What is Stanford neuromodulation therapy (SNT) and how effective is it for treatment-resistant depression?

Transcranial magnetic stimulation (rTMS) is a noninvasive form of brain stimulation in which a magnetic field is used to cause electric current at a specific area of the brain through electromagnetic induction. Stanford neuromodulation therapy, or SNT, is a new type of rTMS that uses 1) an efficient form of rTMS, termed intermittent theta-burst stimulation (iTBS); 2) treatment with multiple iTBS sessions per day at optimally spaced intervals; 3) application of a higher overall pulse dose of stimulation; and 4) personalized targeting of the stimulation using functional imaging technology.

A small randomized trial treated participants who had treatment-resistant depression with either active (N=14) or sham (N=15) SNT. The study found the mean percent reduction from baseline on Montgomery-Åsberg Depression Rating Scale score 4 weeks after treatment was 52.5% in the active treatment group and 11.1% in the sham treatment group. No serious side effects were reported.

Further research in larger and more representative samples is needed to evaluate the potential for more widespread use of SNT in community settings. If the findings from this study are replicated, this form of rTMS may prove to be a promising approach for addressing treatment-resistant depression.



Cole EJ et al. Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial. Am J Psychiatry. 2021 Oct 29:appiajp202120101429.

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