[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100605359":3},{"organization":4,"armGroups":7,"interventions":24,"overallOfficials":32,"centralContacts":33,"locations":39,"responsibleParty":54,"collaborators":56,"id":62,"slug":32,"hasResults":63,"nctId":64,"briefTitle":65,"officialTitle":66,"acronym":32,"eligibilityCriteria":67,"healthyVolunteers":63,"sex":68,"minAge":69,"maxAge":70,"enrollmentInfo":71,"targetDuration":32,"studyType":74,"phases":75,"briefSummary":77,"conditions":78,"keywords":32,"overallStatus":81,"whyStopped":32,"lastUpdateSubmitDate":82,"lastUpdatePostDateStruct":83,"startDateStruct":86,"completionDateStruct":88,"leadSponsor":90,"locationsCount":91},{"fullName":5,"class":6},"Second Xiangya Hospital of Central South University","OTHER",[8,14,19],{"label":9,"type":10,"description":11,"interventionNames":12},"Active Dual-Target rTMS Group","EXPERIMENTAL","Participants receive active repetitive transcranial magnetic stimulation (rTMS) over both the left inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (DLPFC) using MRI-guided neuronavigation. Stimulation is delivered in 5 paired sessions per day (with a 50-minute inter-session interval) for 10 consecutive days. All participants continue stable SSRI or SNRI antidepressant treatment as usual (TAU).",[13],"Device: Repetitive Transcranial Magnetic Stimulation",{"label":15,"type":16,"description":17,"interventionNames":18},"Active Single-Target rTMS Group","ACTIVE_COMPARATOR","Participants receive active rTMS over the left inferior parietal lobule (IPL) and sham stimulation over the right dorsolateral prefrontal cortex (DLPFC) using MRI-guided neuronavigation. Stimulation is delivered in 5 paired sessions per day (with a 50-minute inter-session interval) for 10 consecutive days. All participants continue stable SSRI or SNRI antidepressant treatment as usual (TAU).",[13],{"label":20,"type":21,"description":22,"interventionNames":23},"Sham rTMS Control Group","SHAM_COMPARATOR","Participants receive sham rTMS over both the left inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (DLPFC) using MRI-guided neuronavigation. Sham stimulation mimics the sensation of active rTMS without delivering magnetic stimulation. Stimulation is delivered in 5 paired sessions per day (with a 50-minute inter-session interval) for 10 consecutive days. All participants continue stable SSRI or SNRI antidepressant treatment as usual (TAU).",[13],[25],{"type":26,"name":27,"description":28,"armGroupLabels":29,"otherNames":30},"DEVICE","Repetitive Transcranial Magnetic Stimulation","Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique that uses magnetic pulses to modulate neuronal activity in targeted cortical regions. In this study, rTMS is delivered using a commercially available magnetic stimulator with a figure-of-eight coil. Stimulation targets - the left inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (DLPFC) - are individually localized using MRI-guided neuronavigation based on each participant's structural magnetic resonance imaging. Each stimulation session consists of paired target stimulation (IPL and DLPFC) with a 50-minute inter-session interval. Treatment is administered as 5 paired sessions per day for 10 consecutive days. Sham stimulation uses the same device and coil placement but delivers no active magnetic stimulation, mimicking the sensory experience of active r",[9,15,20],[31],"rTMS",null,[34],{"name":35,"role":36,"phone":37,"phoneExt":32,"email":38},"Jin Liu","CONTACT","13123392823","liujin975@csu.edu.cn",[40],{"facility":41,"status":32,"city":42,"state":43,"zip":44,"country":45,"cosmosGeoPoint":46,"geoPoint":51,"contacts":52},"Xiangya Second Hospital of Central South University","Changsha","Hunan","410011","China",{"type":47,"coordinates":48},"Point",[49,50],112.97087,28.19874,{"lat":50,"lon":49},[53],{"name":35,"role":36,"phone":37,"phoneExt":32,"email":38},{"type":55,"investigatorFullName":32,"investigatorTitle":32,"investigatorAffiliation":32,"oldNameTitle":32,"oldOrganization":32},"SPONSOR",[57,60],{"name":58,"class":59},"Fujian Mental Health Center","UNKNOWN",{"name":61,"class":59},"Xianyue Hospital, Xiamen","100605359",false,"NCT07161492","Brain Functional Connectivity Mechanism of Cognitive