Clinical Research Directory

Inclusion Criteria: 1. age between 20 and 65 years; 2. fulfilling the Diagnostic and Statistical Manual version 5 (DSM-5) criteria of Major depressive disorder assessed by the Structured Clinical Interview Exclusion Criteria: 1. Inability to provide informed consent or comprehend the study procedure; 2. A major psychiatric illness including schizophrenia spectrum disorder, bipolar spectrum disorder, and major depressive disorder with psychotic features. 3. A current DSM-5 diagnosis of substance use disorder except nicotine use disorder or the use of one to two low-potency benzodiazepine tablets for sleep impairment; 4. Have known preexisting noise-induced hearing loss, concurrent treatment with ototoxic medications, or with cochlear implants. 5. Unstable medical illness, including malignancy, uncontrolled diabetes mellitus, unstable cardiac disease or recent myocardial infarction, or cerebrovascular or cardiovascular risk factors that require intensive medical management 6. On medications known to lower seizure threshold (e.g., TCA, bupropion, clozapine) 7. Implants controlled by physiological signals, including pacemaker, implantable cardioverter defibrillator, cochlear implant. 8. Metallic objects in the head, including stenting, suture. 9. Elevated risk of seizure due to traumatic brain history, seizure history, and head trauma, intracranial lesion, and alcohol or benzodiazepines withdrawal syndrome, stimulant intoxication.