The Mechanisms of Underlying Accelerated Repetitive Transcranial Magnetic Stimulation for Treatment-resistant Depression
Treatment-resistant Depression
About this trial
This is an interventional basic science trial for Treatment-resistant Depression focused on measuring Treatment-resistant Depression, Repeated transcranial magnetic stimulation, Prefrontal-hippocampal circuit, Reelin, Synaptic plasticity
Eligibility Criteria
Inclusion Criteria: The current episode met the DSM-5 diagnostic criteria for major depression in patients with first-episode or relapsed unmedicated depression without psychotic symptoms. 24-item Hamilton Depression Scale (HAMD-24) ≥ 20. Age 18-45 years, regardless of gender. Right-handedness. Han Chinese. Signed a written informed consent, willing to participate in the study and be evaluated. Exclusion Criteria: Co-morbid other mental disorders, including: schizophrenia, mental retardation, substance dependence, etc. Patients with metal objects in the body or with other contraindications to MRI scanning Patients with severe or unstable somatic diseases Women during pregnancy or lactation, and women of childbearing age with positive urine HCG test results during the screening period Other conditions that, in the opinion of the investigator, exist that make participation in this clinical trial inappropriate.
Sites / Locations
- The First Affiliated Hospital of Zhejiang UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
active iTBS
sham rTMS
The active group of TRD will receive the accelerated intermittent TBS(iTBS).The iTBS cycles including 10 bursts of three pulses at 50 Hz were delivered in 2-second trains. Each iTBS session comprised 60 x 2 second trains, with an 8-second intertrain interval and total duration of 10-minutes.Treatment sessions were administered hourly 10 times a day totaling 18,000 pulses/day. Patients received this treatment protocol for 5 consecutive days (90,000 pulses in total).
The sham group of TRD will receive sham rTMS stimulation.