Pioneering neuroscientist Nolan Williams—creator of the breakthrough SAINT brain-stimulation therapy for treatment-resistant depression—has died at 43. His legacy lives on. 🌟 #MentalHealth
A neuroscientist, he employed a battery of high-tech tools in devising a fast-acting therapy that targets the area of the brain where depression originates.
Nolan Williams, an innovativeneuroscientist who developed a noninvasive brain-stimulation technique that has
delivered unusually fast relief to people with treatment-resistant depression,
died on Oct. 8 at his home in Northern California. He was 43.
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His wife, Kristin Raj, said he died by suicide. Dr.
Williams himself had struggled with depression, according to two of his
colleagues.
Dr. Williams was hired by the Stanford
University School of Medicine’s department of psychiatry and behavioral
sciences in 2014. He soon started its Brain Stimulation Lab, where he focused
on finding rapid-acting approaches to treat the dysfunctions underlying
psychiatric illnesses, like depression, anxiety, obsessive-compulsive disorder
and post-traumatic stress disorder, or PTSD.
In
addition to stimulating the brain to deal with depression, he led studies of
Special Operations veterans who had symptoms of PTSD and traumatic brain injury
— among them anger, depression, anxiety and insomnia — and who had been treated
in Mexico with the psychedelic drug ibogaine, which is illegal in the United
States.
The nonprofit organization Veterans
Exploring Treatment Solutions, or VETS, which collaborated with Dr. Williams on
the ibogaine study, said in a statement after
his death that “his research demonstrated what these veterans courageously
believed: That healing was possible, that their suffering mattered, and that
science could meet them in their darkest hour.”
Dr. Williams’s fascination with the
brain’s circuitry surged when he was a student at the Medical University of
South Carolina, where he learned about stimulating the brain to relieve
depression that therapy and prescription drugs could not ease.
He went on to devise a fast-acting,
high-tech therapy — called SAINT, for
Stanford Accelerated Intelligent Neuromodulation Therapy — that targets the
area in the brain where depression originates.
In
clinical studies of about 400 people — by Stanford and Magnus Medical, a
company that licensed its technology — about 80 percent saw their depression go
into remission.
“We find a spot to stimulate the brain back
into not being suicidal, not being depressed,” Dr. Williams said this year in an interview on “CBS Sunday Morning.”
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Depression
is the leading cause of disability globally, according to the World Health
Organization. It is variously treated with talk therapy, pharmaceutical
medications and noninvasive therapies that use electrical currents or magnetic
fields on the brain, like electroconvulsive therapy and transcranial magneticstimulation, or T.M.S.
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SAINT employs a
magnetic resonance imaging scanner to pinpoint the region in the brain’s
prefrontal cortex, which is responsible for depression.
Then a device, the
stimulator, with an electromagnetic coil inside it, is placed on the scalp.
When electric current is run through it, the coil produces a magnetic field
that stimulates neurons with rapid, intermittent pulses in the targeted spot.
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Brandon
Bentzley, a psychiatrist and the former director of innovation at the Brain
Stimulation Lab, turned Dr. Williams’s concept into a technological reality.
With Dr. Williams as a partner, he helped start Magnus, which has so far sold
the stimulator and services to 15 clinics around the country.
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“We’ve
seen people who had debilitating depressions for many decades and all of a
sudden, they’re not depressed,” Dr. Bentzley said in an interview, adding that
remission sometimes depends on whether a patient gets therapeutic support.
“They
might relapse in months,” he said. “But we can re-treat them.”
The
stimulation is provided over five days in 10 daily sessions, each lasting 10
minutes — a regimen of more stimulation in less time than other such
treatments.
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In
SAINT’s first major study, published in 2021 in
The American Journal of Psychiatry, 14 of 29 people received the treatment.
Eleven of the 14, or 78.6 percent, experienced remission within four weeks, the
study found; some needed as few as five days. On average, people felt better in
2.6 days.
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“The
effects of SAINT look very promising for people with
treatment-resistant
depression, but more work is needed to verify them,” said Mouhsin Shafi, an associate professor of neurology at
Beth Israel Deaconess Medical Center and director of the Berenson-Allen Center for Noninvasive Brain
Stimulation, both in Boston. “We need to understand more about how durable the
effects are and how to extend them for a longer period of time.”
