Front Psychiatry. 2025 Oct 20;16:1616641. doi: 10.3389/fpsyt.2025.1616641. eCollection 2025.
ABSTRACT
BACKGROUND: The prevalence of adolescent depression has been steadily rising, while the effectiveness of existing treatments remains limited, highlighting the urgent need for novel therapeutic strategies.
OBJECTIVE: To evaluate the efficacy and safety of combining repetitive transcranial magnetic stimulation (rTMS) with transcranial direct current stimulation (tDCS) in treating adolescent depression.
METHODS: This was a prospective, randomized, parallel-group controlled trial. A total of 260 hospitalized adolescents diagnosed with major depressive disorder (MDD) were enrolled and randomly assigned to one of four groups: G1 (medication only), G2 (medication + tDCS), G3 (medication + rTMS), and G4 (medication + combined tDCS and rTMS). Clinical assessments were conducted at baseline and after 4 weeks by trained evaluators blinded to group allocation. The primary efficacy outcome was the reduction rate in HAMD-17 scores. Secondary outcomes included changes in HAMA and PSQI scores.
RESULTS: Both the G3 and G4 groups showed significant improvements in depressive symptoms compared to G1 (p < 0.05 and p < 0.01, respectively), with anxiety symptoms also showing significant improvement (p < 0.05). However, no significant differences were observed for sleep quality improvement (p > 0.05). Regression analysis indicated that baseline depression severity and illness duration were key predictors of treatment response (p < 0.001). All interventions were well tolerated, and no serious adverse events were reported.
CONCLUSION: The combination of rTMS and tDCS demonstrates superior efficacy over pharmacotherapy alone in reducing depressive symptoms in adolescents, with a favorable safety profile.
PMID:41190303 | PMC:PMC12580179 | DOI:10.3389/fpsyt.2025.1616641
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