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REWARD - rTMS Effects in Adolescent Depression and Behavioral Addictions
Johanna K Loy1, Alexander Krieg1, Lena Pokorny1
1Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
Zeitschrift Fur Kinder- Und Jugendpsychiatrie Und Psychotherapie
|November 12, 2025
Summary
This study explores repetitive transcranial magnetic stimulation (rTMS) for adolescents with major depressive disorder (MDD) and behavioral addictions (BAs). It investigates rTMS effects on brain activity and symptoms, aiming to improve treatment strategies.
Area of Science:
- Neuroscience
- Psychiatry
- Neuromodulation
Background:
- Adolescent mental health disorders like major depressive disorder (MDD) and behavioral addictions (BAs) involve impaired reward processing and inhibitory control.
- Repetitive transcranial magnetic stimulation (rTMS) shows promise in adults for targeting these neural circuits, but adolescent data is limited.
- Understanding rTMS neurophysiological effects in adolescents is crucial for developing effective interventions.
Purpose of the Study:
- To investigate the acute, short-term, and medium-term effects of high-frequency rTMS on neurophysiological markers and clinical symptoms in adolescents with MDD and BAs.
- To assess the impact of rTMS on reward processing, cortical excitability, and cue reactivity using EEG-derived event-related potentials.
- To evaluate the safety and efficacy of rTMS as a potential treatment for these adolescent populations.
Main Methods:
- A double-blind, randomized, sham-controlled trial involving adolescents aged 12-17 diagnosed with MDD or BAs.
- Participants received either active rTMS (15 Hz) or sham stimulation targeting the left dorsolateral prefrontal cortex (DLPFC).
- Neurophysiological outcomes (EEG-based event-related potentials) and clinical symptoms (CDRS-R, craving scales) were assessed.
Main Results:
- The study protocol is designed to analyze immediate, short-term, and medium-term effects of rTMS.
- Planned analyses include mixed-effects models with a sample size of 32 participants per group.
- Specific EEG markers (Reward Positivity, N45, P300, P60, N100, LPP) will be examined for modulation.
Conclusions:
- This research will provide novel insights into the neurophysiological mechanisms of rTMS in adolescent MDD and BAs.
- Demonstrating EEG marker modulation and clinical improvement could support rTMS as a viable intervention.
- Findings may inform personalized treatment strategies for adolescents with these mental health conditions.
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