FDA通過史丹佛加速智慧神經調節療法(SAINT)
Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT)
(On September 6, 2022, the U.S. Food and Drug Administration cleared the way for marketing of a rapid-acting brain-stimulation approach for major depressive disorder pioneered by Nolan Williams, M.D., of Stanford University, and colleagues.)
重點:
1. 需使用fMRI定位(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.)
2. 一天10次連續五天(Fifty iTBS sessions (1,800 pulses per session, 50-minute intersession interval) were delivered as 10 daily sessions over 5 consecutive days at 90% resting motor threshold (adjusted for cortical depth).
方法：目前正在經歷中度至重度憂鬱發作的難治性憂鬱症的參與者被隨機分配接受主動或假 SNT。靜息狀態fMRI 用於單獨針對與膝下前扣帶皮層功能最不相關的左背外側前額葉皮層區域(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.)。主要結果是治療 4 週後蒙哥馬利-埃斯伯格憂鬱量表 (MADRS) 的評分。
結果：在計劃的中期分析中，32 名患有難治性憂鬱症的參與者被納入研究，29 名繼續滿足納入標準的參與者接受了主動（N=14）或假（N=15）SNT。治療後 4 週，MADRS 評分從基線的平均下降百分比在積極治療組和假治療組分別為 52.5% 和 11.1%。
結論：SNT 是一種具有功能連接引導靶向的高劑量 iTBS 方案，對於難治性憂鬱症比假刺激更有效。需要進一步的試驗來確定 SNT 的耐受性並將其與其他治療方法進行比較。
參考論文
Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. Cole EJ,et al. Am J Psychiatry. 2022 Feb;179(2):132-141.
Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression. Cole EJ, et al. Am J Psychiatry. 2020 Aug 1;177(8):716-726.
美國TMS醫學會線上課程
新聞來源
https://www.cw.com.tw/article/5119893
https://www.bbrfoundation.org/content/fda-clears-saint-rapid-acting-brain-stimulation-approach-those-suffering-resistant-major
