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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Psychopathology
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1485878
This article is part of the Research Topic Neuroimaging Methods for the Pathogenesis of Children and Adolescents with Affective Disorders View all articles

Effectiveness of Individualized rTMS Under sMRI Guidance in Reducing Depressive Symptoms and Suicidal Ideation in Adolescents with Depressive Disorders: An Open-Label Study

Provisionally accepted
Sun Yuyong Sun Yuyong Xiaoyan Liu Xiaoyan Liu Yi Li Yi Li Qianna Zhi Qianna Zhi Yong Xia Yong Xia *
  • Department of Psychiatry, Hangzhou Seventh Peoples Hospital, Hangzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Background: Major Depressive Disorder (MDD) is occurring at a progressively younger age, and suicide is now the second leading cause of death among adolescents with MDD. Studies have shown that structural magnetic resonance imaging (sMRI) can improve the positioning accuracy and anti-depressant effects of repetitive transcranial magnetic stimulation (rTMS), thereby reducing suicidal ideation. Objective: To compare the efficacy of sMRI-guided rTMS combined with pharmacotherapy, surface 5-cm rTMS positioning combined with pharmacotherapy, and pharmacotherapy alone on reducing depressive symptoms and suicidal ideation (SI) in MDD adolescents. Methods: This was an open-label study of adjustable-dose pharmacotherapy combined with rTMS for the treatment of depressive symptoms and suicidal ideation in MDD adolescents. The three study groups were as follows: sMRI navigation for individualized rTMS coordinates targeting the dorsolateral prefrontal cortex (DLPFC) and in combination with pharmacotherapy for 10 rTMS sessions over two weeks; surface 5-cm positioning for DLPFC in combination with pharmacotherapy for 10 rTMS sessions over two weeks; pharmacotherapy . All patients received only one type of SSRIs anti-depressant. A total of 123 Chinese adolescents aged 13-18 with MDD were enrolled, and psychological parameters were evaluated in the first and second weeks of treatment. Results: Following treatment, the clinical symptoms improved in all three groups. The sMRI navigation group exhibited significantly more improvement in depressive symptoms and suicidal ideation, without severe adverse reactions. Conclusion: Ten sessions of rTMS treatment are feasible and effective in improving depressive symptoms and reducing SI in MDD adolescents. The combination of sMRI navigation rTMS and pharmacotherapy was found to yield the best outcomes.

    Keywords: Adolescent Psychiatry, depressive disorders, Suicide, Magnetic Resonance Imaging, Transcranial Magnetic Stimulation

    Received: 25 Aug 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Yuyong, Liu, Li, Zhi and Xia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yong Xia, Department of Psychiatry, Hangzhou Seventh Peoples Hospital, Hangzhou, Jiangsu Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.