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SAINT proven safe for patients with treatment-resistant depression

22 Apr 2020

The Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) is safe for use and is well tolerated by patients with treatment-resistant depression, a study has shown.

SAINT is an accelerated, high-dose resting-state functional connectivity magnetic resonance imaging (fcMRI)-guided intermittent theta-burst stimulation (iTBS) protocol for treatment-resistant depression.

The authors assessed the feasibility, tolerability and preliminary efficacy of SAINT in 22 patients with treatment-resistant depression. They used fcMRI in each participant to individually target the region of the left dorsolateral prefrontal cortex (DLPFC) most anticorrelated with subgenual anterior cingulate cortex (sgACC).

Participants underwent 50 iTBS sessions (1,800 pulses per session, 50-minute intersession interval), delivered as 10 daily sessions over 5 consecutive days at 90 percent resting motor threshold (adjusted for cortical depth). Neuropsychological testing was performed before and after SAINT.

Twenty-one patients were included in the analysis following the withdrawal of one participant. Of these, 19 (90.5 percent) met the remission criteria (defined as a score <11 on the Montgomery-Åsberg Depression Rating Scale). In intent-to-treat analysis, the same number of participants met the remission criteria (19 of 22; 86.4 percent).

In addition, no negative cognitive side effects were shown in neuropsychological testing.

“Double-blinded sham-controlled trials are needed to confirm the remission rate observed in this initial study,” the authors said, noting that new antidepressant treatments that are effective, safe, tolerable and rapid acting are essential.

A noninvasive brain stimulation treatment, iTBS has been approved by the US Food and Drug Administration for treatment-resistant depression.

According to the authors, recent methodological advances suggest that the current iTBS protocol has several points for improvement. It can be improved by “treating patients with multiple sessions per day at optimally spaced intervals, applying a higher overall pulse dose of stimulation, and precision targeting of the left DLPFC to sgACC circuit.”

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Most Read Articles
01 Dec 2020
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Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Jairia Dela Cruz, 3 days ago
Spending too much time sitting cannot be good for the body, and rising to one's feet breaks up such a behaviour and yields small, but meaningful, reductions in certain cardiovascular disease (CVD) risk factors, according to the results of a meta-analysis.
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Use of thyroid hormone therapy does not seem to protect older adults with subclinical hypothyroidism against mortality, but it appears to confer survival benefits to those aged <65 years, results of a study have shown.