Efficacy study of intermittent theta burst stimulation(iTBS) in the treatment of adolescents with affective disorders

Xinyao Liu; Peiying Li; Yuwei Xia; Shiqi Yuan; Chengfeng Chen; Kun Xie; Wuyou Bao; Shiying Wang; Ru Hao; Cuixia An; Ling Sun; Bin Zhang

doi:10.1016/j.jad.2025.01.002

Efficacy study of intermittent theta burst stimulation(iTBS) in the treatment of adolescents with affective disorders

J Affect Disord. 2025 Jan 4:373:284-290. doi: 10.1016/j.jad.2025.01.002. Online ahead of print.

Authors

Xinyao Liu¹, Peiying Li¹, Yuwei Xia¹, Shiqi Yuan², Chengfeng Chen², Kun Xie², Wuyou Bao³, Shiying Wang¹, Ru Hao¹, Cuixia An⁴, Ling Sun⁵, Bin Zhang⁶

Affiliations

¹ Tianjin Anding Hospital, Tianjin Medical University, 300222 Tianjin, China.
² Psychiatric & Psychological Neuroimage Laboratory (PsyNI Lab), The Affiliated Brain Hospital of Guangzhou Medical University, 510370 Guangzhou, China.
³ Institute of Psychology, Tianjin Medical University, 300222 Tianjin, China.
⁴ Department of Psychiatry, The First Hospital of Hebei Medical University, 050011 Tianjin, China.
⁵ Tianjin Anding Hospital, Tianjin Medical University, 300222 Tianjin, China. Electronic address: sunling@tmu.edu.cn.
⁶ Tianjin Anding Hospital, Tianjin Medical University, 300222 Tianjin, China; Mental Health Center of Tianjin University,Tianjin Anding Hospital, 300072 Tianjin, China. Electronic address: zhang.bin845@foxmail.com.

PMID: 39761754
DOI: 10.1016/j.jad.2025.01.002

Abstract

Background: Affective disorders are the leading cause of disability worldwide. Intermittent theta burst stimulation (iTBS) is a safe and effective brain stimulation therapy for reducing depressive symptoms in adolescents. The purpose of this study is to investigate the clinical efficacy of iTBS in treating adolescent patients with depressive disorders and the factors influencing clinical symptoms.

Methods: Participants were randomized to receive left-sided dorsolateral prefrontal cortex(DLPFC) to navigate either active or sham iTBS treatment 5 sessions daily for 2 days. During 4 weeks of maintenance treatment, two sessions were administered weekly. The primary study outcome was the change in the Montgomery-Asberg Depression Rating Scale (MADRS) from baseline to the post-treatment follow-up period. We also explored relevant clinical factors that influence the efficacy of iTBS.

Results: About 22 adolescents with affective disorders were in the active iTBS group and 18 patients were in the sham iTBS group. Compared to the sham group, patients in the active iTBS group showed significant improvement in depressive symptoms over the two days of treatment. In addition, in the active iTBS group, higher baseline SHAPS and BHS scores were associated with worse outcomes.

Conclusions: The current study suggests that two days of active iTBS to the DLPFC region can rapidly, safely, and effectively improve depressive symptoms in adolescents with depression. We found that iTBS was less effective in baseline patients with greater feelings of hopelessness and anhedonia. Our data can provide valuable recommendations and directions for the clinical management of adolescent depression.

Keywords: Adolescence; Affective disorders; Depression; Intermittent theta burst stimulation (iTBS).