Tag Archives: Stimulation

New brain stimulation technique cured 80% of major depression cases during trial run

We might soon have a reliable treatment for severe depression. New research at the Stanford University School of Medicine reports that a new type of magnetic brain stimulation was successful in treating almost 80% of participants with this condition.

Image via Pixabay.

The treatment approach is known as the Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), or Stanford neuromodulation therapy for short. It is an intensive, individualized transcranial magnetic stimulation therapy, and it shows great promise against severe depression — so far, in controlled trials. While effective, there are some side effects to this treatment: temporary fatigue and headaches.

All in all, the authors are confident that the benefits far outweigh the risks with SAINT, and they hope their work will pave the way towards new treatment options for many patients around the world.

A promising approach

“It works well, it works quickly and it’s noninvasive,” said Nolan Williams, MD, an assistant professor of psychiatry and behavioral sciences, and senior author of the study. “It could be a game changer.”

The study included 29 participants with treatment-resistant depression. They ranged in age from 22 to 80, and had suffered from depression for an average of nine years at the time of the study. All of these cases have proven to be resistant to medication. Participants who were on medication during the study maintained their regular dosage, but those who weren’t did not start any course during the treatment period.

They were split into two groups, one of which received the SAINT treatment, with the other receiving a placebo procedure that mimicked it. Five days into the treatment, 78.6% of the participants in the SAINT group no longer qualified for depression as judged using several evaluation efforts. The effects were sustained over time after the treatment had ceased, the authors note.

Current transcranial magnetic stimulation options that carry the approval of the Food and Drug Administration require six weeks of daily sessions, the authors explain. It’s effective in about half the patients who undergo such treatments, and only about a third show remission from depression following the treatment.

SAINT builds on these approaches by first targeting the pulses in different areas tailored after each patient’s neurocircuitry, and by delivering a greater number of magnetic pulses at a higher frequency.

In order to determine the particularities of each patient’s dorsolateral prefrontal cortex — an area of the brain involved in regulating executive functions –, the authors performed an MRI analysis on each participant before the start of the study. Their goal was to find the exact subregion in the brain that had the strongest functional link to the subgenual cingulate. This structure has been documented to exhibit heightened levels of activity in people experiencing depression. The goal of the magnetic stimulation treatment is to strengthen the link between the two areas in order to allow the dorsolateral prefrontal cortex to better control the activity in the subgenual cingulate.

The density of the pulses delivered in this trial was three times greater than that of currently-approved treatments: 1,800 per session compared to the regular number of 600. Finally, instead of providing one treatment session per day, the team gave their participants 10 10-minute treatments, with 50-minute breaks in between. The control group underwent ‘treatment’ with a magnetic coil that mimics the experience of the magnetic pulses.

Both groups wore noise-canceling earphones and received a topical ointment to dull sensation before each session.

Four weeks after the trial, 12 of the 14 participants in the experimental group showed improvements in their symptoms. According to FDA criteria for remission, 11 of them were officially cured of depression. In the control group, only 2 out of 15 patients met the criteria for remission.

The team is particularly interested in using SAINT to treat patients who are at a crisis point. Their study revealed that participants felt better and had attenuated symptoms within days of starting SAINT; this timeframe is much shorter than what is seen with medication, where improvements can take up to a month or more.

“We want to get this into emergency departments and psychiatric wards where we can treat people who are in a psychiatric emergency,” Williams said. “The period right after hospitalization is when there’s the highest risk of suicide.”

The paper “Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial” has been published in the American Journal of Psychiatry.

New magnetic brain stimulation technique relieved depression in 90% of the participants in a small-scale study

Researchers at the Stanford University School of Medicine have developed a form of magnetic brain stimulation that could ‘rapidly’ relieve symptoms of severe depression in 90% of participants in a small study.

Image via Pxhere.

Although the findings are limited by the small sample size so far, the team is working on a larger, double-blind trial to test the approach; in this trial, half of the patients will receive similar electromagnetic stimulation, while the other half will receive fake treatment. In this second trial, the team hopes to prove that their approach will be effective in treating people whose conditions are resistant to medication, talk therapy, or other forms of electromagnetic stimulation.

The real positive vibes

“There’s never been a therapy for treatment-resistant depression that’s broken 55% remission rates in open-label testing,” said Nolan Williams, MD, assistant professor of psychiatry and behavioral sciences and a senior author of the study. “Electroconvulsive therapy is thought to be the gold standard, but it has only an average 48% remission rate in treatment-resistant depression. No one expected these kinds of results.”

