Mechanistic Trial Evaluating the Effect of Repetitive Transcranial Magnetic Stimulation on RDoC Constructs in Treatment-Resistant Depression

Remission rates for repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD) are as high as 43%, although the large-scale neural circuit mechanisms by which patients improve remain unclear. We assessed the effect of rTMS on neural circuits and concurrent changes in behaviors and symptoms within the NIMH's Research Domain Criteria (RDoC) constructs of reward responsiveness, rumination, attention, and cognitive control in a cohort of subjects with TRD and prominent anhedonia, encompassing loss of pleasure, interest, and/or motivation.