{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:13:10Z","timestamp":1779203590427,"version":"3.51.4"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Accelerated intermittent theta burst stimulation (aiTBS) is an effective rapid-acting treatment for suicidal ideation in adults with major depressive disorder (MDD). However, evidence in adolescents remains limited, and whether dual-site frontal-cerebellar aiTBS enhances antisuicidal efficacy in this population is unknown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the clinical effectiveness and safety of dual-site aiTBS targeting the left dorsolateral prefrontal cortex (DLPFC) and cerebellum vs single-site DLPFC aiTBS for reducing suicidal ideation in adolescents with MDD.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This double-blind, randomized clinical trial with a 1-month follow-up was conducted at the First Affiliated Hospital of Jinan University (Guangzhou, China) from September 2023 to May 2025. Adolescents (aged 12-18 years) with MDD and suicidal ideation and without comorbid medical or neurologic conditions were enrolled and randomly assigned to dual-site aiTBS or single-site aiTBS.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Patients received 5 daily sessions of aiTBS over 4 days. Dual-site aiTBS delivered active stimulation to both the left DLPFC and left cerebellum, while single-site aiTBS delivered active stimulation to the left DLPFC with sham stimulation to the left cerebellum.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measure<\/jats:title>\n The primary outcome was the change from baseline to day 4 in the Beck Scale for Suicide Ideation (BSI) score (range, 0-38; higher scores indicate greater severity of suicidal ideation), assessed with a linear mixed-effects model.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 79 adolescents assessed for eligibility, a total of 59 were included (45 females [76%]; mean [SD] age, 14.78 [1.72] years). Of these, 29 were randomized to the dual-site aiTBS group (23 [79%] female) and 30 to the single-site group (22 [73%] female). For the primary outcome, patients receiving dual-site aiTBS showed a significantly greater reduction in mean BSI scores compared with those receiving single-site aiTBS at day 4 (difference, 4.94 points [95% CI, 0.73-9.14 points];\n t<\/jats:italic>\n \u2009=\u20092.35;\n P<\/jats:italic>\n \u2009=\u2009.02; Cohen\n d<\/jats:italic>\n , 0.61 [95% CI, 0.09-1.13]). No serious adverse events in either group were observed.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This randomized clinical trial found that dual-site aiTBS targeting the left DLPFC and cerebellum was more effective than single-site left DLPFC aiTBS in reducing suicidal ideation for adolescents with MDD and was well tolerated. The findings suggest this protocol may be a promising strategy for rapid reduction of suicidal ideation in the adolescent population.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n Chinese Clinical Trial Registry Identifier:\n ChiCTR2300068954<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.13178","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:00:41Z","timestamp":1779202841000},"page":"e2613178","source":"Crossref","is-referenced-by-count":0,"title":["Dual-Site aiTBS for Suicidal Ideation in Adolescents With Major Depressive Disorder"],"prefix":"10.1001","volume":"9","author":[{"given":"Dong","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongxu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of 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