What is SAINT™?
Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT™) is a novel treatment protocol developed by researchers at Stanford University for individuals with treatment-resistant depression (TRD). It is an enhanced form of repetitive transcranial magnetic stimulation (rTMS), a non-invasive method that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. SAINT™ modifies traditional rTMS by utilizing advanced imaging techniques to target brain regions more precisely and by accelerating the treatment protocol.
Indications for SAINT™
SAINT™ is indicated for individuals who have not achieved satisfactory improvement in their depressive symptoms, such as significant functional impairment, suicidal ideation, or persistent low mood, despite trying other treatment modalities like psychotherapy and multiple antidepressant medications. SAINT™'s accelerated treatment schedule makes it particularly suitable for individuals who require rapid relief from their depressive symptoms, such as those at risk of self-harm or hospitalization.
Preparation for SAINT™
In general, preparation for SAINT™ may involve the following steps:
- A thorough evaluation by a healthcare provider, including a psychiatrist and possibly a neurologist. The evaluation includes a review of medical history, current medications, previous treatments for depression, and assessment of depressive symptoms and severity.
- Functional magnetic resonance imaging (fMRI) to identify brain regions associated with mood regulation.
- Your provider will explain the treatment process in detail, including its potential benefits, risks, and side effects, and obtain your informed consent before proceeding.
- Your provider may also provide additional instructions to follow before each SAINT™ session. This may include avoiding certain foods or medications, refraining from alcohol or caffeine, and getting adequate sleep.
What Happens During a SAINT™ Session?
Based on the evaluation and neuroimaging findings, a personalized treatment plan is developed for each patient. The treatment plan includes the specific brain regions to target with transcranial magnetic stimulation (TMS) and the parameters for TMS pulse delivery. During each TMS session, the patient is seated comfortably, and a magnetic coil is placed on the scalp over the targeted brain region. The TMS device delivers magnetic pulses to stimulate nerve cells in the brain, modulating neural activity in the targeted areas. SAINT™ uses high-frequency repetitive TMS (rTMS), typically delivered at a frequency of 18 Hz. This is significantly higher than the standard 10 Hz used in conventional TMS treatments. Unlike traditional TMS treatments, which are usually administered once daily over several weeks, SAINT™ delivers multiple sessions per day over a shorter period. This accelerated schedule aims to provide rapid relief of depressive symptoms. EEG monitoring is used during TMS sessions to provide real-time feedback on brain activity. Advanced algorithms analyze EEG data to adjust the intensity, frequency, and timing of TMS pulses, optimizing the therapeutic effects based on individual brain responses.
Aftercare
Patients are usually observed for a short period after the session to ensure there are no immediate adverse effects. Most individuals can resume normal activities shortly after the treatment. Patients are typically scheduled for follow-up appointments with their mental health providers to assess their progress post-SAINT™. Regular monitoring helps track changes in depressive symptoms, identify any emerging issues or side effects, and make necessary adjustments to the treatment plan. Medication management, psychotherapy and counseling, and lifestyle modifications are typically recommended to support overall well-being and mood stability.
Risks and Side Effects
Generally, SAINT™ is considered safe and well-tolerated. However, it can cause some temporary side effects, such as:
- Mild pain or discomfort in the area of the treatment site
- Muscle twitching
- Jaw pain
- Fatigue
- Headaches
Benefits
Benefits of SAINT™ over traditional TMS include:
- Rapid Relief: Studies have shown that SAINT™ can produce rapid improvements in depressive symptoms, often within days, which is significantly faster than traditional rTMS and medication-based treatments.
- High Response Rates: Initial clinical trials have reported high response and remission rates among patients with TRD, suggesting that SAINT™ could be a valuable option for those who have not responded to other treatments.
- Non-Invasive: Like traditional rTMS, SAINT™ is a non-invasive procedure, meaning it does not require surgery or implantation of devices.
Summary
Stanford Accelerated Intelligent Neuromodulation Therapy or SAINT™ represents a significant advancement in the treatment of treatment-resistant depression. By combining precision targeting with an accelerated protocol, SAINT™ offers the potential for rapid and effective relief for patients who have not benefited from other interventions.