The method was christened Stanford Accelerated Intelligent Neuromodulation Therapy, or SAINT, and is a form of transcranial magnetic stimulation, an approach currently approved by the Food and Drug Administration for treatment for depression. Transcranial magnetic stimulation involves the use of a magnetic coil placed on the scalp to excite a region of the brain — in this case, those involved in depression.

Compared to other similar approaches, the SAINT method uses more magnetic pulses (1,800 pulses per session instead of the traditional 600), which helps speed up the pace of treatment, and focuses them depending on each patient’s particular neural architecture. Study participants underwent an accelerated treatment program compared to similar treatment approaches, 10 sessions per day of 10-minute treatments, with 50-minute breaks in between.

In their trial study, the team worked with 21 participants with severe depression — as determined by several diagnostic tests — which proved resistant to medication, FDA-approved transcranial magnetic stimulation, or electroconvulsive therapy. After receiving treatment, 19 of them scored within the nondepressed range, the team explains. All of the participants reported having suicidal thoughts before treatment, but none of them reported such thoughts afterward.

“There was a constant chattering in my brain: It was my own voice talking about depression, agony, hopelessness,” explains Deirdre Lehman, 60, one of the participants of the study. “I told my husband, ‘I’m going down and I’m heading toward suicide.’ There seemed to be no other option.”

There were some side effects of this treatment, but they were relatively minor: fatigue and some physical discomfort during treatment.

“By the third round, the chatter started to ease,” she said. “By lunch, I could look my husband in the eye. With each session, the chatter got less and less until it was completely quiet.”

“That was the most peace there’s been in my brain since I was 16 and started down the path to bipolar disorder.”

Although Lehman’s scores indicated that she was no longer depressed after a single day of therapy, it took up to five days for other participants to see the same results. Postdoctoral researcher Eleanor Cole, Ph.D., a lead author of the study, says that the “less treatment-resistant participants are, the longer the treatment lasts”.

The team evaluated each participant’s cognitive functions before and after treatment to ensure safety, and found no negative effects. One month after the therapy, 60% of participants were still in remission from depression. Follow-up studies are underway to determine the duration of the antidepressant effects, the team adds.

The researchers plan to study the effectiveness of SAINT on other conditions, such as obsessive-compulsive disorder, addiction, and autism spectrum disorders.

The paper “Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression” has been published in the American Journal of Psychiatry.

Roy Hamilton (left) is seen here fixing the apparatus that sent stimulated the prefrontal cortex of volunteers. The procedure reduced someone’s intent to commit a violent crime. Credit: Penn Medicine.

Scientists control aggressive and criminal tendencies by zapping the brain

Credit: Pixabay.

Credit: Pixabay.

In a new study that’s sure to raise some eyebrows, researchers performed transcranial direct-current stimulation on volunteers (i.e. zapped their brains) and saw a significant reduction in violent tendencies. The procedure might be useful in treating some patients or criminals who suffer from mental illness and display aggressive, antisocial behavior.  

The aggression trigger

It makes sense to target specific brain areas in order to elicit or inhibit certain behaviors. Our personalities are quite fragile, as Janet Cromer can attest. Cromer’s husband, Alan, used to have a personality which his wife described as being marked by “kindness, love, curiosity, and humor.” A severe anoxic brain injury following a massive heart attack and cardiac arrest, however, rewired Alan’s brain and changed his personality, turning the man into an incredibly moody individual marked by unpredictable bouts of anger and confusion. Cromer compared her husband to Jekyll and Hyde.

A 2009 study found that aggression is a common byproduct of traumatic brain injury (TBI), having a prevalence of 28.4% in a sample of 67 participants, predominantly as verbal aggression. And one cannot discuss traumatic brain injury and its potential to distort personality without mentioning the famous case of Phineas Gage, also known as “the man with a hole in his head.”

Gage and his “constant companion”‍—‌his inscribed tamping iron‍—‌sometime after 1849. Credit: Wikimedia Commons.

A railway worker in Vermont, US, Phineas was responsible for clearing away rocks in order for railway tracks to be laid down. For really big rocks, he would drill a hole in the ground, set explosives, then light a fuse to blow up the ruble. On September 13th 1848, this routine procedure took a turn for the worst when an iron rod scraped the side of a rock, lighting a spark that set off the gunpowder early. The iron rod — one meter long and 3 cm in diameter — plunged right into his skull, just under his left eye, landing some 30 meters away.

Phineas remarkably survived another 12 years, but his life was changed forever. The man became unpredictable, often swearing and making inappropriate remarks out of the blue. Psychiatrists today would class him as ‘disinhibited’, meaning he no longer cared for norms in a social and emotional context. For science, this was an important moment, however — Phineas’ case was one of the first to demonstrate that damage to the brain could affect our behavior and personality.

