Related Experiment Video
Updated: Sep 9, 2025
Neuroimaging-Guided TMS–EEG for Real-Time Cortical Network Mapping
Published on: June 13, 2025
Real-time EEG-triggered transcranial magnetic stimulation combined with group therapy for adolescents with depression
Hong Liu1, Shaowei Liu1, Ming Yu1
1Department of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China.
Objective:
To evaluate the efficacy of real-time EEG-triggered repetitive transcranial magnetic stimulation (rTMS) combined with group therapy versus rTMS alone over the left dorsolateral prefrontal cortex (DLPFC) in adolescents with depression and self-harm behavior.
Methods:
A parallel-group randomized controlled trial (RCT) enrolled 160 inpatients aged 12-18 years with depression and recent self-harm (≤2 weeks prior) from June to December 2024. Participants were 1:1 randomized to rTMS alone (control, n = 80) or rTMS plus group therapy (observation, n = 80).
Primary Outcome:
4-week change in Hamilton Depression Rating Scale (HAMD-24) scores. Secondary outcomes included anxiety (HAMA-14), suicide risk (SPS), self-harm severity, and neurophysiological markers measured by resting-state EEG (α/θ power, θ/β ratio) and event-related potentials (P300 latency/amplitude) from a task-evoked paradigm. Randomization used computer-generated block sequences (size = 4) with sealed-envelope concealment; outcome assessors were blinded.
Results:
Baseline characteristics were balanced. Intention-to-treat analysis showed greater HAMD-24 reduction in the observation group (-14.5 ± 3.2 vs. -9.8 ± 2.9, P < 0.001). Observation group also had significant improvements in HAMA-14 (-10.2 ± 2.5 vs. -6.7 ± 2.1, P < 0.001), SPS (-12.3 ± 4.1 vs. -7.9 ± 3.5, P < 0.001), self-harm severity (-8.7 ± 2.8 vs. -4.9 ± 2.3, P < 0.001), and neurophysiological indices (shorter P300 latency, lower θ/β ratio, all P < 0.001). No severe adverse events occurred.
Conclusion:
Real-time EEG-triggered rTMS combined with group therapy demonstrates superior efficacy in improving clinical symptoms and neurophysiological markers for adolescents with depression and self-harm, offering a potential optimized intervention strategy.
Trial Registration:
This study was registered with ClinicalTrials.gov (Identifier: NCT07047534).
