NOLAN WILLIAMS, M.D.

Assistant Professor of Psychiatry and Behavioral Sciences, Stanford University Medical Center

I work with the most severe cases of depression and OCD

I’m a psychiatrist and neurologist and I specialize in focal neuromodulation, or targeted “brain stimulation,” in which we deliver electrical signals to a single circuit network in the brain in order to bring relief to people who suffer from neurological disorders like depression, epilepsy, and Parkinson’s. In the case of OCD, we use transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) to isolate and tamp down the overactive circuits that are tied to compulsive behaviors. By “muting” or controlling the repetitive obsessive thought that leads to compulsive behaviors, we empower people with OCD to be in control of their actions and their life.

Understanding the limits of tms + dbs

While TMS and DBS have been proven effective on OCD—especially for those whose symptoms are treatment-resistant—they each have their drawbacks. TMS, a treatment where electrical current is transmitted through coils that are placed strategically on the scalp, involves multiple out-patient visits over several weeks or months before there is any sustained effect. DBS, a treatment where electrodes are surgically implanted under the skull and a pacemaker-like device is implanted under the skin to provide ongoing relief, is highly effective, yet invasive and costly.

Scaling a better form of neuromodulation

Our goal is to deliver a modified TMS treatment, but with the sustained effect of DBS. To do that, we’re applying what we’ve learned from repetitive transcranial magnetic stimulation (rTMS), a technique we’ve used to achieve remission-like results for depression, to the treatment targets, dose levels, and frequency for people with treatment-resistant OCD.