Efficacy and Mechanism of rTMS on the Symptoms of Pleasure Deficit in Adolescent Depression

Inclusion Criteria: 1. Age 10-19 years old (both 10 and 19), gender is not limited; 2. Meet the criteria for diagnosing MDD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); 3. First episode or relapse, monophasic or bipolar depressive disorder; 4. No history of any form of antidepressant treatment (including medication, physical and psychotherapy) within 2 weeks prior to enrollment; 5. Habitual right-handedness; 6. Deficit of pleasure scale (DARS) \<22 points; 7. Score \>17 on the 17-item version of the Hamilton Depression Scale (HAMD-17); 8. After fully understanding the safety of rTMS, they were willing to actively cooperate with the treatment and signed an informed consent form. Exclusion Criteria: 1. Complicated with psychotic symptoms; 2. Comorbidity with major psychiatric disorders such as schizophrenia, delusional disorder, delirium, neurocognitive disorder, intellectual disability, and other mental disorders caused by other diseases; 3. History of primary neurologic disease or brain injury; 4. History of electroconvulsive therapy; 5. Contraindications to rTMS treatment, including cardiac pacemakers, neurostimulators, artificial metal heart valves, intracranial aneurysm clips, cochlear implants, and other types of metal implants (with the exception of oral supports);(6)History of epilepsy.