Major depression (MDD) in adolescents is a public health problem. Unfortunately, conventional

treatment options such as medication and psychotherapy are restricted for this age group. The

noninvasive

neuromodulation technique, transcranial magnetic stimulation (TMS), might offer a

solution. A coil is placed over the scalp and generates a varying magnetic field that excites or

suppresses the activity of brain tissue beneath by inducing an electric field. Repetitive TMS (rTMS) is

safe and well tolerated and has been acknowledged as an evidence-based treatment for MDD

patients. In spite that in adult MDD a younger age could be indicative of a beneficial outcome, this

technique has limited use in adolescents thus far. The few existing studies provide preliminary

evidence in support for a safe therapeutic potential of rTMS in adolescent psychiatric disorders.

Nevertheless, before advocating its widespread use more fundamental research seems mandatory.

We will combine rTMS with brain imaging techniques, and use a computational model to simulate

the effect of TMS on the brain activity. We will investigate the main differences of mature versus

immature, and healthy versus mood affected brains. Given that individual neuronal pathways may

influence clinical rTMS outcome, we should further disentangle patient profiles based on structural

and functional connectivity to optimize stimulation parameters and find alternative targets.