Precision Transcranial Magnetic Stimulation for Depression Based on Orbital Frontal Cortex-habenula Circuitry

Safety and Efficacy Study of Precise Transcranial Magnetic Stimulation for Depression Based on Individualized Functional Connectivity Localization of Orbital Frontal Cortex-habenula

Thirty depressed patients will be recruited to select individualized transcranial magnetic stimulation targets based on individual orbital frontal cortex and habenula functional activity connectivity for 10 or 20 treatments to assess the efficacy and safety of this intervention

Inclusion Criteria:

• Gender is not limited, age 18～60 years old;
• Comply with the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) of the United States of America;
• Hamilton rating scale for depression (HAMD) 17-item score ≥ 18;
• The medication/psychotherapy received by the subject prior to the start of the study remained stable for at least 4 weeks .

Exclusion Criteria:

• History of serious somatic diseases or diseases that may affect the central nervous system (e.g., tumors, syphilis, etc.);
• Neurological disorders or risk of seizures, such as previous craniosynostosis, head trauma, alcoholism, abnormal electroencephalograms, MRI evidence of structural abnormalities in the brain, or family history of epilepsy;
• Patients with bipolar disorder and depression due to other psychiatric disorders (e.g., psychoactive and non-dependent substances);
• Contraindications to MRI scanning or transcranial magnetic stimulation therapy, such as metal or electronic devices placed in the body (intracranial metal foreign bodies, cochlear implants, pacemakers and stents and other metal foreign bodies), space phobia;
• People with psychotic symptoms requiring joint application of antipsychotic drugs;
• Those with high risk of suicide, or those who have already committed suicide or serious self-injury behavior requiring urgent intervention;
• Those who are pregnant, breastfeeding or planning to become pregnant during the trial;
• Other conditions judged by the investigator to be unsuitable as research subjects.