iTBS to help anhedonia in depression (dual left DLPFC + OFC or left DLPFC alone)

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional study examines whether intermittent theta burst stimulation (iTBS) can improve anhedonia in adults with major depressive disorder. The protocol compares dual-target stimulation of the left dorsolateral prefrontal cortex and orbitofrontal cortex against single-target left DLPFC stimulation, and includes a sham control in the design. Participants are adults aged 18–45 with stable medication and verified anhedonia, and outcomes will focus on changes in anhedonia and depressive symptoms. The study uses neurofunctional targets to modulate reward circuitry and assess potential functional connectivity changes. Safety monitoring and standardized scales accompany the efficacy assessments.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Aged 18-45 years, and right-handed;
2. Diagnosed with major depressive disorder (MDD) by at least two qualified psychiatrists, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), with a Montgomery-Åsberg Depression Rating Scale (MADRS) score ≥ 20 or a 17-item Hamilton Depression Rating Scale (HAMD-17) score ≥ 17;
3. Evaluated by a psychiatrist as having prominent anhedonia, and meeting the cutoff criteria on two self-report anhedonia scales, including a Snaith-Hamilton Pleasure Scale, Chinese version (SHAPS-C) score ≥ 20, or a Temporal Experience of Pleasure Scale, Chinese version (TEPS-C) score ≤ 76;
4. Medication type and dosage remained unchanged for at least 4 weeks prior to treatment initiation and throughout the study period;
5. MADRS item 10 score ≤ 4.

Exclusion Criteria:

1. A history of epilepsy, seizures, stroke, or other serious organic brain diseases;
2. Presence of severe infectious diseases, malignant tumors, or other major unstable medical conditions;
3. Intellectual disability or developmental delay, presence of psychotic symptoms, or meeting the diagnostic criteria for other psychiatric disorders;
4. A history of substance abuse or psychoactive substance use;
5. Presence of intracranial implants (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes), or any other metallic objects in or near the head that cannot be safely removed (excluding dental fillings);
6. Contraindications to MRI or structural intracranial abnormalities detected on MRI;
7. Pregnant or breastfeeding women;
8. Receipt of electroconvulsive therapy (ECT) within the past 6 months, or transcranial magnetic stimulation (TMS) within the past 3 months;
9. Current daily use of lorazepam \> 2 mg (or an equivalent dose), or use of antiepileptic drugs at any dose;
10. Presence of strong suicidal ideation, or a MADRS item 10 score \> 4.

Where it's running

• The Second Xiangya Hospital of Central South University
  Changsha, Hunan, China Recruiting

Study contacts

• Principal investigator: Wenbin Guo, PhD — Second Xiangya Hospital of Central South University
• Study coordinator: Wenbin Guo, PhD
• Email: guowenbin76@csu.edu.cn
• Phone: +86 73185360921

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.