Depressive disorder
Conditions
Interventions
Trial Group:Individualized Target iTBS based on functional connectivity between sgACC and L-DLPFC: intraburst frequency of 50Hz, interburst frequency of 5Hz, 1800 pulses per session, 4 sessions daily
Control Group:Traditional Target iTBS based on conventional 5cm anatomical targeting: intraburst frequency of 50Hz, interburst frequency of 5Hz, 1800 pulses per session, 4 sessions daily for 10 days (
Sponsors
Shandong mental health center
Eligibility
Sex/Gender
All
Age
12 Years to 18 Years
Inclusion criteria
Inclusion criteria: 1.Adolescents aged 12–18 years, of any sex. 2.A diagnosis of depressive disorder (first or recurrent episode) must be confirmed by a qualified psychiatrist according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 3.A score of >= 40 on the Children’s Depression Rating Scale–Revised (CDRS-R) and >= 27 on the self-report Mood and Feelings Questionnaire (MFQ), indicating at least moderate depression. 4.To exclude confounding anxiety or sleep disturbances: Hamilton Anxiety Scale (HAMA) < 14 and Pittsburgh Sleep Quality Index (PSQI) < 15. 5.No current or past psychotic symptoms (e.g., auditory or visual hallucinations) and no lifetime diagnosis of schizophrenia, bipolar disorder, obsessive–compulsive disorder, post-traumatic stress disorder, panic disorder, or other severe psychiatric conditions. 6.No contraindications to MRI or transcranial magnetic stimulation (TMS). 7.Voluntary signed informed consent/assent agreeing to undergo MRI scanning and TMS treatment, with a commitment to complete all follow-up visits.
Exclusion criteria
Exclusion criteria: 1.History of alcohol or substance dependence. 2.Presence of severe or unstable medical conditions, including neurological, endocrine, or rheumatic diseases, brain disorders, history of traumatic brain injury or intracranial surgery, and infectious diseases. 3.Receipt of repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy within the past 3 months. 4.Contraindications to MRI or rTMS, such as implanted cardiac pacemakers, neurostimulators, prosthetic heart valves, intracranial aneurysm clips, cochlear implants, or any other metallic implants (dental braces excepted). 5.Personal history of epilepsy or prior seizure episodes. 6.Pregnancy (female participants must undergo a pregnancy test with a negative result).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in Children's Depression Rating Scale-Revised (CDRS-R) Score from Baseline to 1 Month Post-Treatment; | — |
Secondary
| Measure | Time frame |
|---|---|
| Hamilton Depression Rating Scale (HAM-D) Score;Hamilton Anxiety Rating Scale (HAM-A) Score;Beck Suicide Ideation Scale Score;Spatial Working Memory Capacity (Accuracy Rate in N-back Task);Cognitive Flexibility (Performance on Wisconsin Card Sorting Test);Self-Control and Risk Decision-Making Ability (Performance on Balloon Analogue Risk Task);Functional Connectivity Strength between Left Dorsolateral Prefrontal Cortex and Subgenual Anterior Cingulate Cortex;Whole-Brain Network Topological Properties (Node Degree, Clustering Coefficient);Cortical Excitability Indices and Neuroplasticity Parameters;Treatment Response Rate;Psychological Resilience Scale Score;Pittsburgh Sleep Quality Index (PSQI) Score; | — |
Countries
China
Contacts
Public ContactWang Duanwei
Shandong mental health center
Outcome results
None listed