Effectiveness of intermittent theta-burst stimulation for major depressive disorder with and without neurodevelopmental comorbidities: A real-world retrospective observational study.

This was an observational study — researchers watched what happened rather than assigning treatments. It can show that two things happen together, but it cannot show that one caused the other.

The number of people who took part is not stated in this record, so the result cannot be judged on size.

The researchers concluded: "iTBS is effective for MDD in routine clinical practice; however, its therapeutic impact appears moderately reduced in patients with ASD and/or ADHD. These findings underscore the need for individualized neuromodulation strategies and further investigation into neurobiological and sensory factors contributing to treatment heterogeneity."

This record does not state:

• the ages of the people who took part
• how long the study ran

This is a plain-language summary of one paper's abstract, not medical advice. Talk to your child's clinician before changing anything.

Journal: Journal of psychiatric research

Year: 2026

Design: Observational Study

Intervention: intermittent theta-burst stimulation (iTBS)

Co-occurring conditions: Major Depressive Disorder, Attention Deficit Disorder with Hyperactivity

Authors: Yoshihiro Noda, Ryota Osawa, Yuya Takeda, Yuka Saijo, Ayaho Tsukamoto, Ryoma Noda, Ryosuke Kitahata

BACKGROUND: Intermittent theta-burst stimulation (iTBS) is an established neuromodulation treatment for major depressive disorder (MDD). However, its clinical effectiveness in patients with comorbid neurodevelopmental disorders, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), remains insufficiently understood despite their high prevalence and distinct neurocognitive and sensory profiles. METHODS: This retrospective cohort study analyzed real-world registry data from three TMS clinics in Tokyo. All participants met DSM-5 criteria for MDD, and ASD/ADHD diagnoses were confirmed by board-certified psychiatrists. Patients received left-DLPFC iTBS using the Beam F3 method. Primary outcomes included percentage changes in Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HAMD-17) scores, response and remission rates, and adverse events. Group differences were examined using t-tests, ANOVA, chi-square tests, and multivariable regression adjusting for demographic and treatment-related covariates. RESULTS: Patients without neurodevelopmental comorbidities demonstrated significantly greater symptom improvement and higher remission rates than those with ASD/ADHD (TD vs. neurodiverse). These differences persisted after covariate adjustment, indicating an independent effect of neurodevelopmental status. Baseline MADRS severity consistently predicted poorer outcomes across all models. Sensitivity analyses confirmed attenuated improvement in each neurodiverse subgroup. Findings for the ASD/ADHD subgroup were exploratory. Neurodiverse patients also reported higher rates of stimulation-site pain, although no serious adverse events occurred. CONCLUSIONS: iTBS is effective for MDD in routine clinical practice; however, its therapeutic impact appears moderately reduced in patients with ASD and/or ADHD. These findings underscore the need for individualized neuromodulation strategies and further investigation into neurobiological and sensory factors contributing to treatment heterogeneity.

Journal of psychiatric research, 2026

PMID 41967364

DOI 10.1016/j.jpsychires.2026.04.008

This record was extracted from the paper's PubMed abstract and metadata. Full-text methods and risk-of-bias details were not reviewed.