For some time, modern science has known that the prefrontal cortex is linked to the control of aggressive behavior, with damage to this brain area being associated with more violent and antisocial behavior. It was never clear, however, whether damage to prefrontal cortex drive violent behavior or some other reason might be at play.

A reverse lobotomy

Roy Hamilton (left) is seen here fixing the apparatus that sent stimulated the prefrontal cortex of volunteers. The procedure reduced someone’s intent to commit a violent crime. Credit: Penn Medicine.

Roy Hamilton (left) is seen here fixing the apparatus that sent stimulated the prefrontal cortex of volunteers. The procedure reduced someone’s intent to commit a violent crime. Credit: Penn Medicine.

Researchers at the University of Pennsylvania in Philadelphia and the Nanyang Technological University in Singapore designed an experiment in which they investigated what happened when they would stimulate the prefrontal cortex with electric currents.

“The ability to manipulate such complex and fundamental aspects of cognition and behavior from outside the body has tremendous social, ethical, and possibly someday legal implications,” said Roy Hamilton, a neurologist at Penn’s Perelman School of Medicine and the senior paper author.

They recruited 86 healthy adult participants, half of whom were given 20 minutes of non-invasive brain stimulation, half of whom were given a mild low-current stimulation for 30 seconds. This was a randomized double-blinded trial, meaning neither the participants nor the people running the experiment knew who was assigned what. Each participant was asked to read two hypothetical scenarios, one about a physical assault (someone bashing a glass on a fellow’s head for chatting up his girlfriend) and one about sexual assault (intimate foreplay leads to rape).

After the transcranial-stimulation sessions, each person was asked how likely they would be to picture themselves as the person perpetrating the violence in those scenarios, on a scale from 0 (completely unlikely) to 10 (extremely likely). They were also asked to rate how morally reprehensible these acts felt to them.

The people in the group who had the electrical stimulation were 47% and 70%, respectively, less likely to relate to the violent person depicted in the two scenarios than the control group (mild stimulation).

In order to pacify or treat extremely violent individuals suffering from various mental illness, historically, doctors have always manipulated the brain in some way. In the past, for instance, frontal lobotomies — an extremely invasive procedure that involves severing fiber tracts connected to the frontal lobe — were routinely used.

Now, rather than removing parts of the brain linked to potentially aggressive behavior, the team of researchers chose to stimulate them. Counter-intuitively to the old school of thought, violent tendencies were actually reduced.

“Historically we haven’t taken this kind of approach to interventions around violence. But this has promise. We only did one 20-minute session, and we saw an effect. What if we had more sessions? What if we did it three times a week for a month?” said psychologist Adrian Raine, a Penn Integrates Knowledge Professor and co-author on the paper.

The findings suggest that this simple, non-invasive biological intervention — either separate or in conjunction with traditional psychological interventions such as cognitive behavioral therapy — could have the potential to reduce violent behavior at large. Before this happens, however, more studies are needed to assess the efficacy of the procedure; the findings need to be replicated and validated with a larger sample size. Additionally, the long-term effects of such an intervention need to be assessed.

“This is not the magic bullet that’s going to wipe away aggression and crime,” Raine says. “But could transcranial direct-current stimulation be offered as an intervention technique for first-time offenders to reduce their likelihood of recommitting a violent act?”

“Perhaps,” Hamilton concludes, “the secret to holding less violence in your heart is to have a properly stimulated mind.”

The findings appeared in the Journal of Neuroscience.

Game

Scientists fed a game into players’ brains to pave the way for artificial senses

University of Washington researchers have hooked some people’s brains up to a computer and asked them to play a simple game — no monitor, speakers, or other stimulus included. And it worked. This is a vital first step in showing how humans can interact with virtual realities only through direct brain stimulation.

Game

Test subjects demonstrating how humans can interact with virtual realities via direct brain stimulation.
Image credits University of Washington.

“The way virtual reality is done these days is through displays, headsets and goggles, but ultimately your brain is what creates your reality,” said UW professor of Computer Science & Engineering and senior author Rajesh Rao.

The paper describes the first case of humans playing a simple, 2D computer game only through input from direct brain stimulation. Five players were presented with 21 different mazes to navigate, with a choice to move forward or down. The game offered them information of obstacles in the form of a phosphene, perceived blobs or bars of light generated through transcranial magnetic stimulation — a technique that uses magnetic coils placed near the skull to stimulate specific areas of the brain.

“The fundamental question we wanted to answer was: Can the brain make use of artificial information that it’s never seen before that is delivered directly to the brain to navigate a virtual world or do useful tasks without other sensory input? And the answer is yes.”

