Determination Of Neurobiology and efficacy of Theta Burst Stimulation for Adolescent Depression (DONT-B-SAD)

Time period:

1 December 2025 – 31 December 2029

Project leader:

Robert Bodén

Project member:

Jonas Persson, Hannes Bohman, Pär Höglund

Funder:

Swedish Research Council

Type of award:

Project grant

Total funding:

5,400,000 SEK

Adolescent depression, encompassing both major depressive and bipolar depressive episodes, remains a significant global health concern, being a leading cause of disability and death by suicide. Many patients fail to respond to first-line treatments such as SSRIs and psychotherapy. In adults, repetitive transcranial magnetic stimulation (rTMS) has been effective in difficult-to-treat depression. However, the conventional rTMS techniques has not yet proven effective in youth. The DONT-B-SAD study proposes a novel rTMS with accelerated continuous theta-burst stimulation (acTBS), targeting the right dorsolateral prefrontal cortex (DLPFC). This randomized, double-blind, two-site, sham-controlled trial will assess the efficacy, safety, and neurobiological effects of acTBS in 80 adolescents aged 13–18 with depression not responding to first line treatments. The primary outcome is reduction in depressive symptoms as measured by Montgomery-Åsberg Depression Rating Scale after a nine-weekday treatment course. Secondary outcomes include functional, cognitive, and neurobiological changes assessed through multi-modal brain imaging and neurophysiological measurements (fMRI, MRS, EEG, fNIRS) and standardized clinical instruments. By addressing both therapeutic efficacy and underlying brain mechanisms, this study aims to advance treatment options for adolescent depression and contribute to the understanding of its neurobiology, with the potential for both individual and societal benefits.