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The Effects of Stanford Accelerated Intelligent Neuromodulation Therapy on Explicit and Implicit Suicidal Cognition

Award Number: R01MH125160
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2020
PERIOD OF PERFORMANCE END DATE: 02/28/2025

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The Effects of Stanford Accelerated Intelligent Neuromodulation Therapy on Explicit and Implicit Suicidal Cognition - ABSTRACT The overarching aim of this proposal is to test the efficacy and safety of a highly efficient and personalized repetitive transcranial magnetic stimulation (rTMS) method, termed Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT). In this proposal, we will utilize SAINT as a rapid-acting intervention for the reduction of explicit and implicit suicidal cognition within the context of an emergency psychiatric admission for suicidal thoughts and behaviors. Although rTMS is FDA approved for treatment-resistant depression (TRD), the average required treatment application is 6 weeks before signs of symptomatic improvement, which is not an optimal strategy for symptomatic treatment of an acute suicidal crisis. This application is motivated by three recent findings in the neuromodulation field. First is a sham-controlled pilot study evaluating an accelerated conventional rTMS protocol, where multiple stimulation sessions were safely delivered to the left dorsolateral prefrontal cortex (L-DLPFC) across three days in patients with suicidal ideation. This study demonstrated that conventional rTMS can be ‘accelerated’ as well as demonstrated a signal of reductions in explicit suicidal cognition. Second, there are two notable randomized trials of intermittent theta-burst stimulation applied to the L-DLPFC that demonstrated the efficacy of intermittent theta burst stimulation (iTBS) as a treatment for TRD, a condition commonly associated with suicidal cognition. iTBS has been demonstrated to have 5X the pulse potency of conventional rTMS, which allows for a much-reduced stimulation session time in comparison to traditional rTMS and therefore makes multiple treatments per day a feasible intervention. The final innovation is that rTMS targeting utilizing resting state functional connectivity improves antidepressant outcomes of rTMS. We designed an approach, which we termed SAINT, which utilizes numerous applications of iTBS per day, as per principles of spaced learning theory (optimized intersession-intervals), within a functional connectivity derived target (L-DLPFC-sgACC). In TRD, we have observed dramatic changes in mood and associated explicit suicidal cognition using SAINT. We propose utilizing SAINT to modulate the neural circuitry that underlies explicit and implicit suicidal cognition along with moderators/mediators (hopelessness, anhedonia, and depression). We will conduct a randomized, controlled trial of SAINT applied to the L-DLPFC-sgACC to assess efficacy of the approach in reducing suicidal cognition in hospitalized psychiatric inpatients.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$902,851 )
2025	2024	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	000	4	7/8/2025	NON-COMPETING CONTINUATION	-$902,851
														Subtotal = -$902,851

Issue Date FY: 2024 ( Subtotal = $464,454 )
2024	2024	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	005	4	7/25/2024	SUPPLEMENT FOR EXPANSION	$86,807
2024	2024	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	004	4	5/13/2024	NON-COMPETING CONTINUATION	$37,765
2024	2024	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	003	4	2/5/2024	NON-COMPETING CONTINUATION	$339,882
2024	2023	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	002	3	1/24/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$480,707
2024	2023	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	000	3	1/19/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2024	2021	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	001	2	1/24/2024	NON-COMPETING CONTINUATION	-$480,707
														Subtotal = $464,454

Issue Date FY: 2023 ( Subtotal = $399,033 )
2023	2023	MAGNUS MEDICAL INC	1350 BAYSHORE HWY	BURLINGAME	CA	94010	SAN MATEO	USA	Mental Health Research Grants	001	3	3/2/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$399,033
2023	2021	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	000	2	3/2/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $399,033

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	001	2	9/7/2022	NON-COMPETING CONTINUATION	$0
2022	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	000	2	8/16/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $619,242 )
2021	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	001	2	7/27/2021	NON-COMPETING CONTINUATION	$619,242
2021	2020	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	000	1	2/28/2021	NEW	$0
														Subtotal = $619,242

Issue Date FY: 2020 ( Subtotal = $630,597 )
2020	2020	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Mental Health Research Grants	000	1	9/14/2020	NEW	$630,597
														Subtotal = $630,597

Grand Total All Awards = $1,210,475

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The Effects of Stanford Accelerated Intelligent Neuromodulation Therapy on Explicit and Implicit Suicidal Cognition

Award Number: R01MH125160

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2020

PERIOD OF PERFORMANCE END DATE: 02/28/2025

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