Flexibility Impairment and rTMS Intervention in Major Depressive Disorder","Individualized Dual-Target Repetitive Transcranial Magnetic Stimulation (rTMS) Targeting Left Inferior Parietal Lobule and Right Dorsolateral Prefrontal Cortex Functional Connectivity for Cognitive Flexibility Impairment in Major Depressive Disorder: A Randomized, Double-Blind-Controlled Trial","Inclusion Criteria:\n\nMeet DSM-5 criteria for major depressive episode confirmed by the Structured Clinical Interview for DSM-5 Disorders (SCID-5), with no prior manic or hypomanic episodes; diagnosed as major depressive disorder without psychotic features by two attending psychiatrists.\n\nFirst episode or recurrent, currently in a depressive episode (HAMD\\_17≥17).\n\nAge 18 to 45 years, all sexes and genders. Han Chinese, right-handed. Junior high school education or above, no color blindness, able to understand and provide informed consent, and complete assessments and tests.\n\nWilling to participate voluntarily and sign written informed consent.\n\nExclusion Criteria:\n\nMeet DSM-5 diagnostic criteria for any psychiatric disorder other than major depressive disorder.\n\nReceived non-pharmacological treatments within the past 6 months, such as electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), or systematic psychotherapy (≥ 10 sessions).\n\nPrior treatment with CCRT. Received antipsychotics or other medications affecting cognitive function within the past month, or cholinergic agents (e.g., donepezil, galantamine) within 14 days, memantine within 20 days, or other racetam drugs (e.g., piracetam) within 2 days prior to randomization.\n\nOrganic brain disorders or severe physical illnesses (e.g., thyroid disease, lupus erythematosus, diabetes, liver\u002Fkidney\u002Flung impairment, infection, major trauma).\n\nHistory of traumatic brain injury with loss of consciousness or other conditions that may interfere with this study.\n\nHistory of alcohol or substance abuse or dependence. Severe suicidal ideation or suicide attempt . Currently receiving hormonal therapy. Pregnancy, lactation, possibility of pregnancy, or planned pregnancy. History of epilepsy or family history of epilepsy. Implanted metal materials in the body (e.g., pacemaker, dental implants, metal intrauterine device).\n\nAny other factors that, in the investigator's opinion, place the participant at potential risk or interfere with the study participation.","ALL","18 Years","45 Years",{"count":72,"type":73},105,"ESTIMATED","INTERVENTIONAL",[76],"NA","Major depressive disorder (MDD) often involves cognitive deficits, particularly in cognitive flexibility, which is inadequately addressed by standard antidepressants. This study tests an innovative brain stimulation regimen: individualized dual-target repetitive transcranial magnetic stimulation (rTMS) to improve cognitive flexibility in MDD patients.\n\nThis is a randomized, double-blind, sham-controlled trial that plans to enroll 105 MDD patients with cognitive flexibility impairment. Participants will be randomly assigned to one of three groups: (1) Active dual-target group - receiving active rTMS over both the left inferior parietal lobule (IPL) and the right dorsolateral prefrontal cortex (DLPFC); (2) Active single-target group - receiving active rTMS over the left IPL and sham stimulation over the right DLPFC; (3) Sham control group - receiving sham stimulation over both targets. All participants will continue their stable antidepressant medication (SSRI or SNRI). The rTMS intervention lasts 10 days, with 5 stimulation sessions per day.\n\nCognitive flexibility, depressive symptoms, and brain functional connectivity will be assessed at baseline, immediately after the 10-day treatment, and at 2-week and 4-week follow-ups using neurocognitive tests, clinical rating scales (e.g., HAMD), and functional MRI. The results will help confirm the role of the IPL-DLPFC connectivity in cognitive flexibility and may establish a new treatment target for cognitive dysfunction in MDD.",[79,80],"Depressive Disorder, Major","Cognitive Impairment","NOT_YET_RECRUITING","2026-06-22",{"date":84,"type":85},"2026-06-25","ACTUAL",{"date":87,"type":73},"2026-07",{"date":89,"type":73},"2028-10",{"name":5,"class":6},1]