Circuit-Based Approach to Suicide: Biomarkers, Predictors, and Novel Therapeutics

This neuroimaging study is a clinical trial investigating the effectiveness of intermittent theta-burst transcranial magnetic stimulation (iTBS-TMS) to the inferior parietal lobule (IPL) in reducing suicide risk in patients with major depressive episode (MDE) or borderline personality disorder (BPD).

Inclusion Criteria: * 18-65 years of age * Diagnosed with BPD or MDE * Chief complaint of suicidal thoughts and behaviors Exclusion Criteria: * Neurological conditions with known structural brain lesion * Prior neurosurgical procedure * Metal in the body that is ferromagnetic or metal injury to the eyes * Epilepsy * Implanted pacemaker, medication pump, vagal stimulator, deep brain stimulator, TENS unit, or ventriculo-peritoneal shunt * Psychopathology not appropriate for the treatment (e.g., manic episode or psychosis) * Current alcohol dependence or active symptoms of non-alcohol psychoactive substance use withdrawal, as indicated by self-report * Inability to meet the safety criteria for MRI scanning according to the protocols of the MGH Department of Radiology * Current pregnancy