University of Iowa Health Care is home to one of the first academic medical centers in the U.S., and the first in the Midwest, offering a potentially groundbreaking treatment for those dealing with major depression.  

The new therapy is a form of transcranial magnetic stimulation (TMS), which UI Health Care has been using for years to treat depression, but advanced software helps identify which specific brain regions should receive the treatment. Known as SAINT® neuromodulation therapy (Stanford accelerated intelligent neuromodulation therapy), this intensive and personalized TMS treatment helps physicians like Nicholas Trapp, MD, UI assistant professor of psychiatry, to pinpoint the best location in each patient’s brain to target with TMS to treat major depressive disorder.  

“SAINT is one of the fastest-acting anti-depressant treatments available,” Trapp says. “It’s well tolerated by patients and early data suggests that up to 80 percent of patients experience remission of their depression symptoms, with effects often lasting months."

Trapp notes that side effects, including headache and fatigue, tend to go away once the TMS protocol is completed.  

Improving TMS effectiveness  

SAINT therapy uses structural and functional MRI (magnetic resonance imaging) to locate the exact part of the patient’s brain that should be stimulated with TMS. That region may be slightly different for each patient, so the MRI-guided localization personalizes the treatment for each patient.  

Unlike a standard course of TMS treatment, which is delivered in single, daily sessions over approximately six weeks, SAINT delivers the therapy in an intensive series of repeated treatments each day over just five days.

UI Health Care is one of only a handful of sites to begin using SAINT therapy after the company Magnus Medical licensed the technology from Stanford University and developed “neuronavigation” software, which uses MRI scans of the patient’s brain to calculate the best target for the magnetic stimulation and help guide clinicians to deliver precision stimulation.  

This targeting is unique to SAINT and studies suggest that it may improve the effectiveness of the TMS treatment. It is also the first time MRI imaging has been used to target treatment for a psychiatric disease (similar to how doctors use imaging to pinpoint the location of a tumor to precisely treat a patient’s cancer.)  

In addition to using the SAINT protocol on patients with major depression, the UI Health Care team will also conduct research studies to better understand how SAINT works so that the technology can continue to be refined and improved.  

"Brain stimulation holds tremendous promise as a treatment approach for illnesses that have failed to respond to traditional medications and psychotherapy efforts,” says Trapp, who also is co-director of interventional psychiatry in the UI Center for Noninvasive Brain Stimulation. “We are excited to be able to offer this advanced form of TMS to our patients, and to be part of the research community that’s actively exploring ways to improve this technology.”

In addition to Trapp, neurologist Aaron Boes, MD, PhD, and psychiatrist Anthony Purgianto, MD, PhD, are co-directors of the program.