Transcranial Magnetic Stimulation for Major Depressive Disorder

(rmPFC-Savoring Trial)

This trial tests a brain stimulation treatment to determine if it can help people with major depressive disorder enjoy positive experiences more. The technique, called transcranial magnetic stimulation (TMS), sends magnetic pulses to specific brain areas to assess its effect on reward processing. Specifically, the trial uses Accelerated Intermittent Theta Burst Transcranial Magnetic Stimulation, a form of TMS. Participants will have their brain activity monitored while performing tasks designed to test this. Suitable candidates for the trial are right-handed individuals who currently experience major depressive disorder and often struggle to enjoy positive moments. As an unphased trial, this study offers a unique opportunity to contribute to groundbreaking research on innovative treatments for depression.

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.

Studies have shown that transcranial magnetic stimulation (TMS), particularly the accelerated intermittent theta burst (iTBS) method, is generally safe for treating major depressive disorder. Research indicates that this treatment can quickly and effectively reduce depressive symptoms without major side effects.

The iTBS method has been compared to other TMS techniques and is considered safe. The FDA has approved it for severe depression, confirming it has passed important safety tests. Some studies have also explored targeting different brain areas, such as the rostromedial prefrontal cortex, and found it to be well-tolerated.

Researchers are excited about these treatments because they explore new brain regions and mechanisms to tackle depression. Unlike standard depression treatments like medication or traditional TMS, this trial uses accelerated intermittent theta burst stimulation, which is a quicker form of transcranial magnetic stimulation. The focus on the left rostromedial prefrontal cortex is unique because it targets reward sensitivity and positive affect, which could lead to new ways of enhancing mood and emotional processing. Additionally, the trial compares this to a more traditional TMS target, the left dorsolateral prefrontal cortex, and a placebo, which helps determine the specific impact of these brain areas on depression.

This trial will compare different applications of accelerated intermittent theta burst transcranial magnetic stimulation (a-iTBS) for major depressive disorder (MDD). Studies have shown that a-iTBS can quickly and effectively reduce symptoms of depression in people with MDD. For some patients, up to 66.7% respond well to the treatment, and up to 57.1% experience complete relief from symptoms. However, results can vary, and some studies show mixed outcomes. Overall, a-iTBS is considered a promising option, especially for those who haven't found success with standard treatments. Participants in this trial will receive a-iTBS targeting either the left dorsolateral prefrontal cortex, the left rostromedial prefrontal cortex, or the left primary somatosensory cortex as a placebo intervention.¹³⁶⁷⁸