青少年抑郁症患病率约8%，严重危害青少年心理健康。目前至少40%青少年患者对抗抑郁药疗效欠佳，因此开展新的治疗技术，并探讨相关治疗机理有重要意义。FDA已批准重复经颅磁刺激（rTMS）可用于成人抑郁症治疗。高频刺激可能会降低青少年癫痫阈值，低频刺激更安全。既往研究提示低频rTMS对青少年抑郁治疗有效，青少年抑郁患者注意网络存在异常。我们推测，低频rTMS刺激青少年抑郁症右侧背外侧前额叶（DLPFC）调节异常的注意网络可能是潜在的作用机制之一。本研究以首发青少年抑郁患者为研究对象，运用fMRI和DTI技术，从注意网络的局部脑活动强度、脑区之间的的功能连接，以及脑区之间的结构连接等不同角度进行分析，探讨6周低频rTMS刺激首发青少年抑郁患者右侧DLPFC前后注意网络的变化，并与治疗前后抑郁症状、执行功能变化进行相关分析，揭示rTMS可能的神经作用机制，并加深对青少年抑郁症神经生物机制的了解。

Adolescent major depressive disorder (MDD) is a recurrent and potentially life-threatening illness, affecting as much as 8% of the adolescent population. It is estimated that at least 40% of adolescents with MDD do not show an adequate clinical response to antidepressant. Accordingly, there is increasing interest in developing new treatments for adolescent MDD such as repetitive transcranial magnetic stimulation (rTMS). The use of rTMS as a therapeutic treatment for MDD in adults was approved by the US Food and Drug Administration (FDA) in October of 2008 and safety guildlines for its use have since been established. We are hopeful there will be increased interest in rTMS for adolescent MDD trials particularly in light of evidence suggesting younger subjects with MDD respond better to the treatment than older subjects depression. High-frequency rTMS stimulation of the left dorsolateral prefrontal cortex (DLPFC) may lower the seizure threshold for adolescent MDD. Instead, low-frequency rTMS stimulation of the right DLPFC is chosen which is considered to be relatively safe during treatment of adolescent MDD. Low-frequency rTMS was introduced as a promising new treatment option for adolescent MDD and showed beneficial effects in some studies.A previous study demonstrated that the abnormalities of functional connectivity exist in the attentional network of adolescent depression. We suppose that low-frequency rTMS applied over the right DLPFC results in changes of neuralactivity of attention network, and these brain network activity changes may be one of the potential mechanisms of rTMS. More recently, with the development of the resting state fMRI and diffusion tensor imaging (DTI) technology, the magnetie resonance imaging seems to be a good tool for us to study on brain network connections in MDD. In this study, we analyse the effects of the rTMS treatment on attention network through different view as measured with fMRI and DTI, like the regional brain activity intensity, functional connection among the brain regions, and structure connection of brain regions. The effect of six-week of low-frequency rTMS stimulation of the right DLPFC on attention network in first-episode adolescent MDD was explored, and relative analysis was taken over the comparison on depression symptoms and executive function before and after rTMS treatment, which would derive the possible neural mechanisms of rTMS and further enhance the understanding of neurobiological mechanisms on adolescent MDD.