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The Food and Drug
Administration cleared SAINT for psychiatric treatment in 2022; Medicare covers
it in hospitals; and some insurance companies cover it in private clinics. The
cost for a one-week regimen can run from $18,000 to $36,000.
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Side
effects include headaches and short-lived pain at the stimulation site during
treatment.
Nolan
Ryan Williams — his father, a baseball fan, named him after the Hall of Fame
pitcher Nolan Ryan — was born on June 25, 1982, in Bamberg, S.C., and grew up
in Charleston. His father, Bryan, was a fisherman and carpenter. His mother,
Ann (Hewitt) Williams, ran a day care center and later worked as a caterer.
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Nolan,
who attained a black belt in taekwondo at 18 and was a skilled kitesurfer,
earned a bachelor’s degree in molecular biology from the College of Charleston
in 2003.
After
receiving his medical degree from the Medical University of South Carolina in
2008, he remained there for residencies in neurology and psychiatry as well as
fellowships in clinical neuromodulation and human neuroscience with Mark George, a neurologist and
psychiatrist who runs the university’s brain stimulation lab.
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“Nolan started working in
the lab when he was still an undergraduate and was enormously curious,” Dr.
George, a pioneer in T.M.S. treatment for depression, said. “And once he was in
medical school, he came after class or on weekends and summers to do research.
He was always asking ‘why?’ questions and dreaming up the next step or two or
three.”
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Dr.
George recalled Dr. Williams telling him while in his residency that he wanted
to combine three ambitious steps — each of which had been studied — to create
what became SAINT.
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“I said, ‘Nolan did I not
teach you anything? You do one thing at a time in science,’ but he said, ‘I
want to move us forward,’” Dr. George recalled.
Dr.
Williams’s first step was to greatly accelerate the pace of magnetic pulses and
condense the time span of treatment. The second involved using magnetic
resonance imaging to accurately target the spot in the brain to stimulate. And
the third was to have the M.R.I. measure brain atrophy and adjust the intensity
of the brain stimulation to account for it.
“What
he did was transformative,” Dr. George said.
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Dr. Williams’s interest in
the brain’s reaction to ibogaine led to a collaboration with VETS, which helps
veterans get access to psychedelics to treat traumatic brain injuries. One of
its founders, Marcus Capone, a retired member of the Navy SEALs, first took
ibogaine in 2017 and had a remarkable recovery.
His
wife, Amber Capone, who founded VETS with her husband, recalled the relief she
felt when she met Dr. Williams in 2018 after being rejected by doctors,
researchers and military leaders when she sought their help in validating the
impact of ibogaine on veterans.
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“I had
been desperately trying to get anyone I could to listen to me,” she said in aninterview. “Nolan was the first person to listen and take me seriously.”
Dr.
Williams designed a study in which 30 Special Operations veterans were tested
and evaluated before and after they were treated at an ibogaine clinic in
Mexico from 2021 to 2022. Ibogaine is an alkaloid derived from the bark of the
African shrub iboga.
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The
first of two studies, published in 2024 in the journal Nature Medicine, showed that a
month after treatment, 83 percent of the veterans had achieved remission from
PTSD, 73 percent had achieved remission from depression, and 86 percent had
achieved remission from anxiety.
“These
are the most dramatic drug effects I’ve ever captured in an observational
study,” Dr. Williams told
The New York Times in 2024. But, he added, “Without a
greenlight to conduct studies from the F.D.A., you just can’t do the kind of
randomized trials that are
the gold standard for
clinical studies.”
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In
addition to his wife, a clinical professor of psychiatry and behavioral
sciences at Stanford who has treated patients with SAINT, Dr. Williams is
survived by his mother; a daughter, Autumn; a son, Hendrix; and a brother,
Kyle.
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Dr. George said that he had been aware
of Dr. Williams’s own depression and had encouraged him to get help, but that
he wasn’t certain if Dr. Williams was treated with SAINT.
He added: “I wonder if somewhere inside
him he still harbored some stigma about depression. But these brain stimulation
treatments combat the stigma.”
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If you are having thoughts of suicide, call or text 988 to reach
the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional
resources.
Richard
Sandomir, an obituaries reporter, has been writing for The Times for
more than three decades.
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