The participants made the right move (avoided obstacles) 15% of the time when they didn’t receive any input. But under direct brain stimulation, they made the right move 92% of the time. They also got better at the game the more they practiced their hand at detecting the artificial stimuli. This goes to show that new information — from artificial sensors or computers — can be successfully encoded and transmitted to the brain to solve tasks. The technology behind the experiment — transcranial magnetic stimulation — is usually employed to study how the brain works, but the team showed how it can be used to convey information to the brain instead.

“We’re essentially trying to give humans a sixth sense,” said lead author Darby Losey.

“So much effort in this field of neural engineering has focused on decoding information from the brain. We’re interested in how you can encode information into the brain.”

This trial was intended as a proof of concept and as such used a very simple binary system — whether a phosphene was present or not — as feedback for the players. But the experiment shows that in theory, the approach can be used to transmit information from any sensor, such as cameras or ultrasounds — to the brain. Even a binary system such as the one used for the game can give a lot of help to certain individuals, such as helping the blind navigate.

“The technology is not there yet — the tool we use to stimulate the brain is a bulky piece of equipment that you wouldn’t carry around with you,” said UW assistant professor of psychology and co-author Andrea Stocco.

“But eventually we might be able to replace the hardware with something that’s amenable to real world applications.”

The team is currently investigating how to create more complex perceptions of various senses by modulating the intensity and location of stimulation in the brain.

“Over the long term, this could have profound implications for assisting people with sensory deficits while also paving the way for more realistic virtual reality experiences,” Rao concluded.

The full paper “Navigating a 2D Virtual World Using Direct Brain Stimulation” has been published in the journal Frontiers in Robotics.

Georgetown University team found you can literally zap creativity into your brain

Electrically stimulating the frontopolar cortex can enhance creativity, a new study from Georgetown University found.

Image credits aboutmodafinil.com (Creative Commons)

We tend to think of creativity as something you’re either born with or you’re not; that some people are just wired to be artists while others couldn’t paint to save their life. But this trait stems from your brain, and psychology professor Adam Green, Dr. Peter Turkeltaub from Georgetown University Medical Center (GUMC) and their team found that this organ can be coaxed into thinking more creatively.

“We found that the individuals who were most able to ramp up activity in a region at the far front of the brain, called the frontopolar cortex, were the ones most able to ramp up the creativity of the connections they formed,” Green explains. “Since ramping up activity in frontopolar cortex appeared to support a natural boost in creative thinking, we predicted that stimulating activity in this brain region would facilitate this boost, allowing people to reach higher creative heights.”

And it worked; by stimulating test subjects’ brains using tDCS (transcranial direct current stimulation) in combination with verbal cues, the participants could be made to think more creatively. Then the tDCS was focused on the frontopolar cortex, subjects formed more creative analogical connections between sets of words the researchers gave them to use. They also thought of more and more creative associations between these words.

“This work is a departure from traditional research that treats creativity as a static trait,” Green adds. “Instead, we focused on creativity as a dynamic state that can change quickly within an individual when they ‘put their thinking cap on.’ ”

“The findings of this study offer the new suggestion that giving individuals a “zap” of electrical stimulation can enhance the brain’s natural thinking cap boost in creativity,” he concludes.

The researchers write that their results offer “novel evidence” that tDCS can be used to enhance “conscious augmentation of creativity elicited by cognitive intervention” and extends the known boundaries of tDCS enhancement “to analogical reasoning, a form of creative intelligence that is a powerful engine for innovation.”

Dr. Turkletaub, a cognitive neurologist with the GMUC, hopes that their method of brain stimulation used in conjunction with verbal cues will one day be used to help people with brain disorders.

“People with speech and language difficulties often can’t find or produce the words they need,” he explains. “Enhancing creative analogical reasoning might allow them to find alternate ways of expressing their ideas using different words, gestures, or other approaches to convey a similar meaning.”

Electrical brain stimulation has also been shown to improve learning. Still, Turkeltaub and Green caution that while their results show promise, “it is important to be cautious about applications of tDCS.” This method’s full effects on brain function are still unknown, and experimental data gathered up to know needs further replication before researchers can safely apply it.

“Any effort to use electric current for stimulating the brain outside the laboratory or clinic could be dangerous and should be strongly discouraged,” Green cautioned.

The full paper, titled “Thinking Cap Plus Thinking Zap: tDCS of Frontopolar Cortex Improves Creative Analogical Reasoning and Facilitates Conscious Augmentation of State Creativity in Verb Generation” has been published online in the journal Cerebral Cortex and can be read here..