the Depression Research Clinic at Standford University.

To conduct the study on accelerated intelligent neuromodulation therapy, 22 subjects between the ages of 19 and 78 years (13 females and 9 males) who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of a nonpsychotic major depressive episode or bipolar disorder type II and had not responded well to Antidepressant medication to treat their mental disorder, so they had been suffering from depressive symptoms for several years.

In addition, these participants were assessed with the Hamilton Depression Rating Scale and had to score at least 20 points, indicating that they were suffering from severe depression. On the other hand, The women also had to take a drug test, and the women also had to take a pregnancy test.The patients who had applied to participate in the study were excluded because they had a history of seizures, cardiac pacemakers or some type of neurological disorder, among others.

Patients who had applied to participate in the study and were excluded were excluded because they had a history of seizures, cardiac pacemakers or some type of neurological disorder, among others. There was also one participant who had been selected to participate in the study but on the first day of stimulation had to drop out after suffering high levels of anxiety, so that the study ended up being conducted with 21 subjects, instead of 22 as planned.

Methods for applying accelerated intelligent neuromodulation therapy

Before starting the stimulation within the accelerated intelligent neuromodulation therapy, a previous examination of the resting brain of all participants was performed through a functional MRI and a structural MRI.

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

In addition, before and after the accelerated intelligent neuromodulation therapy they performed a series of assessments on all the participants to know if they had suicidal ideas, through the Columbia Suicide Severity Rating Scale and on the state of their depression through the Beck Depression Inventory and the Hamilton Depression Scale.

They also had to perform neurological tests to detect any neurological disturbances that could cause the treatment, through the Hopkins Verbal Learning Test, the Wechsler Adult Intelligence Scale and a series of tests on the executive functions of Delas Kaplan.

Results of its effectiveness.

The most noteworthy aspect of this study is that 19 of the 22 participants met all the criteria for remission of depression, which represents an 86.4% success rate, since on the depression scale answered at the end of the treatment they showed a score of less 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 on the first day because of anxiety symptoms, the rest did not suffer any serious adverse effects and were able to complete all the treatment sessions.

The only side effects reported by some of the participants in the treatment were the sensation of fatigue, some discomfort in the facial muscles and headache, but without being excessively bothersome. In addition, in the pneumological tests there were also no negative effects after the end of the treatment..

This study was also able to demonstrate that the spaced sessions (with 50 minutes of rest between each session in this case) produced an accumulation of advances, so 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 detailed above have been very positive, which is encouraging for the future. However, it has been carried out 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 in order to be administered more widely in hospitals around the world.

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