Transcranial Magnetic Stimulation (TMS) therapy is an approved and effective treatment option for treatment-resistant depression (TRD). This study aims to identify biomarkers that predict TMS treatment response in TRD, provide insights into the neurobiological mechanisms underlying TMS efficacy, and contribute to personalized treatment strategies. By establishing proteomic and metabolomic signatures, this research seeks to enhance clinical decision-making, reduce healthcare costs, and improve patient outcomes in TRD. The findings will align with the precision medicine movement in psychiatry, advancing biomarker-driven therapeutic approaches for treatment-resistant depression.
Diagnosis of Major Depressive Disorder (MDD) according to DSM-5-TR criteria.
Inadequate clinical response to at least two different antidepressants and/or anti-obsessive agents administered at therapeutic doses and durations.
Clinical symptoms not better explained by metabolic or organic medical conditions.
No epileptic activity detected on routine electroencephalography (EEG) prior to TMS initiation.
Any contraindication to TMS as identified in the standardized pre-TMS risk assessment form.
Presence of epileptic focus detected on pre-TMS EEG.
History of significant head trauma, loss of consciousness, or intracranial surgery.
Presence of metal implants or foreign bodies incompatible with TMS (e.g., aneurysm clips, surgical clamps, metallic fragments).