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Randomized Controlled Trial
. 2025 Aug 15:383:101-107.
doi: 10.1016/j.jad.2025.04.112. Epub 2025 Apr 23.

Repetitive transcranial magnetic stimulation frequency effects on suicidal ideation in adolescents with major depressive disorder

Dicle Buyuktaskin  1 , Charles P Lewis  2 , Paul A Nakonezny  3 , Karina Delaney  4 , Lucero Sangster-Carrasco  1 , Magdalena Romanowicz  1 , Julia Shekunov  1 , Michael J Zaccariello  1 , Jennifer L Vande Voort  1 , Paul E Croarkin  5
Affiliations
Randomized Controlled Trial

Repetitive transcranial magnetic stimulation frequency effects on suicidal ideation in adolescents with major depressive disorder

Dicle Buyuktaskin et al. J Affect Disord. .

Abstract

Previous research has explored Transcranial Magnetic Stimulation (TMS) interventions for suicidal thoughts and behaviors. However, the optimal dose parameters for TMS interventions targeting suicidal ideation in adolescents remain unknown. This exploratory study examined the impact of 1 Hz and 10 Hz TMS treatment on suicidal ideation in adolescents with major depressive disorder. Participants (N = 41) aged 12-18 years were randomized to TMS treatments with 1 Hz or 10 Hz frequency over 6 weeks and included in the exploratory analyses. The change in the intensity of suicidal ideation throughout treatment was estimated with ordinal logistic regression models with and without adjustments for the change in depressive symptom severity. The predicted odds of intensity of suicidal ideation significantly decreased over six-weeks of acute TMS treatment for both the 10 Hz TMS group (OR = 0.754, 95 % CI = 0.634 to 0.897, p = 0.0015) and the 1 Hz TMS group (OR = 0.780, 95 % CI = 0.668 to 0.909, p = 0.0016). However, after adjustment for the change in depression severity as a time-varying covariate in the ordinal logistic regression model, the magnitude of the decrease (or predicted odds) in intensity of suicidal ideation was attenuated and rendered non-significant for both the 10 Hz and 1 Hz TMS groups. TMS treatment suicidal ideation outcomes were not significantly different between the 10 Hz and 1 Hz TMS groups. Low-frequency TMS may be as effective as high-frequency TMS in treating suicidal ideation in adolescents with depression. Notably, 1 Hz TMS may have a favorable tolerability and safety profile for adolescents.

Keywords: Adolescent; Major depressive disorder; Neuromodulation; Suicide; Transcranial magnetic stimulation.

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Conflict of interest statement

Declaration of competing interest Dr. Lewis has received research grant funding from the National Institute of Mental Health (K23MH127307), the Brain & Behavior Research Foundation (NARSAD Young Investigator Grant No. 27488, Alan G. Ross Memorial Investigator), the American Foundation for Suicide Prevention (Young Investigator Grant YIG-0-108-20), and the Klingenstein Third Generation Foundation. He has served as a site investigator in multicenter studies funded by Neuronetics, Inc. and NeoSync, Inc. Dr. Lewis has received a speaker’s honorarium and travel expenses from CentraCare Health System, Inc. Dr. Croarkin has received research support from the National Institutes of Health (NIH), National Science Foundation (NSF), Agency for Healthcare Research and Quality (AHRQ), Brain and Behavior Research Foundation and the Mayo Clinic Foundation. Dr. Croarkin has received research support from Pfizer, Inc. He has received grant-in-kind equipment support from Neuronetics, Inc. and MagVenture, Inc. for investigator-initiated studies. He received grant-in-kind supplies and genotyping from Assurex Health, Inc. for an investigator-initiated study. He served as the principal investigator for a multicenter study funded by Neuronetics Inc., a site principal investigator for a study funded by NeoSync, Inc., and site principal investigator for a study funded by Innosphere. Dr. Croarkin served as a paid consultant for Engrail Therapeutics, Meta Platforms, Inc., MindMed, Myriad Neuroscience, Procter & Gamble Company, and Sunovion. Dr. Croarkin is employed by Mayo Clinic. He receives compensation as the Editor-in-Chief for the Journal of Child and Adolescent Psychopharmacology. Dr. Vande Voort has received grant-in-kind supplies and genotyping from Assurex Health for an investigator-initiated study. Dr. Buyuktaskin is supported by the Scientific and Technological Research Council of Türkiye. The other authors have no disclosures to report.

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References

    1. Bloch Y, Grisaru N, Harel EV, Beitler G, Faivel N, Ratzoni G, & Levkovitz Y (2008). Repetitive transcranial magnetic stimulation in the treatment of depression in adolescents: an open-label study. J ect, 24(2), 156–159. - PubMed
    1. Boldrini M, Xiao Y, Sing T, Zhu C, Jabbi M, Pantazopoulos H, & Mann JJ (2024). Omics Approaches to Investigate the Pathogenesis of Suicide. Biological Psychiatry. - PMC - PubMed
    1. Bozzay ML, Primack J, Barredo J, & Philip NS (2020). Transcranial magnetic stimulation to reduce suicidality - A review and naturalistic outcomes. J Psychiatr Res, 125, 106–112. - PMC - PubMed
    1. Brent DA, Greenhill LL, Compton S, Emslie G, Wells K, Walkup JT, & Turner JB (2009). The Treatment of Adolescent Suicide Attempters Study (TASA): Predictors of Suicidal Events in an Open Treatment Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48(10), 987–996. - PMC - PubMed
    1. Brunoni AR, Chaimani A, Moffa AH, Razza LB, Gattaz WF, Daskalakis ZJ, & Carvalho AF (2017). Repetitive transcranial magnetic stimulation for the acute treatment of major depressive episodes: a systematic review with network meta-analysis. JAMA psychiatry, 74(2), 143–152. - PubMed

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