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Updated: Dec 24, 2025

Targeted Neuronal Injury for the Non-Invasive Disconnection of Brain Circuitry

Targeted Neuronal Injury for the Non-Invasive Disconnection of Brain Circuitry

Published on: September 27, 2020

Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression.

Eleanor J Cole¹, Katy H Stimpson¹, Brandon S Bentzley¹

¹Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif.

The American Journal of Psychiatry

|April 8, 2020

Summary

This summary is machine-generated.

Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) shows high remission rates for treatment-resistant depression. This novel intermittent theta-burst stimulation (iTBS) protocol is safe, well-tolerated, and suggests a promising new treatment option.

Keywords:

Depression-Treatment Resistant Functional Connectivity Intermittent Theta-Burst Stimulation Precision Medicine Repetitive Transcranial Magnetic Stimulation Targeted Brain Stimulation

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Last Updated: Dec 24, 2025

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Published on: September 3, 2020

Area of Science:

Neuroscience
Psychiatry
Medical Imaging

Background:

Treatment-resistant depression (TRD) necessitates novel therapeutic approaches.
Intermittent theta-burst stimulation (iTBS) is an FDA-approved noninvasive brain stimulation for TRD.
Current iTBS protocols may be enhanced by increased session frequency, higher pulse dosage, and precision targeting.

Purpose of the Study:

To evaluate the feasibility, tolerability, and preliminary efficacy of the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) protocol.
SAINT is an accelerated, high-dose iTBS protocol guided by resting-state functional connectivity MRI (fcMRI).

Main Methods:

Twenty-two participants with TRD received open-label SAINT.
fcMRI identified optimal left dorsolateral prefrontal cortex (DLPFC) to subgenual anterior cingulate cortex (sgACC) targeting.
Fifty iTBS sessions were administered over 5 days at 90% resting motor threshold.

Main Results:

Ninety-five percent (19/21) of participants achieved remission based on Montgomery-Åsberg Depression Rating Scale scores.
An intent-to-treat analysis showed 86.4% (19/22) remission.
Neuropsychological testing revealed no adverse cognitive effects.

Conclusions:

SAINT, a high-dose, accelerated iTBS protocol with fcMRI-guided targeting, is safe and well-tolerated.
The observed remission rate warrants further investigation.
Future double-blind, sham-controlled trials are necessary to validate these findings.