Dual-target iTBS for Youth With ADHD

Inclusion Criteria: 1. ADHD Diagnosis: Meets the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5); 2. Inadequate Response to Medication: After a full course of pharmacological treatment, the SNAP-IV Parent Rating Scale (first 18 items, assessing inattention/hyperactivity-impulsivity) score \>1, and the Clinical Global Impression-Severity Scale (CGI-S) score \>2; 3. Age and Gender: 10-18 years old; males or females; 4. Intellectual Functioning: Full-scale intelligence quotient (IQ) \>70 on the China-Wechsler Intelligence Scale for Children (C-WISC) (excluding participants with intellectual disability); 5. Symptom Severity: A score of ≥1.6 on either the Inattention or Hyperactivity/Impulsivity subscale of the SNAP-IV Parent Rating Scale; 6. Medication Requirements: 1\) Medication-naïve or currently off medication; 2) If currently on medication, must be on a stable medication regimen for at least 4 weeks prior to the baseline visit and throughout the study duration; 3) Prohibited medications: Psychostimulants; 7. Right-handed. Exclusion Criteria: 1. Contraindications for TMS therapy include epilepsy, cardiac pacemakers, cochlear implants, and metal implants. 2. Contraindications for MRI include metal implants in the body, claustrophobia, and tattoos. 3. Significant medical history: history of epilepsy, organic brain disorders, traumatic brain injury (TBI), or severe physical illnesses. 4. Behavioral risks: history of violent or suicidal behavior. 5. Comorbid neurodevelopmental disorders, such as autism spectrum disorder (ASD), tic disorders, etc. 6. Comorbid psychiatric disorders: any other primary psychiatric disorders, except conduct disorder/oppositional defiant disorder, mild anxiety, or depression. 7. Substance abuse. 8. Currently receiving any non-medical treatments, such as cognitive behavioral therapy (CBT), neurofeedback, etc. 9. Female participants must not be pregnant or breastfeeding.