Stanford Advisors


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  • Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. The American journal of psychiatry Cole, E. J., Phillips, A. L., Bentzley, B. S., Stimpson, K. H., Nejad, R., Barmak, F., Veerapal, C., Khan, N., Cherian, K., Felber, E., Brown, R., Choi, E., King, S., Pankow, H., Bishop, J. H., Azeez, A., Coetzee, J., Rapier, R., Odenwald, N., Carreon, D., Hawkins, J., Chang, M., Keller, J., Raj, K., DeBattista, C., Jo, B., Espil, F. M., Schatzberg, A. F., Sudheimer, K. D., Williams, N. R. 2021: appiajp202120101429

    Abstract

    OBJECTIVE: Depression is the leading cause of disability worldwide, and half of patients with depression have treatment-resistant depression. Intermittent theta-burst stimulation (iTBS) is approved by the U.S. Food and Drug Administration for the treatment of treatment-resistant depression but is limited by suboptimal efficacy and a 6-week duration. The authors addressed these limitations by developing a neuroscience-informed accelerated iTBS protocol, Stanford neuromodulation therapy (SNT; previously referred to as Stanford accelerated intelligent neuromodulation therapy, or SAINT). This protocol was associated with a remission rate of 90% after 5 days of open-label treatment. Here, the authors report the results of a sham-controlled double-blind trial of SNT for treatment-resistant depression.METHODS: Participants with treatment-resistant depression currently experiencing moderate to severe depressive episodes were randomly assigned to receive active or sham SNT. Resting-state functional MRI was used to individually target the region of the left dorsolateral prefrontal cortex most functionally anticorrelated with the subgenual anterior cingulate cortex. The primary outcome was score on the Montgomery-Asberg Depression Rating Scale (MADRS) 4 weeks after treatment.RESULTS: At the planned interim analysis, 32 participants with treatment-resistant depression had been enrolled, and 29 participants who continued to meet inclusion criteria received either active (N=14) or sham (N=15) SNT. The mean percent reduction from baseline in MADRS score 4 weeks after treatment was 52.5% in the active treatment group and 11.1% in the sham treatment group.CONCLUSIONS: SNT, a high-dose iTBS protocol with functional-connectivity-guided targeting, was more effective than sham stimulation for treatment-resistant depression. Further trials are needed to determine SNT's durability and to compare it with other treatments.

    View details for DOI 10.1176/appi.ajp.2021.20101429

    View details for PubMedID 34711062

  • Resting-State Functional Connectivity: Signal Origins and Analytic Methods NEUROIMAGING CLINICS OF NORTH AMERICA Chen, K., Azeez, A., Chen, D. Y., Biswal, B. B. 2020; 30 (1): 15-+

    Abstract

    Resting state functional connectivity (RSFC) has been widely studied in functional magnetic resonance imaging (fMRI) and is observed by a significant temporal correlation of spontaneous low-frequency signal fluctuations (SLFs) both within and across hemispheres during rest. Different hypotheses of RSFC include the biophysical origin hypothesis and cognitive origin hypothesis, which show that the role of SLFs and RSFC is still not completely understood. Furthermore, RSFC and age studies have shown an "age-related compensation" phenomenon. RSFC data analysis methods include time domain analysis, seed-based correlation, regional homogeneity, and principal and independent component analyses. Despite advances in RSFC, the authors also discuss challenges and limitations, ranging from head motion to methodological limitations.

    View details for DOI 10.1016/j.nic.2019.09.012

    View details for Web of Science ID 000504338300004

    View details for PubMedID 31759568

  • Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT-TRD) induces rapid remission from treatment-resistant depression in a double-blinded, randomized, and controlled trial. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation Phillips, A., et al 2020; 13 (6): 1859-1860
  • Disrupted focal white matter integrity in autism spectrum disorder: A voxel-based meta-analysis of diffusion tensor imaging studies PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY Di, X., Azeez, A., Li, X., Haque, E., Biswal, B. B. 2018; 82: 242-248

    Abstract

    Autism spectrum disorder (ASD) is a mental disorder that has long been considered to result from brain underconnectivity. However, volumetric analysis of structural MRI data has failed to find consistent white matter alterations in patients with ASD. The present study aims to examine whether there are consistent focal white matter alterations as measured by diffusion tensor imaging (DTI) in individuals with ASD compared with typically developing (TD) individuals.Coordinate-based meta-analysis was performed on 14 studies that reported fractional anisotropy (FA) alterations between individuals with ASD and TD individuals. These studies have in total 297 subjects with ASD and 302 TD subjects.Activation likelihood estimation (ALE) analysis identified two clusters of white matter regions that showed consistent reduction of FA in individuals with ASD compared with TD individuals: the left splenium of corpus callosum and the right cerebral peduncle.Consistent focal white matter reductions in ASD could be identified by using FA, highlighting the cerebral peduncle which is usually overlooked in studies focusing on major white matter tracts. These focal reductions in the splenium and the cerebral peduncle may be associated with sensorimotor impairments seen in individuals with ASD.

    View details for DOI 10.1016/j.pnpbp.2017.11.007

    View details for Web of Science ID 000424701600023

    View details for PubMedID 29128446

    View details for PubMedCentralID PMC5800966

  • A Review of Resting-State Analysis Methods NEUROIMAGING CLINICS OF NORTH AMERICA Azeez, A. K., Biswal, B. B. 2017; 27 (4): 581-+

    Abstract

    Resting-state functional connectivity is the synchronization of brain regions with each another. Alterations are suggestive of neurologic or psychological disorders. This article discusses methods and approaches used to describe resting-state brain connectivity and the results in neurotypical and diseased brains.

    View details for DOI 10.1016/j.nic.2017.06.001

    View details for Web of Science ID 000414275000005

    View details for PubMedID 28985930