A SHIFT in The Possible: fMRI Guided Brain Stimulation Crosses a New Threshold
Nolan Williams, M.D. does it again in a new publication.
The Frontier Psychiatrists is a daily health-themed newsletter. One could be forgiven if they imagine it’s a secret propaganda campaign to advocate for awarding the Nobel Prize in Medicine to Nolan Ryan Williams, M.D. I have written 470 articles in under two years, and it can be hard to keep up. However, this goal of mine has not been kept secret.
It’s not just that he’s got the kind of excellent star rating common among physicians…
Excellence in terms of reviews, I share:
Dr. Williams deserves the Nobel for finding ways to change how we think about brain-based interventions with science. He’s already revolutionized depression treatment with SAINT Neuromodulation. Yes, the therapy that gets depression to remission in 79% of study subjects. Without any medicine at all—which I think we can all agree is the limit as one reaches the smallest effective dosage of psycho-active drugs.
Today, a new paper hit the press. And it will change what you understand to be possible. Depression is, you see, a state problem. You, the stable person over time that you imagine yourself to be, can become depressed, and you go from a non-depressed state to a depressed one. Much of medicine is focused on changing less functional states back to more functional ones. We accept, for the most part:
“Some men, you just can't reach. So you get what we had here last week -- which is the way he wants it. Well, he gets it. And I don't like it any more than you men.”
—Cool Hand Luke
Some things aren’t states we can change. Except…what if they were more changeable than we imagined? What if we could reach the unreachable? What if…we could change traits? Some examples of personality traits are here:
One could imagine those personality traits leading to problems…for example, one could imagine they could lead to the perception of someone being narcissistic:
That kind of physician review would hint at some difficult—but presumably stable— traits in either the physician or the reviewer…but there is “no cure” for a stable trait! Unless, of course, there was to be a way to modify traits…
Dr. Williams has pushed what is possible in science forward again: this time, modifying a trait with a similar methodology to SAINT…by using a movie of the brain’s function to determine the best node in a functional connectivity network.
The trait chosen was hypnotizability. This trait has a stability (not-changing-over timeness) in the brain close to handedness. Most people don’t change which hand is as dominant often!
Announcing…
Stanford Hypnosis Integrated with Functional Connectivity-targeted Transcranial Stimulation (SHIFT): a preregistered randomized controlled trial
Hypnotizability, one’s ability to experience cognitive, emotional, behavioral and physical changes in response to suggestions in the context of hypnosis, is a stable neurobehavioral trait associated with improved treatment outcomes from hypnosis-based therapy. Increasing hypnotizability in people who are low-to-medium hypnotizable individuals could improve both the efficacy and effectiveness of therapeutic hypnosis as a clinical intervention.1
And using fMRI-guided brain stimulation with TMS, they found:
(changes in hypnotizability) were significantly greater in the active SHIFT group compared with the sham group (U = 601, P = 0.046; small effect size: r = 0.25;)…
SHIFT, a novel neuromodulation approach, demonstrated immediate modulation of hypnotizability—a stable, clinically relevant neurobehavioral trait.
The Stanford team uses a movie of how the brain functions, combined with precise stimulation, to change a trait. I’m not saying I am one of the most narcissistic and arrogant physicians out there, but if I were, my colleagues in Dr. Williams' lab would have brought a ray of hope!
And if that isn’t enough to get the man his Nobel in medicine, perhaps his other publication—TODAY— in nature medicine on the role of magnesium-ibogaine therapy in special operations veterans with traumatic brain injuries will do it.2
The best biomedical science lifts us all. I’m thrilled to see that if SHIFT can’t be modified to treat my problems, Kristen Cherian, Ph.D. et al.’s remarkable work with magnesium-ibogaine might be the kind of broad spectrum and potent healing we all hope for access to, in the context of both psychiatric illness and traumatic brain injury:
Disability, trauma, depression, and anxiety all resolve in what were historically the toughest cases to treat. Yes, I do want to give this human a medal…
If you want to hear more from Dr. Williams, he will join us this Sunday night at Rapid Acting Mental Health Treatment 2024! Tickets are still available! (in SF…live!)
Faerman, A., Bishop, J. H., Stimpson, K. H., Phillips, A., Gülser, M., Amin, H., Nejad, R., DeSouza, D. D., Geoly, A. D., Kallioniemi, E., Jo, B., Williams, N. R., & Spiegel, D. (2024). Stanford Hypnosis Integrated with Functional Connectivity-targeted Transcranial Stimulation (SHIFT): A preregistered randomized controlled trial. Nature Mental Health, 1-8. https://doi.org/10.1038/s44220-023-00184-z
Cherian, K. N., Keynan, J. N., Anker, L., Faerman, A., Brown, R. E., Shamma, A., Keynan, O., Coetzee, J. P., Batail, J., Phillips, A., Bassano, N. J., Sahlem, G. L., Inzunza, J., Millar, T., Dickinson, J., Rolle, C. E., Keller, J., Adamson, M., Kratter, I. H., . . . Williams, N. R. (2024). Magnesium–ibogaine therapy in veterans with traumatic brain injuries. Nature Medicine, 1-9. https://doi.org/10.1038/s41591-023-02705-w